By Christopher M. Beausoleil, B.S., CCRP
With the current situation concerning the COVID-19 pandemic and the increased frequency of washing hands or using hand sanitizer, cleaning and disinfecting, the constant use of PPE by healthcare professionals (HCP), as well as the requirement by local governments to wear masks when in the public, there is a potential risk of skin irritation from use of such products. The WHO has long established the importance of frequently washing hands and use of alcohol-based hand sanitizers in preventing the spread of disease as well as limiting touching of the face. (1, 2) An increase of HCP experiencing damage to the skin of the face and hands has been associated with the increased use of masks, goggles, gloves, and soaps. (3, 4) This increase in irritation, especially to the face, may also increase facial touching. (5)
Products that irritate the skin have had an effect on HCP adherence to hand hygiene guidelines in the past highlighting the importance of providing HCP with non-irritating products or procedures to mitigate skin irritation so that adherence can be maintained. (6, 7) While the world plans to loosen quarantine restrictions, local governments and federal organizations are recommending to wash/sanitize hands frequently and use masks when social distancing cannot be maintained in public places (2, 8). The potential issue with skin irritation may soon become a factor with the general population which could have a deleterious effect on adherence to those guidelines as well.
In addition to effect on skin condition, a product should also not inhibit the ability of other products. It has long been proven that certain lotions can inhibit the effect of chlorhexidine-containing antimicrobial hand washes. (9, 10) Mitigation strategies, such as lotions and creams, to decrease the occurrence of skin irritation may adversely affect the capabilities of the products being used. It is also important to understand the biocompatibility of such strategies, whether a product or procedure, to other products and equipment being used to also prevent the spread of disease.
BioScience Laboratories, Inc. has long understood the importance of products used by professionals and the general population for personal care or for preventing the transmission of disease should be effective but also safe. A proper understanding of a products’ ability to not irritate the skin or prevent/mitigate the occurrence of skin irritation is also important if the product is going to be used frequently. (11, 12) It is vitally important in the current situation that HCP and the general population are provided with products that do not cause them discomfort or prevent discomfort from frequent use of a product to allow for continued adherence to those guidelines intended to slow the spread of disease. It is also important that products do not decrease the effectiveness of other products being used to also slow the spread of the disease.
BioScience Laboratories, Inc. has numerous protocols that are capable of determining a product’s effect on skin condition and compatibility with other products. These protocols can be used to establish a product’s efficacy and safety for use, as well as identify any potential issues a user may have with the product. Many of our protocols employ the use of non-invasive bioinstrumentation to measure the condition of the skin and modifications of standardized test methods to measure the effects on the effectiveness of a product or combination of products. It is now as important as ever that the public is provided with safe and effective products to help with slowing and preventing the spread of disease. BioScience Laboratories, Inc. can help you provide such products.
1. World Health Organizations. (2009) WHO Guidelines on Hand Hygiene in Health Care. https://www.who.int/gpsc/5may/tools/9789241597906/en/
2. World Health Organizations. (2020, May 5) Coronavirus disease (COVID-19) advice for the public. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
3. Lan, J., Song, Z., Miao, X., Li, H., Li, Y., Dong, L., Yang, J., An, X., Zhang, Y., Yang, L., Zhou, N., Yang, L., Li, J., Cao, J., Wang, J., & Tao, J. (2020). Skin damage among health care workers managing coronavirus disease-2019. Journal of the American Academy of Dermatology, 82(5), 1215–1216. https://doi.org/10.1016/j.jaad.2020.03.014
4. Darlenski, R. & Tsankov, N. (2020, March 24) Covid-19 pandemic and the skin -
What should dermatologists know? Clinics in Dermatology (2020). https://doi.org/10.1016/j.clindermatol.2020.03.012
5. Kantor, J. (2020). Behavioral considerations and impact on personal protective equipment use: Early lessons from the coronavirus (COVID-19) pandemic. Journal of the American Academy of Dermatology, 82(5), 1087–1088. https://doi.org/10.1016/j.jaad.2020.03.013
6. The Joint Commission (2009) Measuring Hand Hygiene Adherence: Overcoming the Challenges. https://www.jointcommission.org/-/media/deprecated-unorganized/imported-assets/tjc/system-folders/topics-library/hh_monographpdf.pdf?db=web&hash=7F1A70731D44DC2D183B1038CE34EC46
7. Sax, H., Uçkay, I., Richet, H., Allegranzi, B., & Pittet, D. (2007). Determinants of Good Adherence to Hand Hygiene Among Healthcare Workers Who Have Extensive Exposure to Hand Hygiene Campaigns. Infection Control & Hospital Epidemiology, 28(11), 1267-1274. https://doi.org/10.1086/521663
8. Centers for Disease Control and Prevention. (2020) Coronavirus Disease 2019 (COVID-19) Protect Yourself. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html
9. Benson, L., LeBlanc, D., Bush, L., & White, J. (1990, February) The Effects of Surfactant Systems and Moisturizing Products on the Residual Activity of a Chlorhexidine Gluconate Handwash Using a Pigskin Substrate. Infection Control & Hospital Epidemiology, 11(2), 67-70. https://doi.org/10.2307/30144264
10. Kaiser, N., Klein, D., Karanja, P., Zachariah, G., and Newman, J. (2009, September) Inactivation of chlorhexidine gluconate on skin by incompatible alcohol hand sanitizing gels. American Journal of Infection Control, 37(7), 569-573. https://doi.org/10.1016/j.ajic.2008.12.008
11. Paulson, D. (1998, November) Topical Antimicrobials and Skin Irritation: The Next Step. Soap Cosmetics Chemical Specialties, 74(11), 46-49.
12. Paulson, D. (2003) Importance of Skin Care Attributes in Developing Topical Antimicrobials. In D. Paulson (Ed.), Handbook of Topical Antimicrobials Industrial Applications in Consumer Products and Pharmaceuticals (pp. 355-362). Marcel Dekker, Inc.