Tips to help combat eczema and skin flare-ups due to excessive handwashing and wearing face masks
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National Eczema Week: Are you finding the anti-Covid-19 handwashing regime is taking a terrible toll on your skin? Here are some tips to help
It’s not as if any of us need any added stress and anxiety in 2020: but if you live with eczema, continual handwashing and sanitising can take a terrible toll on your skin.
I have lived with eczema since birth and not only is the condition exacerbated hugely by stress, it reacts terribly to hand gel and sanitisers: when I see a pump dispenser waiting expectantly at the doorway of shops, I shudder.
While I know that regular handwashing is essential to remove dirt and germs from the skin, continual washing and the use of hand gel makes it difficult to control the disease or avoid exacerbating it.
In addition to fear of Covid-19, I also fear the effects of using the products I need to use in order to lessen my chances of being infected with it: Catch 22.
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The reason why hot water and soap work so well in the battle against pesky microbes is the same reason they’re not great for the skin: soap bonds with oils and allows them to be washed away and breaks down the structure that encloses viral particles.
The hotter the water you use, the more effectively the oils on the skin are loosened to be washed away with all those nasty viral-laden layers of grease and grime. I hope you’re not reading this as you eat.
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But: remove the natural oils from the skin and the barrier function that they offer is also broken down and can lead to dehydration, damage and inflammation.
And the real downer for eczema sufferers is that for those of us that haven’t used ‘normal’ hand soap for years, using an emollient wash or aqueous cream instead, these ‘softer’ soaps just don’t have the same virus-killing effect. Curses.
Before the coronavirus stopped life as we know it, I had just been approved for NHS light therapy treatment for my eczema which is at times utterly debilitating (other writers say their work has involved blood, sweat and tears, mine actually has).
Phototherapy involves the use of ultraviolet light when topical treatments have failed to control eczema and patients must attend treatment sessions several times a week in order for the therapy to work and must avoid sun-soaked holidays for some time.
I remember putting off the course of therapy ahead of an anticipated summer holiday to France: in the end, neither the therapy or the holiday went ahead, Covid-19 put paid to both, although on the plus side, the heatwave in the early days of lockdown was slight compensation.
Instead, along with everyone else, I found myself (literally) plunged into a new world of handwashing – all necessary, of course, but a nightmare if your skin is ridiculously sensitive at the best of times. And these, my friends, are not the best of times.
Washing my hands vigorously, continually drying them, being unable to moisturize immediately, all of these can trigger a flare-up that leaves skin red, raw and cracked – and when you factor stress into the mix, it’s a heady recipe for skin-based disaster.
On the plus side, the National Eczema Society offers the following reassurance for those of us suffering with flare-ups due to handwashing regimes who worry that their cracked skin will make a Covid-19 infection more likely: “Because coronavirus seems to be spread through respiratory droplets from the coughs and sneezes of an infected person that land in the mouths, noses and airways of people nearby, it seems to be unlikely that a damaged skin barrier would increase the risk of developing Covid-19.”
For those of us that know how closely our stress-levels are associated to the state of our skin, Dr Anthony Bewley, consultant dermatologist at Barts Health NHS, has this to say on the complex links between eczema and mental health.
“Eczema is much more than just a skin disease. It can really affect how you feel, how you behave and your self-esteem,” he said.
“Some people with eczema cope well and seem to thrive psychologically but others struggle. What’s really important is that individuals, their family and friends, and their healthcare professionals do not undermine the experience of living with eczema by saying things like ‘stop scratching’, ‘it’s only eczema’ or ‘it’s just your skin; it’s not that important.’
“Nerves in our bodies have neuropeptides that connect the brain to the skin, so it’s not surprising that if you’re feeling anxious and/or depressed, it may have an effect on your skin.
“Conversely, anger, depression, anxiety and low self-esteem can all be psychological effects of eczema. Stress leads to skin disease, and having a skin disease is very stressful, so the whole cycle between stress and skin disease is perpetuating.”
From September 13 it is National Eczema Week and with that thought in mind, here are a few tips designed to help those of us for whom it’s always eczema week and those who are new recruits to the Sore Skin Club. Stay smooth.
How to ease Covid-19 related eczema flare-ups
Use the right kind of cleanser: if you’ve lived with eczema for a long time, you’ll be fully aware of the importance of using unscented products and avoiding harsh detergents. You can be prescribed a moisturising handwash by your GP which can also be used as a moisturiser but the National Eczema Society suggests using soap and water which it says is more effective at breaking the lipid envelope surrounding coronavirus particles and removing the virus from the skin. One solution is to wash with soap and water and then re-wash using an emollient cleanser to protect the skin. Also: use lukewarm rather than hot water.
Dry your hands but don’t OVER dry them: The advice from the health professionals is that germs can transfer more easily to and from wet hands than from dry, but it is important not to over-dry eczema-prone skin which can traumatise the skin and make it more prone to flare-ups. Try to use clean towels or disposable paper towels and pat your skin gently (don’t rub).
If you have to use sanitising gel: Apply your usual moisturizer immediately afterwards to minimise irritation. Or try to find a gel which includes vegetable glycerin to help mitigate the drying effects of alcohol and without the perfumes, colours and extra ingredients that some sanitisers use and which can aggravate eczema.
Don’t stop washing your hands…If you can, take your own products with you when you are out so that you can be sure that your hands will not react badly to products that you may be allergic to. If it isn’t an option, the risk of an eczema flare-up is preferable to increasing your risk for infection personally or the spread of infection to other people.
Rehydrate at night: If your hands are red, sore or raw, use your prescribed ointment and wear clean cotton gloves overnight in order to try to repair some of the damage.
Eczema-friendly face coverings: Try to use 100 per cent cotton masks that you can wash regularly, particularly those with cloth ear loops which are less likely to irritate the skin. Mask headbands or tube scarfs in cotton are also an option. Make sure your mask isn’t too tight and that you don’t use moisturising ointments on your face before you put on a mask as they can make your face too hot.
Fancy a hot bath? DON’T. Hot baths are dehydrating so try to keep them warm rather than as hot as you can bear and make sure you use unscented products in the bath and then moisturise your skin within five minutes of getting out of the bath.
If your symptoms get worse: If your eczema becomes significantly worse or you suspect your skin is infected, contact your GP to discuss. You may need prescription medicine to reduce the inflammation.
Covid-19 triggers epidemic of eczema among health workers
Covid-19 has triggered an eczema epidemic among NHS workers - from washing their hands so regularly, according to new research.
Of those seeking medical help for skin problems, 60 per cent are suffering irritant contact dermatitis and 18 per cent required time off work.
It highlights the impact of PPE (personal protective equipment) and frequent hand hygiene on medical workers.
Dr Isha Narang, of University Hospitals of Derby and Burton NHS Foundation, said: “Wearing PPE for long periods can cause pressure and irritant effects on the skin and frequent handwashing with soap is drying; sometimes the effects can be bad enough to require time off work.
“As PPE and handwashing are essential methods of reducing the spread of Covid-19, it’s important to provide healthcare workers with advice and support in managing their skin.”
The findings are based on a study of 200 hospital staff workers by the British Society of Cutaneous Allergy.
The phenomenon is increasing the burden on the NHS during an extremely difficult time.
The duration for which PPE is worn, frequency of handwashing and use of alcohol hand gel were found to have an impact on the time off work required.