Hand Hygiene During COVID-19: Recommendations from the American Contact Dermatitis Society

Rundle CW, Presley CL, Militello M, et al. Hand Hygiene During COVID-19: Recommendations from the American Contact Dermatitis Society [published online ahead of print, 2020 Jul 21]. J Am Acad Dermatol. 2020;S0190-9622(20)32256-8. doi:10.1016/j.jaad.2020.07.057


Use of Soaps, Synthetic Detergents:

• Wash hands with lukewarm or cool water and soap for at least 20 seconds.
• Avoid hot and very cold water.
• Non-frictional, pat drying (don’t rub).
• Immediate application of moisturizer following cleansing practices is recommended.
• Products with antibacterial ingredients are not necessary for proper hand hygiene.
• Look for soaps or synthetic detergents that are devoid of allergenic surfactants, preservatives, fragrances,     or dyes.
• Look for synthetic detergents with added moisturizers(e.g.petrolatum, vegetable oils, shea butter).
• Dry hands are common with frequent use of soaps or synthetic detergents.

Use of Alcohol-based hand sanitizers:

• At least 60% alcohol is recommended.
• Look for hand sanitizers that are devoid of allergenic
surfactants, preservatives, fragrances, or dyes.
• Look for Alcohol-based hand sanitizer with added moisturizers.
• Dry hands are common with frequent use. Application of a moisturizer following hand washing is       recommended.

Use of Moisturizers:

• Avoid moisturizers in jars to prevent “double dipping” into and potentially contaminating the product.
• Use moisturizers packaged in tubes, instead.
• Look for pocket-sized moisturizers to keep on one’s person for frequent reapplication.
• At night, application of moisturizer followed by cotton or loose plastic gloves (e.g.plastic, clear, disposable      food gloves) to create an occlusive barrier.

For healthcare workers:

• A moisturizer under gloves can also be effective. Moisturizers with a water base are safe under all gloves,   however, oil-based moisturizers can breakdown latex and rubber by making the material swell or become   brittle.
• Latex, vinyl, and nitrile gloves are resistant to break down from ethanol or isopropyl alcohol.
• Soak and smear: Soak the hands in plain water for 20 minutes and immediately apply 16 moisturizers of     choice to damp skin nightly for up to 2 weeks.

• For glove ACD, accelerator-free gloves should be utilized, such as rubber-free neoprene or nitrile gloves.
• Apply moisturizer after washing hands and before wearing gloves.
• Consider a cotton glove liner or loose plastic gloves (e.g. plastic, clear, disposable food gloves).
• Individuals with suspect hand ACD should be patch tested.


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