Is excessive hand hygiene during the COVID-19 pandemic causing an increase in hand eczema in Denmark?

Carsten Sauer Mikkelsen | Mai 2020 | COVID-19 | Dermatologi |

Carsten Sauer Mikkelsen
Specialist in Dermato-venereology,
Private Practice in Dermato-venereology,
Brønderslev, Denmark
& Research lab.
Department of Dermato-venereology,
Aalborg University Hospital, Denmark

Kristian Bakke Arvesen
Specialist in Dermato-venereology,
Research lab.
Department of Dermato-venereology,
Aalborg University Hospital, Denmark

Peter Bjerring
Specialist in Dermato-venereology,
Research lab.
Department of Dermato-venereology,
Aalborg University Hospital, Denmark

Luit Penninga
Specialist in Surgery,
Ilulissat Hospital,
Avannaa Region,
Ilulissat, Greenland

Our globe has changed dramatically since the beginning of the COVID-19 pandemic. The novel corona virus disease poses enormous challenges for society as a whole, and for all health care workers, including dermatologists.1 As the virus is highly contagious via respiratory transmission and via contact with contaminated surfaces, community transmission can be decreased through the practice of frequent and proper hand hygiene. Adequate hand hygiene is one of the major preventive measures to control the COVID-19 pandemic.2 Though, frequent hand washing implies a prolonged exposure to water and other chemical and physical agents. Denmark is the first European country to gradually ‘reopen’ society after a ‘lockdown’. In Denmark the population is requested to follow national guidelines about proper handwash. These guidelines from the national health authorities suggest very frequent handwash (every second hour) and do not recognize the importance of applying emollients/cream. Especially, schools and child-day care centers are following the guidelines strictly. As a result, many general practitioners and dermatologists have reported an increased incidence, especially in the youngest part of the population, of severe hand eczema (figure 1). Fortunately, the authorities have just changed their recommendation for hand wash, now acknowledging the importance of frequent application of cream/emollients. Studies with questionnaires are now being send to school children to gather information about the scale of this problem. Figure 1: A nine-year old patient without any previous medical history developed severe hand eczema after frequent handwash during the COVID-19 pandemic. (Photo: Carsten Sauer Mikkelsen).  Discussion Almost one out of five children have a sensitive skin and are at high risk of developing hand eczema due to atopic disease. Excessive hand hygiene due to the COVID-19 pandemic may lead to an increased number of cases of hand eczema. The frequent disinfection and handwashing procedures may induce several pathophysiologic changes such...