Dr Ian Webster
Dr Ian Webster

Hand Cleansing during the COVID1-19 Pandemic

Healthcare professionals all over the world have recommended that one of the best ways to prevent the spread of the COVID-19 virus is to regularly wash your hands with soap and water.

I agree with this wholeheartedly.

Your first priority is to kill the virus

Fortunately, the coronavirus has a lipid or fatty membrane and when the surfactants in soap come into contact with this lipid membrane it breaks it down, causing the virus to fall apart and die. Soap traps dirt – and the destroyed virus – in tiny bubbles and lifts it off the skin, allowing it to be washed away when you rinse your hands with water.

It is recommended that you wash your hands thoroughly for at least 20 seconds and rinse thoroughly, preferably under running water.

Repeated handwashing with an alkaline soap

Bars of soap have been around since Egyptian times. They are made by a reaction (saponification) between caustic soda (sodium hydroxide) and animal and/or vegetable fats.

Caustic soda is alkaline and, therefore, most traditional bars of soap found in supermarkets are alkaline and often have a pH of either 9 or 10. The natural pH of the skin is 5.5 making it slightly acidic and this lower pH forms what is called the protective ‘acid mantle’ of the skin. This acid mantle is essential for the normal, healthy functioning of the skin.

“Repeated hand washing with more alkaline bathroom soaps can adversely affect the barrier function of the skin, causing an irritant contact dermatitis”

A better-suited soap for frequent cleansing is one with a lower pH (5.5-7.5) but that still foams.

Anti-bacterial bars of soap are of no extra benefit than plain soap. They may well do harm by disrupting the skin’s normal microbiome by removing good bacteria needed for a healthy skin barrier. This said, if you only have access to anti-bacterial soap your first priority is to kill the virus, so do not stop using it. Hand eczema is a secondary concern but its good to know what might be causing it so you can plan your options going forward.

People with a family history of asthma, hayfever, and eczema will also be more at risk of developing hand dermatitis by using a hand soap with a high pH.

“Anti-bacterial bars of soap are of no extra benefit than plain soap. They may well do harm by disrupting the skin’s normal microbiome”

Gentle soaps that we have researched with a better pH that we can recommend in South Africa include:

Advice for businesses

If you are a business owner it may be more convenient to have liquid skin cleanser for hands that can be dispensed from a pump-action container. These usually contain synthetic detergents (Syndets) that have a lower pH and are more skin-friendly. It is, however, very important that these liquid skin cleansers foam as it is this foaming action (surfactant) that kills the coronavirus and allows it to be washed away.

Make sure to dry your hands with disposable paper towels. I would also recommend using a pedal bin to dispose of them.

Advice for home

Bars of soap are practical for home use and can be shared by families. They are also better for the environment (no plastic containers) and generally last longer than liquid soaps. Some pH skin-friendly bar soaps also work out cheaper for a family who is on a budget.

Hand sanitizers

Hand sanitizers are not as effective as normal soap and water if they don’t contain a minimum of 60% alcohol which kills the virus by disrupting its lipid membrane. If the brand you are using doesn’t state the alcohol % you might not be adequately protecting yourself. Hand sanitizers are a good back-up when normal soap and water are not available. We recommend buying from a reputable manufacturer as ‘backyard’ manufacturers might be using less pure forms of alcohol which can be harmful to the skin. The frequent use of alcohol-based sanitizers may also cause some skin dryness but many of the better sanitizers also contain humectants such as glycerol to reduce this dryness.

To prevent full-blown hand eczema as a result of this frequent washing and cleansing, I would recommend the regular use of an appropriate hand cream after washing and to carry a smaller container with you or in your handbag. Your hands should be completely dry before applying a moisturiser. Apply the moisturiser as frequently as necessary but especially at night before you go to bed.

Examples of creams I would recommend for the hands:

References:

Acta Derm Venerology 2013; 93 261-267

South African Child Health 2017; 11(3); 146

Read the safety measures we have put in place at Dermastore in response to COVID-19.

Posted in LEARN / BODY, HAIR & NAILS on March 20th, 2020.

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La Roche-Posay Cicaplast Balm B5

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