It seems that many of those who are advising us about personal action to minimise the risk of infection from COVID-19 appear to know little or nothing about our skin and how it interacts with the working environment.

The exhortation to wash our hands frequently can actually increase the risk of our skin becoming damaged – although we will not see or feel this – and thus more easily colonised by transient micro-organisms such as the COVID-19 virus. In the NHS excessive hand washing was – and in some Trusts still is – a major cause of occupational contact dermatitis. Washing hands more than 20 times each day constitutes what, in COSHH terms can be classified as ‘wet work’, i.e. a situation that, under COSHH, will require remedial action.

Furthermore, the frequently heard advice to wash hands in hot water is wrong. Water above 380C will damage the microscopically thin layers of lipids (fatty molecules) in our skin that ensure the skin maintains sufficient moisture to provide an effective barrier. The popular concept that hot water helps kill bacteria on the skin ignores that fact that to kill bacteria/viruses the temperature would need to be so hot that skin would be scalded.

The NICE accredited guidance for healthcare workers hand hygiene in healthcare establishments recommends that for hand decontamination – which is what we are talking about here – with certain exceptions, e.g. where hands are visibly soiled with organic matter, hands should be treated with an alcohol sanitising rub. Studies exist that show this is more effective than hand washing and, provided that the sanitising rub is properly formulated, does not damage the skin. In fact, it can actually act as a skin conditioner, helping to ensure a healthy skin, more able to fend off the assault by the foreign micro-organisms.

A sanitising rub is also more convenient as a small bottle can be carried on the person, eliminating the need to search for that elusive washroom. It can be used immediately after sneezing or coughing, before handling food, etc.

Please avoid the non-alcohol-based sanitisers. These are less effective and will contain a biocide as the active ingredient. Frequent use can result in the infective micro-organisms becoming resistant to the biocide. Most biocides are irritant to the skin and frequently skin sensitisers causing a risk of an allergic skin reaction if used frequently.