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Hand Hygiene and Skin Reactions

Hand Hygiene & Skin Reactions

Hand washing effects on skin.

Proper Hand Washing And Your Skin

In recent times, news of COVID-19 outbreak has dominated our media. There are many precautionary instructions across many platforms informing the general public on protecting themselves as well as those around them to prevent the spread of harmful viruses, germs and illnesses. One of the most effective ways to stop germs and viruses from spreading is proper hand hygiene. Hand washing is an important part of hand hygiene.

Watch this video on Hand Washing Steps using the World Health Organization (WHO) Technique:

This should take between 40-60secs. Summary of steps are here.

WHO Hand Washing Technique

The thing that concerns us about this WHO hand washing steps is the amount of water ‘wasted’ during the process of washing. This would present a challenge in water scarce countries like Singapore. Probably, a good additional step would be to use another towel tissue to switch on and off the tap if you are concerned about wasting water and contacting germs after you have finished washing.

Some frequently asked questions are:

Should I use soap and water to wash my hands?

Ans:  Germs can get onto your hands and items you touch throughout the day. Washing hands with soap and water is one of the simplest and most effective ways to remove whatever germs and chemicals that may be on them. However, it is important to choose your handwash wisely to prevent skin dryness and eczema especially if you have a pre-existing skin condition.

Is Warm or Cold water more effective?

Ans: Either is fine as long as it’s clean. Washing with water that is too hot or too long may have other adverse effects like causing skin dryness.

Bar Soap or Liquid is better?

Ans: Bar soap is fine as long as it is kept in a clean and dry dish, though there is still risk of contamination. For this reason, more people are switching to liquid soap.

Must a soap be anti-bacterial?

Ans: No. Plain soap and water works well enough.

Do I have to clean under my fingernails? How?

Ans: Yes, germs can accumulate under fingernails. Make sure to clean under nails by watching the video or image above.

Towel or air dry?

Ans: Towel is fine but make sure the towel is clean if you are using one.  Air dry is advisable if one is available as it helps to minimise contact.

What if there’s no soap and water to wash my hands? Hand Sanitisers vs Water & Soap

Ans: Many commercially available alcohol-based hand sanitisers containing at least 60% alcohol can quickly kill most types of germs on hands but it may not kill certain bacteria and viruses that cause diarrhea. It is still best to wash hands before eating.

As there are many articles about the harmful effects of ethyl alcohol and BAC (benzalkonium chloride), common ingredients in hand sanitisers, it is highly recommended to use one with natural ingredients containing aloe vera gel, essential oils like tea tree, thyme and lavender etc. There are many youtube videos on home-made (DIY) hand sanitisers. However, there is a lack of studies on the efficacy of these DIY sanitisers against the host of viruses.

As we step up our vigilance, the frequency of hand washing will also increase. This can have an adverse effect on your skin, especially your hands, leading to hand dryness and eczema.

Two major types of skin reactions are Irritant Contact Dermatitis and Allergic Contact Dermatitis.

Irritant Contact Dermatitis is commonly caused by repeated and frequent use of hand hygiene products, healthcare professionals especially nurses being most susceptible. Skin reactions range from mild to severe, including skin dryness, irritation, itching and cracking which may lead to bleeding and weepy wounds. So whilst we learnt that hand sanitisers need to have an alcohol content of 60% and above to be effective in killing viruses, these products also cause skin irritation.

Potential irritants also include detergents and antimicrobial soaps. Hand hygiene products containing these substances damage the skin by progressively depleting the surface lipid barrier of skin, this results in deeper action of detergents into the superficial layers.

Allergic Contact Dermatitis is an allergy to some ingredient in a hand hygiene product. Reactions range from mild, localised, generalised to severe. In its most serious form, allergic contact dermatitis can even cause respiratory distress. Causes are typically fragrances, preservatives and less commonly, emulsifiers in liquid soaps, lotion, ointment and creams. Besides skin irritations, these toxic ingredients can potentially cause damage to our bodies when absorbed into our bloodstream.

Avoid products that contain these in their labels: (not comprehensive)


Sodium Lauryl Sulfate (SLS), Sodium Laureth Sulfate

Parabens eg. Methylparaben, butylparaben, propylparaben

Ureas eg. diazolidinyl urea, Imidazolidinyl, DMDM hydantoin, sodium hydroxymethylglycinate

Synthetic Colours eg. Labelled as FD&C or D&C followed by colour/number

Diethanolamine (DEA)

Propylene Glycol, Propylene Oxide, Polyethylene Glycol

Synthetic Fragrances containing phthalates

1,4-Dioxane eg. By products of ethoxylation process including those with myreth, oleth, laureth, ceteareth and other “eth”, PEG, polyethylene, polyethylene glycol, polyoxyethylene or oxynol, in their names.

Ethyl Alcohol

Benzalkonium Chloride (BAC)


How to prevent negative side effects of frequent hand washing.

  • Wash your hands in cold or mildly warm (Not hot) water
  • Do not wash them for too long
  • Use an authentic ‘natural’ or ‘organic’ hand sanitiser if water and soap is unavailable
  • Make your own (DIY) hand sanitiser from natural, skin friendly ingredients
  • Avoid the above listed toxic chemicals
  • Choose a liquid wash specially formulated for sensitive skin.


Recommended Wash and Moisturisers

1.Emu Tracks Liquid Hand & Body Wash for frequent hand wash

An exceptionally mild soap-free formula, gentle enough for hands or as an all over body application.  Ideal for frequent use and for dry and sensitive skin types. Selected plant-based ingredients are blended with nature’s most effective moisturisers to simultaneously cleanse and nourish while preserving the skin’s natural protective oils. The antibacterial properties of Eucalyptus are combined with soothing, moisturising Emu Oil, Shea Butter and Lavender, resulting in naturally soft, smooth skin.

2. Emu Tracks Bio-Active Emu Oil for moisturising

Emu Oil has extraordinary penetrating and anti-inflammatory properties to respond quickly and provide thorough relief from symptoms. 100% Natural with no added ingredients – Proven, Safe, Highly Effective for the whole family including babies. Targets and relieves symptoms due to dry skin, dermatitis and eczema.

3. Emu Tracks Baby Shampoo & Body Wash 

Specially designed as a dual-purpose product that is suitable for babies and children of all ages to keep their skin soft, smooth and fresh. Emu Oil provides exceptional soothing and moisturising qualities. Enriched with plant extracts, including Shea Butter and Lavender to cleanse, nourish and calm. Particularly suited for sensitive skin and scalps.

Emu Oil is derived from Australia’s native, flightless emu bird and processed in an integrated facility that guarantees the emu oil’s efficacy and potency. Studies have shown that Emu Oil is a natural powerful anti-inflammatory used for centuries by aborigines and contains Omega 3,6,9 & K2 beneficial for skin, hair, nails and cardiovascular health. Emu Tracks is Australia’s premium brand of Emu Oil manufacturer. All products do not contain synthetic fragrances, preservatives and harsh chemicals.

Cautionary Note: The recommendations and advice in this article is for information only. They should not be taken as medical or expert advice and should not be used as diagnosis for any medical conditions. Readers who exhibit symptoms written here should consult a healthcare professional.

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