The Hidden Toll of Hand Hygiene on Healthcare Providers

As December 1-7 marks National Handwashing Awareness Week, the healthcare community is again rallying around hand hygiene's critical importance. Handwashing is a cornerstone of infection control, dramatically reducing hospital-acquired infections and safeguarding our most vulnerable patients, especially those who are immunocompromised. [1]. Yet, while the benefits to patient health are clear, we rarely discuss the unintended consequences of rigorous handwashing on healthcare providers, namely, its toll on our skin.

As a medical student, I experience firsthand the relentless cycle of hand hygiene. During hospital rounds, we’re instructed to wash our hands or use alcohol-based sanitizers before and after every patient encounter. Seeing ten patients in a day means scrubbing our hands about 20 times. While alcohol-based sanitizers may be less harsh than soap and water, they’re far from gentle. The result? Dry, cracked, and irritated skin is not just uncomfortable but harmful.

Healthcare professionals know that the skin barrier is a vital defense mechanism. Environmental factors like frequent washing, coupled with the natural aging process, can weaken skin structure and function. Aging skin struggles with reduced elasticity, impaired vascular reactivity, and diminished barrier protection. [2]. Add the harsh effects of repeated handwashing, and the damage can accelerate, leaving our hands raw, vulnerable, and less capable of performing the very duties we rely on them for.

This isn’t merely a cosmetic issue. Compromised skin increases the risk of dermatitis and infection among healthcare workers, a population already prone to occupational hazards. Ironically, by adhering to hand hygiene protocols to protect patients, we may be inadvertently neglecting our own health.

So, how do we balance infection control with preserving the integrity of our skin? It starts with a shift in mindset: protecting providers is as crucial as protecting patients. Just as hospitals invest in hand hygiene education, they should also educate staff about skincare and implement measures to support it.

Here are a few actionable steps we can take:

1. Choose Better Hand Soaps

   Not all soaps are created equal. Many strip the skin of its natural oils, leaving it raw and irritated. Healthcare facilities should prioritize mild, fragrance-free soaps formulated to maintain the epidermal layer's integrity.

2. Provide Moisturizers Alongside Handwashing Stations

   Hospitals should supply high-quality, fast-absorbing lotions near sinks and sanitizing stations. Encouraging staff to moisturize immediately after handwashing can help restore the skin barrier and prevent dryness.

3. Promote Skin Care Education 

   Just as we’re trained to wash our hands properly, we should be taught how to care for our skin. Staff should understand the importance of moisturizing, using barrier creams, and recognizing early signs of dermatitis.

4. Invest in Hand-Friendly Sanitizers

   Alcohol-based hand sanitizers are essential for infection control, but many are unnecessarily harsh. Facilities should choose sanitizers with added emollients to reduce skin damage without compromising efficacy.

5. Advocate for Policy Changes

   Beyond individual efforts, we need institutional change. Hand hygiene protocols should include guidance on skincare to create a more sustainable approach for healthcare providers.

It’s time to acknowledge that healthcare providers need protection too. Our hands are among our most valuable tools in delivering care, yet we seldom prioritize their health. By incorporating skin-friendly practices into our hand hygiene routines, we can safeguard both our patients and ourselves.

As we champion the importance of handwashing this National Handwashing Awareness Week, let’s also start a conversation about skin health. Healthy hands are essential not just for patient care, but for the well-being of the caregivers who dedicate their lives to it.

References

1. Toney-Butler, T. J., Gasner, A., & Carver, N. (2023). Hand Hygiene. In StatPearls. StatPearls Publishing.
2. Rorteau, J., Chevalier, F. P., Fromy, B., & Lamartine, J. (2020). Vieillissement et intégrité de la peau - De la biologie cutanée aux stratégies anti-âge [Functional integrity of aging skin, from cutaneous biology to anti-aging strategies]. Medecine sciences : M/S, 36(12), 1155–1162. https://doi.org/10.1051/medsci/2020223

Note: The views expressed in this article are the author’s own and do not necessarily represent the views of ACOI.