Hand dermatitis (HD) presents as a chronic, relapsing, and remitting inflammatory condition. It not only affects the quality of life of the individual but also negatively impacts the mental and socio-economic well-being by compelling professional hindrance causing loss of wages. 

Although it is one of the commonest skin conditions encountered by dermatologists, it is constantly underreported. 

Coronavirus pandemic has prioritized and widely publicized hand hygiene as a crucial preventive measure to control the spread of the Coronavirus disease (COVID-19) virus. But this hand hygiene campaign has caused a surge in the cases of HD, which has in turn again compromised hand hygiene practices and this infringement in the skin barrier is making another portal of entry of infective agents. 

A study searched the literature for various clinical, diagnostic as well as therapeutic aspects of this debilitating skin condition which demands more attention especially during the times of the COVID-19 pandemic and explained that the increased frequency of hand washing in contrast to the lower frequency of moisturizer application and other accumulative factors as cold weather, occlusion under personal protective equipment and gloves, atopic predisposition, friction, etc., further increases the risk of HD, especially Irritant contact dermatitis (ICD).

To sidestep these, it is crucial to educate people on the recommendations suggested by the American Contact Dermatitis Society regarding:

A) Handwashing- 

• Must be done with Lukewarm or cool water along with avoiding Very hot or cold water.
• Washing must follow pat drying and not rubbing.
• The products with antibacterial ingredients are not essential to be used, rather soaps or synthetic detergents without allergenic surfactants, preservatives, fragrances, or dyes but with added moisturizers should be used.

B) Sanitizers

• Hand sanitizers with 60% alcohol, without allergenic surfactants, preservatives, fragrances, or dyes but with added moisturizers should be used.

C) Moisturizers

• Should be used immediately after handwashing or hand sanitization.
• Moisturizers in jars should be avoided to prevent double-dipping into and potentially contaminating the product.
• Individuals with HD can soak their hands in plain water for 20 min followed by immediate moisturizer application to the damp skin, to be done at night for 2 weeks. Further, an occlusive barrier can be created over moisturized skin by wrapping loose cotton or plastic gloves.
• Health care workers can use a moisturizer with a water base under gloves. Oil-based moisturizers are to be avoided to be used under gloves as they tend to break down the latex and rubber by making the material swell or brittle.

D) Gloves

• Moisturizer must be applied after washing hands and before wearing gloves. Prefer a cotton glove liner or loose plastic gloves (e.g., plastic clear, disposable food gloves).
• Since Latex, vinyl, and nitrile gloves do not react with ethanol or isopropyl alcohol; accelerator and rubber-free gloves like neoprene and nitrile are advised.
• The patch test is advised for individuals with suspected hand allergic contact dermatitis.

Source- Ahmed ZH, Agarwal K, Sarkar R. Hand dermatitis: A comprehensive review with special emphasis on COVID-19 pandemic. Indian J Dermatol 2021;66:508-19