Hand Hygiene Handwashing and Clean Hands Saves Lives


Soap & Water: An Enemy To Our Skin?

I can just hear you now questioning the title of this  article, “How can soap and water be bad for my skin?” I may sound crazy, but bear  with me while I explain.

The skin serves  several purposes, but a couple are  worth pointing out.  First, the outer  skin acts as the body’s first line of defense to foreign objects including  microorganisms.  Secondly, the skin  serves to minimize the amount of water the body loses.  It is easy to see the importance of maintaining  healthy skin.

Looking at the  physiology of the skin, the outermost section of the skin is called the  epidermis and the outermost layer of the epidermis is called the stratum  corneum (also referred to as the “horny layer”). The horny layer is composed of  natural lipids that keep the skin hydrated. Without this layer, the skin would  dehydrate resulting in cracked, damaged skin. The thicker the horny layer is,  the more hydrated the skin is.

Every time we wash our hands, layers of natural lipids are  stripped away reducing the skin’s ability to preserve water. The epidermis will  regenerate the lipids, but if we wash our hands in excess our body cannot keep  up with the production of this protective layer. The end result of frequent  handwashing is contact dermatitis symptoms of skin irritations.

I am not claiming nor suggesting we should stop washing your  hands, but rather we wash in moderation. Washing with soap and water is important  to a healthy lifestyle and should be part of our regular routine. So when  should we wash our hands? Proper hand hygiene states handwashing is required  under the following conditions:

  1. Before eating a meal
  2. After using the bathroom
  3. When hands are visibly soiled or dirty.
  4. When contact has been made with bodily fluids or  blood.

If cleaning is required at any other time, hand sanitizers are  recommended to be used as a substitute. Hand sanitizers are alcohol-based and  do not break down the natural lipids of the skin.  For this reason, alcohol-based hand sanitizers  (or antiseptic) are preferred whenever handwashing with soap and water is not  required.

How much washing is considered too much? Proper handwashing  technique states hands should be washed for at least 15 seconds, but not to  exceed 1 minute.  There are many  professions, like the medical industry, that require more frequent handwashing  compared to the average person. It is In these cases, handwashing should be  conducted whenever needed, but extra precaution should be taken by utilizing  skincare cream or lotions to assist in the restoration of the lipid layers.

For healthcare professionals, if the above handwashing  requirements do not apply, use the alcohol-based antiseptic. Alcohol kills the  most amount and broadest range of germs. In addition, the alcohol-based  antiseptic has the quickest kill rate compared to washing with antimicrobial  soap. Best of all, the alcohol-based antiseptic will not strip away the skin’s  lipid layers that locks in moisture.

Although handwashing is known to strip away lipid layers of our  skin, handwashing should not be avoided.   On the contrary, washing hands should be encouraged as it is an important  part of a healthy lifestyle. When handwashing is done properly, soap and water  is not an enemy, but rather a friend to healthy skin.

- Commission for Hospital Hygiene and Infectious Disease Prevention of the Robert Koch Institute. Hand hygiene. Bundesgesundheitsbl - Gesundheitsforch - Gesundheitsschutz. 2000;43:230-233.
-Kampf G, Loeffler H. Dermatological aspects of a successful introduction and continuation of alcohol-based hand rubs for hygenic hand disinfection. Journal of Hospital Infection. 2003;55:1-7.