The first line of defense

Dr Vikas Sharma

Here are some skin essentials amid coronavirus, sanitizers and face masks

First, it was face mask. Now, it’s hand sanitizer. Items that weren’t valuable just a few months ago are now coveted, hoarded and flying off store shelves.

Everyone wants a bottle of hand sanitizer. Covid-19 fears have turned the once unremarkable product into something very precious.

Know your sanitizer

Hand sanitizer comes in gel, foam and liquid formulations. It sounds pretty simple as an alternative to washing your hands with soap and water. However one needs to look carefully at the label before buying any of these products. Check the bottle for active ingredients. It might say ethyl alcohol, ethanol, isopropanol or some other chemical, and those are all fine. But make sure that whichever of those alcohols is listed, its concentration is between 60 and 95 per cent. An alcohol concentration under 60 per cent won’t kill the microbes. It’s really frightening to think that there are products out in market that contain levels lower than the required 60 per cent and sometimes much lower.

Good old soap & water

Hand sanitizer isn’t fully effective unless you use the one with right composition and in the right manner.

It can be useful if you have no soap or water around but if you have the latter then it’s much better to opt for the older option. Be pro-active and must check the labels on the hand sanitizer bottle mentioning the constituents and the concentration of active ingredients to be safe.

For anyone other than medical practitioners moving quickly between patients, good old soap and water is still the best way to decontaminate your hands by scrubbing for at least 20 seconds. Hand washing, which removes germs from your skin, remains the best way to protect against the coronavirus and other pathogens. Hand sanitizer, by contrast, kills most germs but doesn’t remove them from your skin. Alcohol is also the key ingredient in disinfecting wipes.

Effects on skin

With coronavirus around, hand washing and usage of hand sanitizers, face masks has increased manifold and thus also the after effects on our skin of this changed habit, which also necessitates the modification of skin care routine. Wearing a mask all day long can leave your skin dry and cause irritation. In some prone to urticaria can develop itchy rash over pressure or contact areas. If you’re religiously washing your hands (you should be!) and slathering on hand sanitizer to ward off coronavirus, chances are your skin is dry as a bone.

The skin of the hands can become painfully dry and cracked because you’ve been following the widespread advice to frequently wash them or apply hand sanitizer to prevent the spread of the coronavirus.

Don’t over do

So how frequently are we supposed to be washing our hands? And when should we put the hand sanitizer down? An intact and healthy skin barrier is very important part of our body system as it forms our first line of defense against various harmful pathogens including viruses and environmental allergens. Overuse of hand sanitizers and over hand washing can cause micro-breaks in your skin because your skin is dry. Although the corona virus primarily enters the body through the eyes, nose and mouth, skin micro-breaks or skin fissures may cause other kinds of discomfort.

Watch out for these signs

Signs you’re over-washing include itchy, flaky skin, as well as pain and redness. So, whenever you notice any of these signs, it’s the point where you should stop over doing. A barrier cream is a product applied directly to the skin surface to help maintain the skin’s physical barrier, providing protection from pathogens and irritants.

Steps to follow

After washing, pat your hands dry and then apply barrier moisturiser cream all over, including on your fingertips, where you may be prone to cracking. You don’t need fancy formulas with special additives or lotions. Extra fragrances and additives can be irritating. It is important to balance the hand washing with right moisturiser. Atopic or those having hand dermatitis or eczemas, palmar psoriasis are most susceptible. Moisturise your hands and face with a good quality non-fragrant cream immediately after cleansing.

Skin, in fact, is 64 per cent water, making water an essential ingredient of healthy skin. If the top layer gets too dry, the skin can become itchy, scaly, inflamed and leathery.

Goodness of moisturiser

On the most basic level, moisturisers hold water in the outermost layer of skin. They also act as a temporary barrier against viruses, allergens and other harmful environmental agents. There are myths and rumours about moisturisers that they attract viruses but the fact is that they form a barrier protective layer over the skin.

Some of the newest formulations contain ceramides or waxy lipid molecules composed of sphingosine and fatty acids. Ceramides help restore skin water permeability and barrier function.

(Dr Sharma is a Chandigarh-based dermatologist)