COVID-19 Pandemic Increased Hand Cleansing and Related Dermatologic Problems

Nonmedicated soap, as used by the population during the COVID-19 pandemic, significantly affects skin moisture and elasticity.

Hand-cleansing frequencies increased during the COVID-19 pandemic by as much as 2.5 times per day, and nonmedicated soap significantly affects skin moisture and elasticity, investigators reported in a study published in the Journal of Cosmetic Dermatology.

An internet survey entitled “Hand hygiene habits acquired during the COVID-19 pandemic,” was administered to the general population, and a prospective, analytical, open, and self-controlled study was conducted from November 2021 to January 2022.

The trial included adult patients with no history of atopic dermatitis, allergies, or adverse reactions to the products that were used in the study. The treatments were on-demand washing with anionic nonmedicated liquid soap removed with tap water, or with 1-mL alcohol-based solution (70% ethanol) or 0.4-g alcohol-based gel (70% ethanol). The treatments were applied every 30 minutes, and measurements were made at baseline and after treatments at 0, 2, and 4 hours. The participants spent at least 30 seconds washing for each treatment.

A total of 138 survey responses were received (mean age, 39 years [range 18-74 years; 68.8% women). Before the COVID-19 pandemic, 84% of responders washed their hands a mean of 6.7±4.6 times per day. During the COVID-19 pandemic, 97% of respondents washed their hands a mean of 14.5±10.3 times per day (P <.0001).

The excessive use of soap or alcohol-based products has caused dermatological problems in the population, highlighting the need to help the skin to recover using different moisturizers.

In addition, 59.4% of the respondents washed their hands more than 8 times in 4 hours, and 70.3% reported skin changes associated with the high frequency of cleansing, such as dryness (61.5%), irritation (10.1%), itching (6.5%), redness (4.3%), and skin wounds (7%). Alcohol-based gel (42.8%), soap (15.2%), and alcohol-based solutions (11.6%) were the products associated with the most negative reactions.

The moisture and skin elasticity noninvasive trial included 19 health workers or health sciences students. The participants included 15 men with a mean age of 38 years (range, 23-62) who had no history of skin disease; skin moisture was measured with corneometry.

Soap was associated with a progressive decrease in skin moisture percentage after 2 hours of treatment (baseline vs 2 and 4 hours, respectively; P <.001 and P <.05). Alcohol-based gel treatment decreased corneometry measures after 2 hours of treatment when the percentage of moisture change was assessed (0 hours vs 2 and 4 hours, P <.05 and P <.001, respectively.)

In the assessment of skin elasticity in both forearms, the net elasticity, and percentage of elasticity change increased in the control skin without treatment (baseline or 0 hours vs 4 hours; P <.05), compared with the effect in skin treated with soap, in which net elasticity lessened during the assay (baseline vs 4 hours, P <.01). Participants’ skin elasticity did not change when cleansing was done with alcohol-based treatments.

Researchers noted as a limitation that their study assessed the short-term effects of hand cleansing in a small number of participants.

“Hand hygiene habits during the pandemic have changed, causing an increase in the frequency of the use of products to sanitize the skin,” stated the study authors. “The excessive use of soap or alcohol-based products has caused dermatological problems in the population, highlighting the need to help the skin to recover using different moisturizers.”


Chopin-Doroteo M, Krötzsch E. Soap or alcohol-based products? The effect of hand hygiene on skin characteristics during the COVID-19 pandemic. J Cosmet Dermatol. Published online November 21, 2022. doi:10.1111/jocd.15523