Expert recommendations on supportive skin care for non-surgical and surgical procedures
Mar. 2024Skin care recommendations to prevent skin damage
- May 2023
- 45min
COVID-19 infection is a pandemic communicable disease with a relatively high fatality rate in elderly people. To date, no effective antiviral drug or approved vaccine have been identified. Consequently, the implementation of effective preventive measures is the only option left to counteract the virus. These measures include appropriate hand sanitization, wearing a mask and other personal protective equipment, cleaning surfaces with suitable disinfectants, etc. Crucial to prevent COVID-19 from spreading, they have also been shown to cause skin and mucous membrane damage (acute & chronic dermatitis, secondary infection, underlying skin disease aggravation).1
A panel of Chinese experts have recently published a consensus related to protective measures that healthcare professionals can adopt to minimize harm to their hands and faces while staying protected against the virus.2
Prolonged water exposure due to repeated hand washing can induce skin irritation. Moreover, long-term use of gloves may lead to overhydration of stratum corneum, which may cause maceration and erosion. Also, chemical materials in latex gloves are likely to cause contact dermatitis.
How to avoid damages caused when wearing gloves?
- Do not use more than one layer of gloves at a time*
- Try avoiding wearing gloves for a long period of time and apply hand cream to reverse maceration
- Consider using cotton gloves inside latex gloves.
If maceration cannot be relieved and subsequent erosion and exudation occur:
Resort to using hydropathic compress with 3% boric acid solution or normal saline or topical use of zinc oxide ointment.
In case of contact dermatitis:
Use topical glucocorticoid cream.
If an existing hand eczema becomes worse:
Apply moisturizer together with topical glucocorticoid cream.
*in the absence of existing skin barrier damage or underlying risk of gloves breaking
How to avoid damages caused by excessive hand washing?
- In daily life, use foamless cleansing products containing moisturizing ingredients
- Apply hand cream every time after hand hygiene (when possible)
- Chose emollients containing hyaluronic acid, ceramide, vitamin E or other repairing ingredients
- Go for urea-containing emulsions in case of skin rhagadia
Healthcare workers fighting against COVID-19 are prone to skin and mucosa barrier damage. To minimize it, they should keep wearing PPE while avoiding over-protection. Also, they may consider implementing skincare measures described by the board of Chinese experts. Indeed, this consensus provides professional advice on prevention and management of mild skin disorders.
Bibliography
- Pradhan D, et al. A review of current interventions for COVID-19 prevention. Arch Med Res 2020;51:363-374.
Link to full publication - Yan T, et al. Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatol Ther 2020.
Link to full publication
The adverse skin reactions caused by prolonged wearing of masks and goggles include pressure injury, urticaria, contact dermatitis, skin dryness, and aggravation of existing skin diseases.
How to avoid pressure injury caused by goggle protection?
- Avoid over-tight goggles
- Apply a moisturizer or a gel before wearing facial protective equipment to lubricate and reduce friction between skin and goggles.
How to avoid pressure injury caused by mask protection?
- Wear a properly fitted mask
- Use masks in different ways alternately to avoid sustained friction and pressure on the same site
- Apply a moisturizer or a gel before wearing facial protective equipment to lubricate and reduce friction between skin and mask
How to manage mild skin indentation?
To relieve redness and swelling:
- Include hydropathic compress with 3-4 layers of gauze soaked in cold water or normal saline for about 20 minutes each time every 2 to 3 hours and then applying a moisturizer
- Avoid washing your face with overheated water, ethanol or other irritative products
How to manage severe skin indentation?
To avoid infection secondary to severely swollen or blistered and erosive lesions:
- Use hydropathic compress with povidone iodine diluted by normal saline at a ratio of 1:9
- Apply medical dressing after hydropathic compress
If the skin is intact:
Apply a moisturizer
If the skin is infected:
Consider topical antibiotic ointments such as compound polymyxin B, mupirocin, or fusidic acid
How to prevent delayed pressure urticaria caused by vertical pressure from PPE (Personal Protective Equipment)?
- Choose well-fitted PPE and avoid using it too tight
- Change to other types of PPE
- Resort to taking antihistamines such as cetirizine and loratadine
- If needed, add antileukotriene agents.
How to prevent mask-related contact dermatitis?
- Avoid facial cleansing with over-hot water, 75% ethanol, or facial cleanser
- Apply emollients before wearing your mask
In case of itching or stinging:
Switch to a mask made out of another material (if switching is an option)
Put 2 layers of gauze inside the mask (if switching is not an option)
In case of mild contact dermatitis:
Apply a moisturizer after cleansing
In case of severe contact dermatitis:
Chose low- to medium-potency topical glucocorticoids without fluorine
In case of blisters and erosion:
Use hydropathic compress and subsequent topical glucocorticoid ointment
In case of severe pruritus:
Take antihistamines orally
How to prevent skin dryness and scales?
- Use a highly potent moisturizer before and after wearing PPE
- Apply a lip balm before donning and after doffing PPE
How to prevent the aggravation by masks and goggles of existing acne vulgaris?
- Apply moisturizers containing oil-controlled ingredients before and after using of your mask
- Use a topical antibiotic cream or benzoyl peroxide for mild papules and pustules, and topical retinoids creams for blackheads and whiteheads
How to prevent the aggravation by masks and goggles of other facial skin disorders? (seasonal facial dermatitis, seborrheic dermatitis, and rosacea)
- Try to control time spent wearing PPE
- Use gauze inside your mask
- Apply a moisturizer before donning and after doffing masks
Healthcare workers fighting against COVID-19 are prone to skin and mucosa barrier damage. To minimize it, they should keep wearing PPE while avoiding over-protection. Also, they may consider implementing skincare measures described by the board of Chinese experts. Indeed, this consensus provides professional advice on prevention and management of mild skin disorders.
Bibliography
- Pradhan D, et al. A review of current interventions for COVID-19 prevention. Arch Med Res 2020;51:363-374.
Link to full publication - Yan T, et al. Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatol Ther 2020.
Link to full publication
Ear-dependent masks may damage external ears and retroauricular areas and increase the risk of infection.
How to prevent external ear damage caused by mask protection?
- Cover retroauricular areas with a surgical cap before wearing ear-dependent protective equipment
- Clean and dry the external ear and its canal with cotton swab after taking off your PPE
- Apply a moisturizer after cleansing
- Choose a non-ear-dependent mask to reduce pressure on retroauricular areas (if possible)
- Reduce friction between skin and mask by using a moisturizer and thin hypoallergic dressing
- Carefully check retroauricular areas for skin indentation
- Treat lesions with previously-mentioned management of skin indentation
Healthcare workers fighting against COVID-19 are prone to skin and mucosa barrier damage. To minimize it, they should keep wearing PPE while avoiding over-protection. Also, they may consider implementing skincare measures described by the board of Chinese experts. Indeed, this consensus provides professional advice on prevention and management of mild skin disorders.
Bibliography
- Pradhan D, et al. A review of current interventions for COVID-19 prevention. Arch Med Res 2020;51:363-374.
Link to full publication - Yan T, et al. Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatol Ther 2020.
Link to full publication
Scalp pruritus, folliculitis, and exacerbation of existing scalp seborrheic dermatitis can result from hydrosis.
How to protect hair and scalp?
- Use the same water temperature for hair and body cleansing
- Massage scalp and hair with fingertips instead of scratching with fingernails
Healthcare workers fighting against COVID-19 are prone to skin and mucosa barrier damage. To minimize it, they should keep wearing PPE while avoiding over-protection. Also, they may consider implementing skincare measures described by the board of Chinese experts. Indeed, this consensus provides professional advice on prevention and management of mild skin disorders.
Bibliography
- Pradhan D, et al. A review of current interventions for COVID-19 prevention. Arch Med Res 2020;51:363-374.
Link to full publication - Yan T, et al. Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatol Ther 2020.
Link to full publication
