Due to the COVID-19 pandemic, recommendations to prevent infection suggest increasing the frequency of handwashing and disinfection; however, these measures can have negative implications on our skin. This study aims to evaluate whether these measures correlate with new-onset skin damage or can exacerbate hand eczema among the general population. Materials and Methods: This was a descriptive, cross-sectional, survey-based study, including the general population of Mecca region, Saudi Arabia. To achieve the study's aim, an online questionnaire to the general population comprising 25 items was distributed via social media apps during the pandemic between October 23 and November 21, 2020. Data were automatically collected in Excel and entered into SPSS for analysis. Results: A total of 783 participants were included in this study, of whom 695 (88.8%) were female. A history of hand eczema was reported among 123 (15.7%) participants, and 270 (34.5%) had a history of atopy. During the COVID-19 pandemic, 86 (13.0%) participants noticed new-onset skin irritation, while 81 (31.3%) of the participants reported exacerbation of earlier hand allergic dermatitis. The most frequent symptoms were dryness and feeling of tightness. Additionally, most participants among both groups noticed that skin lesions appeared for less than 10 days. The frequent handwashing statistically increased following the onset of the pandemic (p=0.001), there is association between new-onset symptoms and more frequent handwashing, as well as the use of hand disinfectants, during the pandemic (p=0.001). Conclusion:Our study suggests that the general population's skin was negatively affected by COVID-19 precautions, particularly those with a history of hand eczema. We recommend spreading awareness of skin protective modalities and the use of new infection prevention measures, such as regular skin moisturization for hand protection and possibly using less damaging skin disinfectants like ozonized water provided it is scientifically proven effective in disinfecting COVID-19 virus.

Topical corticosteroids (TCS) are among the most prescribed medications for the treatment of dermatological diseases. However, the inappropriate use on the face without any prescription might result in several adverse effects such as purpura, atrophy, and rosacea-like dermatitis. This emphasized the need to evaluate the prevalence of non-prescribed use of these products in females to determine appropriate action. In this cross-sectional study, we aimed to estimate the point prevalence of using non-prescribed TCS on the face of female citizens of Makkah, Saudi Arabia. This study was conducted among women living in Makkah using an electronic questionnaire distributed through social media applications from October 2020 to January 2021. The questionnaire comprised of various questions about the participant's characteristics, the pattern of using TCS, the reason for usage, and how frequently the participants used TCS. The study included 565 women from Makkah; 258 (45.7%) of the participants used topical skin treatment, 126 (48.8%) reported that the treatment contained TCS, most of the participants who used this topical skin treatment (52.4%) did not have a medical prescription. Doctor’s prescription had no significant association with the duration of using TCS (p = 0.06), frequency of using TCS (p = 0.05), or how TCS was accessed (p = 0.06). Most of the women, 47 (71.2%), who used un-prescribed TCS did not know that TCS can cause acne (P = 0.003). A significant association was found between topical steroids and having no prior knowledge that it can cause telangiectasia (P=0.005). The most common area for TCS use was face (41.5%). The use of TCS among women in Makkah is high, primarily for the treatment of the face. However, more than half of the women use it without a doctor’s prescription.

Hyperkeratotic spicules are rare cutaneous lesions associated with underlying systemic illnesses. In more recent times, facial spinulate demodicosis has been suggested as an etiological factor. Demodicosis is a common dermatological condition characterized by the presence of Demodex mites in the pilocutaneous follicles. This report describes the case of a 40-year-old otherwise healthy woman who reported having undetected facial follicular spicules as a result of demodicosis. The diagnosis was confirmed by physical examination and skin punch biopsy. Initial treatment with 5% permethrin did not resolve the rash. As such, 1% Ivermectin was prescribed, after which the rash resolved completely within 3 weeks.