The Prevalence and Clinical Features of Skin Irritation Caused by Infection Prevention Measures During COVID-19 in the Mecca Region, Saudi Arabia

Abstract

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.

Dermatological impact of hand hygiene practices during COVID‐19: A cross‐sectional web‐based survey among doctors in a tertiary care hospital in Eastern India

“…The mean age of doctors participating in the survey was found to be 31.5 years, comparable with the study by Leelawadee et al, 10 where it was 32 years. In our study, males (58.7%) outnumbered females (41.3%) in contrast to previous studies by Leelawadee et al, 10 Guertler et al, 11 Zahr Allayali et al, 12 and Keily et al 13 where there was female predominance due to inclusion of female nurses as HCWs in most of the studies.…”

“…The most common symptom in our survey was dryness [60 (42%)], followed by itching [25 (17.5%)]. It is similar to the study by Keily et al, 13 Leelawadee et al, 10 Zahr Allayali et al, 12 Guertler et al, 11 and Agarwal et al 18 It is secondary to depletion of the lipid barrier due to lipid‐emulsifying detergents and lipid‐dissolving alcohols 18 . The most common skin changes seen were scaling in 30 (21%) and redness in 16 (11.2%) doctors, respectively.…”

Hand hygiene and hand eczema: A systematic review and meta‐analysis

“…The majority ( n = 28, 62.2%) of studies were performed in healthcare workers, 12 (26.7%) were in non‐healthcare workers and five included the general population regardless of occupation. 23 , 26 , 27 , 28 , 29 Outcomes were assessed by self‐reported questionnaire in most studies ( n = 35), of which 12 were based on the NOSQ‐2002 questionnaire, 30 and 10 studies relied on clinical examination by dermatologist or trained professional. Most of the studies were of high quality ( n = 35), and 10 were considered lower quality (NOS < 7).…”

Hand hygiene products and adverse skin reactions: A cross-sectional comparison between healthcare and non-healthcare workers of Bangladesh during COVID-19 pandemic

“…Numerous individual studies looking into the healthcare and general population separately revealed an increase in the incidence of adverse skin reactions in both groups. 4 , 5 , 6 , 7 , 8 , 9 , 10 In Wuhan (China), 74.5% of health professionals developed hand eczema, with an increased frequency of handwashing as a significant predictor. [ 4 ] Similar studies in Germany, [ 5 ] Turkey, [ 6 ] and India [ 7 ] also revealed a rise in hand eczema reported by healthcare workers at 90.4%, 50.5%, and 65.5% respectively.…”

“…24 new cases of hand eczema were diagnosed in urgent care in a study in Milan, [ 8 ] 16 new cases were reported in 10 days in a survey India [ 9 ] and nearly half the participants in a study in Saudi Arabia experienced skin reactions, particularly people those with a history of eczema. [ 10 ] But very limited research was carried out to compare the risks in both the groups side by side. 11 , 12 This study aims to explore these adverse effects within both the groups identify potential risk factors and propose appropriate changes in an attempt to prevent or reduce these effects.…”