Cold temperatures and low humidity are a tough combination for the many among us who wash our hands countless times throughout the day. Adding flu season and a COVID pandemic to the mix has made hand eczema common in children and teens who are doing their part to prevent the spread of germs. This blog post reviews many methods you can use to keep your hands healthy and germ free during the winter months. Most of these tips come from a publication on hand hygiene recommendations created by the American Contact Dermatitis Society (https://www.jaad.org/article/S0190-9622(20)32256-8/pdf).

Tips on washing your hands with soap and water:

• • Wash your hands in lukewarm or cool water and soap for at least 20 seconds. Extra hot water will lead to skin irritation and does not kill more germs. The same goes for ice cold water—keep the temperature comfortable and cool.
  • The best hand soaps also contain moisturizers and do not contain extra preservatives, fragrances, dyes, or allergenic surfactants. Some of my favorite hand sanitizers are Neutrogena Ultra Gentle Cleanser Creamy Formula, Pipette Hand Sanitizer, and Avène XeraCalm Oil Cleanser. For people with allergies, some hand soaps with very few allergens include Aveeno Baby Cleansing Therapy Moisturizing Wash Fragrance Free, Babyganics Moisturizing Therapy Cream Wash Fragrance Free, Free & Clear Liquid Cleanser, and VMV Hypoallergenics Moisture Rich Creamy Cleansing Milk for Dry Skin.
  • Pat your hands dry, when you are done washing. Rubbing or friction from harsh cloths can remove protective oils making your hands drier and more cracked.
  • Immediately apply a moisturizer to your hands. My favorite hand moisturizers are Neutrogena Norwegian Hand Formula, CeraVe Therapeutic Hand Cream, Cutemol, and Avène Cicalfate For Hands. For people who want to avoid petrolatum, Pipette Baby Balm and Waxelene are good choices. For people who have lots of skin allergies, products with very few allergens include Better Shea Butter Unrefined Shea Butter, Vaseline Original Petroleum Jelly, Aveeno Eczema Therapy Moisturizing Cream, and Smellgood African Shea Butter.
  • Wait 1 to 3 minutes for the moisturizer to set in before resuming activity. Products containing petrolatum and beeswax will be more moisturizing, but they will take longer to set in than moisturizers containing ceramides, glycerin, and/or free fatty acids. If you are in a rush, CeraVe Therapeutic Hand Cream and Neutrogena Norwegian Formula Hand Cream tend to set in the fastest.

Tips on using hand moisturizers:

• • Use moisturizers packaged in tubes instead of jars. This will help prevent contaminating your product through double dipping into jars. If your moisturizer is in a jar, look for containers with pumps (e.g., Vanicream Moisturizing Cream with Pump).
  • Try the “Soak and Smear” method for two weeks. For extra-dry hands, soak your hands in plain water for 20 minutes and immediately apply a moisturizer followed by cotton gloves. Leave the gloves and moisturizer on overnight. My favorite overnight moisturizers include CeraVe SA Cream for Rough & Bumpy Skin, Goldbond Rough & Bumpy Daily Skin Therapy Cream, La Roche Posay Lipikar Balm AP+ Moisturizer for Extra Dry Skin, and Avène Cicalfate+ Restorative Protective Cream.
  • Chap stick can be used on hands too. If you have small cuts and fissures on your hands, chap stick can be used to heal them without getting the rest of your hands messy. My favorite chap sticks for this purpose are Dr. Dan’s Cortibalm and FixMySkin Unflavored Healing Lip Balm.

Tips on using alcohol-based hand sanitizers:

• • Don’t forget to moisturize. Frequent use of any hand sanitizer can dry out your hands, so remember that you will still need to apply a moisturizer multiple times a day to keep your skin healthy. If you have dry hands, you should be moisturizing them at least every three hours.
  • The best hand sanitizers have added moisturizers and lack allergenic surfactants, preservatives, fragrances, and dyes. Some good products with few potential allergens include Purell Advanced Hand Sanitizer Refreshing Aloe, Purell Advanced Hand Sanitizer Refreshing Gel, and Kiss My Face Moisturizing Hand Sanitizer with Alcohol.

Common skin irritants and allergens to avoid:

• • Washing hands with dish detergent
  • Using disinfectant wipes to clean your hands
  • Working with bleach and other strong cleaning products without gloves
  • Products with added antibiotics (neomycin or bacitracin)
  • Applying superglue (ethyl cyanoacrylate) to fissures and inflamed areas
  • Not applying moisturizer when wearing gloves for long periods of time
  • Immediately applying gloves without allowing your hands to dry after washing them
  • Occlusive, self-adherent hand wraps
  • Tight plastic, rubber or latex gloves

If you or your child are following all these tips and the hand dermatitis will not go away, you should talk to a medical provider. Often, a dermatology consult can be very helpful in identifying underlying conditions and offering additional therapies. I also suggest considering a pediatric dermatologist for hand eczema in young children, as causes and therapies for dry hands in children are often different from those in adolescents and adults.