Effect of topical treatments on irritant hand dermatitis in health care workers.
BACKGROUND
Irritant contact dermatitis (ICD) from repetitive hand hygiene is the primary reason for compliance failure among health care workers (HCWs). Chronic ICD has implications for infection control because higher bacterial counts are associated with increased skin compromise. Guidelines recommend lotions/creams to lessen irritation. We evaluated the effects of 5 to 10 daily applications of a test cream (A, glove and chlorhexidine gluconate compatible) and current lotions/creams (B) compared with a control of normal skin care.


METHODS
Outcomes were visual skin erythema and dryness, excess erythema (quantitative image analysis), and hydration among 80 HCWs in an intensive care unit.


RESULTS
Knuckle dryness was lower for both treatments than the no treatment control (P < .02) after 2 weeks. Skin treated with A had lower knuckle erythema (P=.03) than B and control. HCWs using A had lower excess erythema (right) than B and control (P < .04). Excess erythema was lower for A and B versus control (P=.003).


CONCLUSIONS
Reduction in erythema suggests that frequent use of cream A may mitigate the damaging effects of repetitive hand hygiene and allow the skin to recover. Intensive treatment of HCW ICD may be required to counteract the skin compromise and minimize the negative impact on infection control.
Visscher
Marty
M
Skin Sciences Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. Marty.Visscher@cchmc.org
Davis
Jennifer
J
Wickett
Randy
R
D000279:Administration, Cutaneous; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003877:Dermatitis, Contact / Q000188:drug therapy*; D004202:Disinfectants / Q000009:adverse effects*; D006229:Hand Dermatoses / Q000188:drug therapy*; D006282:Health Personnel; D006801:Humans; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D004202:Disinfectants