Contact Dermatitis from Hand Hygiene Practices in the COVID-19 Pandemic

Ann Acad Med Singap. 2020 Sep;49(9):674-676.


Coronavirus disease 2019 (COVID-19) pandemic continues to spread globally at a staggering speed. At present, there is no effective treatment or vaccine for COVID-19. Hand disinfection is a cost-effective way to prevent its transmission. According to the Centres for Disease Control and Prevention (CDC) guidelines, we should wash our hands with soap and water for at least 20 seconds. If soap and water are not readily available, alcohol-based hand rubs (ABHRs) with at least 60% alcohol are the alternative. With diligent hand disinfection reinforced during COVID-19, there is an increased prevalence of contact dermatitis. This commentary highlights the fact that contact dermatitis is a readily treatable condition and should not cause any deviation of proper hand hygiene. In irritant contact dermatitis (ICD), the management strategies are selection of less irritating hand hygiene products, frequent use of moisturisers to rebuild the skin barrier, and education on proper hand hygiene practices. In allergic contact dermatitis (ACD), the identification and avoidance of the contact allergen is the key to treatment. However, ACD is less common and only accounts for 20% of the cases. The identified allergens in hand cleansers are predominantly preservative excipients and ACD attributable to ABHR are very uncommon. Alcohol-free hand rubs are widely available on the market but it is not a recommended alternative to ABHRs by the CDC.

MeSH terms

  • 1-Propanol / adverse effects
  • 2-Propanol / adverse effects
  • Anti-Infective Agents, Local / adverse effects
  • COVID-19 / prevention & control*
  • Dermatitis, Allergic Contact / etiology
  • Dermatitis, Allergic Contact / therapy*
  • Dermatitis, Irritant / etiology
  • Dermatitis, Irritant / therapy*
  • Dermatitis, Occupational / etiology
  • Dermatitis, Occupational / therapy
  • Detergents / adverse effects
  • Emollients / therapeutic use*
  • Ethanol / adverse effects
  • Hand Dermatoses / etiology
  • Hand Dermatoses / therapy*
  • Hand Disinfection / methods*
  • Hand Hygiene
  • Hand Sanitizers / adverse effects
  • Health Personnel
  • Humans
  • Hygroscopic Agents / therapeutic use*


  • Anti-Infective Agents, Local
  • Detergents
  • Emollients
  • Hand Sanitizers
  • Hygroscopic Agents
  • Ethanol
  • 1-Propanol
  • 2-Propanol