Nurses’ skin is under assault. Continuous handwashing; irritation from personal protective equipment (PPE); and exposure to disinfectants, sterilants, and other chemicals take their toll on our protective barrier. The sun and cold weather also can damage and exacerbate skin dryness and damage. What can we do?
Making sure your skin remains healthy is part of being a healthy nurse. The American Nurses Association (ANA) discovered strategies for mitigating skin issues in a recent virtual interview with board certified dermatologist Sejal K. Shah, MD, who has a private practice in New York City. Her expertise encompasses all aspects of dermatology, including cosmetic dermatology and lasers, hair loss, and ethnic skin.
Protecting skin against harsh weather and winter sun
Shah emphasizes the importance of daily sunscreen use, even when it’s cloudy, raining, or snowing. She suggests covering skin when outside to limit exposure to harsh weather, and when indoors, using a humidifier to alleviate excessive dryness in the environment.
“In winter, the reduced humidity in the air leads to dry skin, so it’s important to avoid factors that strip the skin’s moisture and replenish the skin with a good moisturizer,” she said. “Keep your shower brief and use lukewarm water and a mild, soap-free cleanser. After showering, pat skin dry and apply moisturizer while the skin is still slightly damp. Use a moisturizer containing ingredients that strengthen the skin barrier, such as ceramides, niacinamide, and fatty acids, as well as humectants, such as hyaluronic acid and glycerin.”
Preventing skin breakdown due to PPE
“PPE-related skin reactions tend to occur after continuous, extended use, and usually are due to pressure, friction, and/or moisture buildup,” Shah said. “They can occur anywhere PPE is used.” She advises the following:
Face, head, and ears
• Use a gentle, soap-free cleanser.
• Follow cleansing with a moisturizer.
• Look for ingredients that hydrate the skin and restore the skin barrier, such as ceramides, hyaluronic acid, amino acids, glycerin, niacinamide, and fatty acids. Dimethicone is beneficial because it moisturizes and acts as a skin protectant.
• Avoid products with irritating ingredients.
• Allow time for your moisturizer to absorb fully before donning PPE.
• Minutes before donning PPE, use an alcohol-free liquid skin protectant where PPE comes into contact with skin. A dressing, such as thin hydrocolloid or foam, also can protect the skin but ensure it doesn’t interfere with mask effectiveness. For example, an N95 respirator requires an airtight seal, so if using a dressing, arrange an additional fit test to accommodate.
• When off-duty, use masks that don’t contact the same areas of the skin as those you wear at work.
• Use lukewarm water and a mild soap or cleanser.
• Wet hands before applying soap or cleanser.
• After cleansing, gently pat the skin dry rather than rubbing with a towel.
• Apply a thick cream with reparative and hydrating ingredients.
• Allow hands to completely dry before donning gloves.
• Use gloves only for tasks that require them.
• Prior to sleep, apply a thick cream or ointment and slip on cotton/cotton-lined gloves.
• If the skin is cracked or split, try a liquid bandage to promote healing and prevent further damage.
• Hydrocortisone can be used to treat itchy, scaly patches.
• If your hands don’t respond to these treatments and are worsening, consult with a board-certified dermatologist to discuss treatment options.
This content is made possible in part by the support of CeraVe, a funder of HNHN.