Photo by Kudriavtsev at Shutterstock
COVID-19 has dominated news cycles and headlines in the area and across the United States since it was first identified. The sheer volume of media output concerning COVID is astounding. Even with all this information, the field of dermatology barely gets a nod. This relative lack of information can be misleading. Dermatology has an important role in managing the pandemic.
Dermatology Symptoms of COVID-19
A COVID-induced rash usually occurs at the same time as other symptoms, but it has been reported as the first symptom in a minority of cases. The most commonly reported skin condition is a rash resembling measles. Most cases are associated with moderate COVID infections.
A symptom known as “COVID toes” is characterized by itchy red or purple bumps on toes, fingers, or heels. This symptom is associated with mild viral infections and seems to develop after the affected skin was exposed to cold surfaces or air.
A net-like rash called retiform purpura is the most severe COVID-related symptom. The rash may not look serious, but its appearance is the result of blood clots in small vessels beneath the skin. Reported cases of retiform purpura have only been observed in people that were already hospitalized with severe illness. You will want to contact a dermatology expert.
Secondary Relationships Between COVID and Dermatology
Hand hygiene awareness has reached new heights since the COVID-19 pandemic began. The CDC recommends frequent hand washing to slow transmission of the virus. Health care workers and other ‘front-line’ and essential employees with a variety of job functions are very focused on strict hand washing procedures. This is necessary to slow or prevent COVID infections, but constant hand washing, sometimes with harsh products, can alter or damage skin integrity.
Dermatitis and the Skin Barrier
Healthy skin is a barrier between the body and harmful substances and pathogens in the environment. The stratum corneum, a layer of keratin and lipids, is the major component of a healthy skin barrier.
The American Contact Dermatitis Society predicts an increasing number of irritant contact and allergic contact hand dermatitis cases related to hand hygiene. Effects of frequent hand washing are an indirect, but very important, link between dermatology and the COVID pandemic. Symptoms of both types of contact dermatitis include
- red rash
- mild to severe itching
- dry, cracked or flaky skin
- lichenification (thickening skin with leathery texture and appearance)
- fluid-filled bumps
- tenderness and soreness when moving hands or fingers
Hand Hygiene Products
Various types of hand hygiene products include liquid or bar soaps, antiseptic hand washes, alcohol-based hand sanitizers, and synthetic detergents. There are hundreds upon hundreds of hand hygiene products available in the Southlake area, and some products may affect skin negatively.
The term ‘soap’ is frequently used to describe any cleanser, but true soap is made of lye and fats. Soap has pH levels of 9 to 10.6. It removes dirt, breaks down grease, and deactivates viruses by destroying lipid membranes. Washing hands with soap and warm water has an added benefit of physically removing dirt particles and pathogens from the skin’s surface. Unfortunately, soap also disrupts protective lipids in our skin.
Synthetic detergents are a mixture of petrolatum derivatives and chemical surfactants. They have a pH between 5.5 to 7, which is similar to pH levels of healthy skin. Chemical surfactants function like soap and deactivate viruses by disrupting lipid membranes. Not all viruses have lipid membranes, but COVID does. Synthetic detergents, like soap, deplete skin’s beneficial lipids.
Antiseptic Hand Wash
Antiseptic hand washes are synthetic detergents or soaps with additional antimicrobial ingredients. Antimicrobials damage viral membranes, which deactivates viruses. Bleach, alcohol, and povidone iodine are effective against bacteria and viruses.
Disinfectant wipes usually contain alcohol or other antimicrobial ingredients. Pay close attention to labels when purchasing wipes. Hand wipes and baby wipes are designed for use on skin, while disinfectant wipes are formulated to disinfect surfaces.
Harsh chemicals in disinfectant wipes aren’t safe for skin and may cause severe irritation. Alcohols dissolve lipids, and several types of antimicrobial ingredients can denature proteins, so these wipes present a combined threat to protective components of our skin.
Treat and Prevent Dermatitis
Allergic contact dermatitis develops when skin experiences sensitization to an allergen. Initial exposure to the allergen may not trigger a reaction, but repeated exposure results in inflammation and other dermatitis symptoms. People can develop allergies to many components of hand hygiene products, such as preservatives, surfactants, and antimicrobial substances. Other additives, including perfumes, moisturizing agents, and dyes, are also potential allergens. A dermatology expert can help you.
Many products contain multiple ingredients, so it can be difficult to pinpoint the allergen. People experiencing dermatitis may switch products, but the alternative product might contain the same allergen. Visit your local dermatology clinic to identify the causative substance so you can avoid products with that ingredient in the future.
It isn’t uncommon to develop sensitization to more than one component in hygiene formulations, which can make it difficult to find acceptable products. Your dermatologist can help you find appropriate cleaners and sanitizers.
Irritant contact dermatitis, ICD, isn’t an allergic reaction. Our skin possesses an ‘acid mantle’ to act as a buffer against harsh substances that disrupt protective lipids and proteins. ICD occurs when protective elements in our skin deteriorate. Examples of potentially harmful substances and conditions include alkaline soaps or detergents, hot water, extremely cold water, constant glove use, low humidity, and friction.
Moisturizers can prevent and treat contact dermatitis to some extent. General categories of moisturizers include ointments, lotions, creams, and gels. Many hand hygiene products contain moisturizing ingredients, such as beeswax, petrolatum, glycerin, or emollients. Emollients are fats and oils to replenish lipids in skin. Some moisturizing products contain protein rejuvenators, such as keratin and collagen, to replenish protein as well.
Make an appointment at Compassion Dermatology in the Southlake area if you’re experiencing symptoms of dermatitis. Caring and knowledgeable professionals can help you figure out the underlying cause and develop an effective treatment and prevention plan.