Expert tips: A dermatologist on how to look after your skin at the moment

Geraldine Morrow is a dermatologist in private practice since 1995. She lectures in UCD on the Higher Diploma in Occupational Health course. Here she shares some of her skin care tips and advice.

– Frequent hand washing forms a critical part of the health strategy for defence and protection against infection, including coronavirus. A combination of soap, plus mechanical disruption of virus particles is best – ie washing all surfaces of hands with soap and water for at least 20 seconds. The type of soap does not matter. As Covid-19 is a viral disease there is no advantage in using antibacterial soap. “Soap” also includes detergents eg sodium laureth sulphate, which is the active ingredient in some body washes and shampoos. This acts as a surfactant, and disrupts the lipid layer around virus particles.

– However, repeated exposure to soap and water, other detergents, or alcohol hand gels, can cause dry skin and a form of eczema known as irritant contact dermatitis. This is more common in people already predisposed to eczema or other atopic diseases such as asthma or hayfever. It is also more common in the elderly who tend to have drier skin, or in people on medication which has a drying effect such as Isotretinoin or some cholesterol lowering medication.

– If skin becomes irritated continue to follow Government guidelines on hand washing although this may be difficult. Contact dermatitis can cause the skin to get sore or itchy and to sting when alcohol gels are applied. The skin may become red and cracked with small blisters and or deep cracks (fissures) which can be very painful.

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– Soap/detergent can trap under finger rings and this is where irritant contact dermatitis often starts. Remove rings when washing hands, or leave them off entirely for the moment. Another starting place for dermatitis is in the finger webs where the skin is thinner so be careful to dry well.

– Be sure to dry your hands fully by patting them rather than rubbing. Hand driers or leaving the skin to “air dry” are more likely to dry and aggravate the skin.

– Apply moisturiser (generously) after washing and regularly throughout the day especially if your skin feels dry. A perfume/fragrance free moisturiser is preferable as it is less likely to trigger an irritant or allergic reaction. One with fewer preservatives will also irritate less.

– Overnight moisturising using a thick layer of moisturiser under clean cotton gloves is often helpful. Or cover a thick layer of moisturiser with a damp pair of cotton gloves, followed by a dry pair of cotton gloves. Now wrap your hands in a warm towel and leave for 1 - 2 hours, eg when watching television. This can drive the moisturiser more deeply into your skin, though do not use this “wet wrapping” technique if your skin is infected.

– If you develop severe hand dermatitis, or if you suspect an infection eg larger blisters, skin oozing pus, or a golden crust formation, then you should contact your GP. Take good quality well lit photos using your phone as these will help your doctor make a diagnosis during a virtual video or telephone consultation.

– For any wet work at home, eg doing dishes or washing hair, try to wear cotton gloves under loose fitting household rubber gloves. Wearing tight fitting latex, nitrile (such as surgical gloves), or polythene gloves directly next to the skin can aggravate matters, by increasing sweating and trapping it next to the skin where it irritates. Leave latex/nitrile gloves for frontline healthcare workers

– Many skin diseases can be aggravated by stress including acne, pruritus (itch) and psoriasis. Try stress-relieving measures such as home exercise or mindfulness, and try to maintain social-connectedness using technology where in-person contact is no longer possible.

– Certain foods are also known to aggravate itch and facial redness through histamine release or by opening up blood vessels. These include red wine and dark chocolate which you may be consuming more of at this time!

– Now is a good time to focus on diet, especially concentrating on water and vegetable intake. There is a considerable anti-inflammatory effect to be gained from eating a good mix of vegetables. Vitamin A , which has a beneficial role in acne treatment, is especially found in red and orange vegetables such as carrots, and is better absorbed if the carrots are cooked rather than raw and eaten with some oil or fat.

– Vitamin D is especially beneficial to the immune system. It also helps the gut to absorb calcium and phosphorus which are essential for bone health. Low levels have been associated with depression, fatigue and muscle weakness among other things. While it is found in food such as egg yolk, salmon and fortified foods, we mainly make our vitamin D in the skin as a result of sun exposure from April to September. While the best time for vitamin D manufacture is around midday, this is also the time of greatest risk of sunburning which increases the risk of skin cancer, especially malignant melanoma, so it is important to balance the benefits of vitamin D with the risks of sun burn – be careful to cover up or apply sun protection before your skin begins to turn red.

– If you are prone to acne, try to avoid touching your face or leaning your face on your hand when studying or working, as this can stimulate oil glands. If you hold your phone close to your skin a lot, your should clean it regularly as a build up of dirt, oil and makeup can transfer to your skin aggravating acne.

– Be cautious with home hair colouring if you have not used it previously. As per the product instructions, it is important to do a patch test for contact allergy EACH time you use hair colour.

– If considering a home-piercing or tattoo – stop. It is very hard to remove a home-done tattoo by laser due to the uneven depth of ink placement, while there is high risk of serious infection from piercings.