If the constant handwashing and skin disinfection over the past months has taken its toll on your hands, leaving them dry, damaged and looking 10 years older, read on, as I have some important information for you. However, before I tell you about the solutions available, let’s talk about what exactly is happening to your hands right now.
What happens to the skin on our hands when it gets incredibly dry? And why does this happen?
Dry hands can be caused by a variety of factors including genetic predisposition to eczema, strong detergent and disinfectant contact as well as frequent hand washing, ultimately resulting in increased ‘transepidermal water loss’ known as TEWL. TEWL is the invisible water evaporation that happens via our skin all the time. Increased water loss from the skin ultimately leads to a reduced water content in the outer horny layer of the skin (so-called stratum corneum).
In healthy, well hydrated skin, there is a nice balance between water loss via evaporation, and water holding capacity of the skin. However, when this balance is out of sync, for example from frequent hand washing and disinfectant use, the increased TEWL leads to a lower water content in the stratum corneum. A well hydrated stratum corneum contains approximately 30% water. If it’s below 10%, we feel that as dry skin.
As a consequence of the reduced stratum corneum water content, the horny layer also loses its flexibility and the skin surface may become cracked and flaky.
So, how can frequent hand washing and disinfectant use lead to increased TEWL?
It happens because the detergents in hand wash/soap and the alcohol in skin disinfectants will dissolve some of the lipid components in the skin that are important for holding on to water in the skin and preventing excessive TEWL. As dermatologists, we call this ‘impaired barrier function’. When the skin’s natural barrier function gets damaged (by frequent hand washing and disinfectant use for example), increased water evaporation from the skin is the consequence, which leads to dry and flaky, possibly cracked skin.
When our skin’s barrier function is weakened, this also leads to an increased risk for developing contact dermatitis. Contact dermatitis looks similar to eczema and is itchy. It is a common issue on our hands and can be caused by either irritation or an allergy.
What is the best home treatment for dry, damaged hands?
As in the current Covid situation, you will need to continue washing your hands more often than usual, it’s important to try and prevent dry skin and cracks by using the right type of hand wash as well as increasing your hand cream use (and using the right type!). Prevention is better than cure…
While detergent based hand washes and soaps are very drying for your skin, emollient washes do not dry your hands. An example of a hydrating emollient wash is Dermol lotion, which also contains an antiseptic ingredient. So, my first tip is to have a 500ml pump container of Dermol lotion on each sink in the house (and office, if possible). This is available at Boots and all high-street chemists.
It is also important to increase the frequency of hand cream application and upgrade your hand cream to a more hydrating, richer version. The most important time to apply hand cream is straight after hand washing, when your skin is still damp. This is to lock in moisture and stop excessive water evaporation from your skin. Wash your hands first, then pad dry them and apply the moisturiser straight away, so that evaporating water doesn’t draw even more moisture from your dry skin. So, my second tip is to have a hand cream pump container on each sink in the house (and office, if possible…), next to your Dermol lotion to wash with. Having a hand cream on each sink, will also act as a reminder to apply hand cream often.
In theory, Dermol lotion itself can be used as emollient as well as as a wash. However, because of the antiseptic ingredient, it can be slightly irritating, if used as a leave-on product in my experience, so my recommendation is to use a separate hand cream.
This hand cream should be lipid rich. Neutrogena’s Concentrated Norwegian formula is an example of an inexpensive lipid rich formula (ideally use the non-fragranced version). Again, this is available at Boots and high-street chemists.
Personally, I love NeoStrata’s Problem Dry Skin cream (available at EUDELO), which is particularly great for overnight deep hydration (when you don’t have to touch anything, as it’s very rich). This hydrates even dry skin immensely, but make sure not to use it on cracks and fissures, as the hydroxy acids will sting on cracked skin.
You can make any hand cream work even harder, if you apply a thick layer under cotton gloves overnight.
A few days of applying rich emollients will make a big difference already, however, it may take a full epidermis renewal cycle (which is about 4 weeks) to fully restore your skin, so prevention really is key.
If the skin on your hands is so damaged, that contact dermatitis or deep cracks developed, you may need to see a doctor, ideally a dermatologist, for a short course of an anti-inflammatory prescription cream (steroid creams), as it can be tricky to restore strongly damaged hands without that (especially if you have to keep washing your hands). These prescription creams work stronger than over-the-counter creams and can help even the most damaged skin.
EUDELO offers dermatologist consults in person in clinic or as virtual video consultations from the comfort of your own home. We can then arrange for the prescription to be send to your home.
What is the best in-clinic treatment for damaged, old looking hands?
In recognition of the past few months that have been extremely hard on everybody’s hands and may well have added 10 years to the visual appearance of your hands, EUDELO has created the Lockdown Hand Rescue treatment. This will revitalise your skin and restore youthful looking hands by combining HA (Hyaluronic Acid) Skin Boosters with Platelet Rich Plasma (PRP) Needling, resulting in noticeably smoother, more hydrated and younger looking hands.
HA Skin Boosters work to improve plumpness of the skin and gently replace lost volume on the backs of the hands in a very natural looking way. They hide the gaunt looking veins and tendons on the back of the hands, whilst improving skin hydration, roughness and elasticity, making the hands appear smoother, feel softer and look younger.
PRP Needling provides a firming, regenerative, 100% natural treatment that encourages the skin to build more collagen and elastin to rejuvenate itself. PRP Needling is a combination of medical strength needling and infusion of a physiological mix of multiple growth factors (derived from your own blood, AKA ‘vampire facial’, but for the backs of your hands) back into the skin. These growth factors will then stimulate fibroblast skin cells to produce fresh collagen and elastin.
If you are interested in any of the above, just give us a ring on 020 7118 9500 to discuss. We are looking forward to helping your hands.