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Physiologic and Microbiologic Changes in Skin Related to Frequent Handwashing

Published online by Cambridge University Press:  02 January 2015

Elaine Larson ,
James J. Leyden ,
Kenneth J. McGinley ,
Gary L. Grove  and
George H. Talbot
Elaine Larson*
Affiliation:
Robert Wood Johnson Foundation, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Department of Dermatology, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania University of Pennsylvania Section of Infectious Diseases, Philadelphia, Pennsylvania
James J. Leyden
Affiliation:
Robert Wood Johnson Foundation, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Department of Dermatology, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania University of Pennsylvania Section of Infectious Diseases, Philadelphia, Pennsylvania
Kenneth J. McGinley
Affiliation:
Robert Wood Johnson Foundation, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Department of Dermatology, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania University of Pennsylvania Section of Infectious Diseases, Philadelphia, Pennsylvania
Gary L. Grove
Affiliation:
Robert Wood Johnson Foundation, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Department of Dermatology, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania University of Pennsylvania Section of Infectious Diseases, Philadelphia, Pennsylvania
George H. Talbot
Affiliation:
Robert Wood Johnson Foundation, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Department of Dermatology, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania University of Pennsylvania Section of Infectious Diseases, Philadelphia, Pennsylvania
*
Johns Hopkins University School of Nursing, 600 N. Wolfe St., Baltimore, MD 21205
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Abstract

Handwashing practices may be adversely influenced by the detrimental effects of handwashing on skin. A protocol was developed to assess the physiologic and microbiologic effects of frequent handwashing. Fifty-two female volunteers washed their hands 24 times per day for 5 days. Five agents were tested: water alone, non-medicated bar soap, a chlorhexidine-containing antiseptic, and two agents containing povidone-iodine (one currently available on the market and one being tested for possible marketing). Some damage to the outer membrane of skin, the stratum corneum, occurred in all groups. There were significant changes in the amount of evaporation water loss (p=.001) and in self assessments of skin condition (p=.005) from pre-to-post test for the entire group. Skin damage was also assessed by visualizing desquamating stratum corneum cells, which are shed in large aggregates when detergents injure skin. Significantly less such shedding occurred in subjects using water alone, bar soap, and the Chlorhexidine formulation (p=.02). Greater antimicrobial activity of an agent was not correlated with increased skin trauma. We have quantitated, using objective physiologic parameter, the skin damage that occurs during even a short period of frequent handwashing. We recommend that further studies using the methods described be conducted to quantitate skin damage over longer periods of time, more closely resembling handwashing practices of health care personnel.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 7 , Issue 2 , February 1986 , pp. 59 - 63
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

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