PREVENTION OF DRYNESS AND ECZEMA OF THE HANDS OF HOSPITAL STAFF BY EMULSION CLEANSING INSTEAD OF WASHING WITH SOAP

The acceptability of two handwashing/cleansing methods, cleansing with emulsion or washing with liquid soap and water, were compared in a randomized, prospective long-term study. Thirty-eight members of hospital staff who had a history of hand skin dryness or eczema and a need for frequent handwashing used either liquid soap or emulsion for handwashing or cleansing. The clinical assessment of skin condition was done blindly by the same dermatologist at the onset of the study, and after 2 and 4 months with a predetermined scoring system. The median skin dryness index of persons in the liquid soap group increased significantly from an initial 1·4 to 3·6 during the 4-month winter study period (P < 0·001), while the corresponding figure in the emulsion group decreased during the same time from 1·9 to 1·1 (P = 0·053). The difference in dryness between the groups was significant after 2 months (P = 0·04) and after 4 months (P < 0·001). After 4 months, six people in the emulsion group had no dryness of the hands compared to only one in the liquid soap group. Similar trends were noticed in the occurrence of eczema. The median eczema index decreased significantly in the emulsion group from 0·4 to 0·1 during the study. In the liquid soap group, the increase in the median eczema index was from 0·4 to 0·7 (difference not significant). On an individual level, the eczema became worse in only one subject in the emulsion group, but in seven in the liquid soap group. The use of emulsion instead of liquid soap and water as a component of hand hygiene reduces drying of the skin and even the occurrence of eczema caused by frequent handwashing and aggravated by the cold and dry winter season. The study further stresses the importance of long-term studies in testing the compatibility of handwashing methods. © 1991.