Frequent Hand Hygiene-Induced Skin Symptoms and Alterations in Hand Microbiota: A Neglected Form of Chronic Occupational Exposure Among Health Care Workers.

BACKGROUND

Frequent hand hygiene is essential for infection control among health care workers (HCWs) but may cause adverse skin effects.

PURPOSE: To assess the relationships between frequent hand hygiene practices, skin symptoms, and microbiota alterations in HCWs.

METHODS

A comprehensive search of 7 databases was conducted to identify articles published between January 2014 and July 2024 in English and Chinese.

RESULTS

A total of 24 studies were included in the review. Frequent hand hygiene was associated with reduced microbial flora in 2 studies and high incidences of skin dryness, itching, peeling, erythema, fissures, burning, and pain in 18 studies. Fifteen studies linked frequent hand hygiene to eczema, dermatitis, acne, and folliculitis, while 1 study found higher Staphylococcus aureus detection in severe eczema cases.

CONCLUSIONS

Prolonged frequent hand hygiene alters hand microbiota and induces various skin symptoms, necessitating attention to chronic occupational exposure among HCWs.