Hand disinfection: how irritant are alcohols?

Irritant contact dermatitis is commonly found on hands of healthcare employees and is often explained by contact to water and detergents. Studies on the dermal tolerance clearly show that the degree of skin irritation is significantly lower after application of alcohol in comparison to detergents. It has also been shown in standardised wash tests using a foam roller that the application of alcohol or water immediately after a detergent-based wash can significantly decrease the degree of skin irritation, probably due to a wash-off of residual detergent. If evidence-based hand hygiene is taught early during nurses training it can substantially reduce irritant contact dermatitis supporting initiatives of primary prevention among healthcare employees. The irritant potential of commonly used alcohols in hand antiseptics is very low. If the skin is pre-irritated, e.g. by detergents or water, alcohols can cause a burning sensation which is, however, not an allergic reaction and does not further harm the skin. True allergic reactions to alcohols have so far not been confirmed. From the dermatological point of view the use of alcohols for hand hygiene has clear advantages over washing with water and detergents.