Take care of your skin at home and at work.

There is delicate balance to be maintained in cleansing and protecting the integrity of the skin whilst at the same time preventing damage such as dermatitis. Prolonged exposure to some substances, even such simple ones as hot water can challenge the skins protective mechanisms. 

The Hazards

When it comes to the skin there are two main classes of hazards

1.      Physical  

2.      Chemical

 
1.      Physical and Environmental

• Direct and indirect heat can alter the makeup of the skin cells thereby changing the amount and/or nature of the natural fats on the surface.

• Cold can reduce the circulation to the peripheries and thereby result in dry skin.

• The sun’s UVA & UVB rays can burn the skin, cause dryness and even skin cancer.

• Wind can also exacerbate the effects of cold and UV light.

• Sharp items can break the continuity of the barrier and predispose the body to various infections.

• Excessive moisture and that includes sweat, can both irritate it and increase its permeability.

• Abrasive materials can rub away the outer surface exposing the more delicate dermal layer as well as the nerve endings and capillaries.

• Dirt and grime can irritate the skin by blocking its pores thereby reducing its ability to release sweat.

2.      Chemical

• Chemicals can enter the body through the skin by permeation (this means movement through the skin without causing any visible damage) or through damaged skin, e.g. cuts, abrasions, etc. Each individual’s reaction to chemicals can vary and especially if they have skin allergies. Broken skin conditions such as eczema and dermatitis may also increase chemical absorption.

Chemical groups to be aware of  …

• Acids and Alkalis can damage the skin by burning it and some toxic chemicals like phenol can be absorbed through the skin.

• Solvents and mineral oils break down the lipid structure thereby increasing the permeability of the skin.

• Many proprietary cleaning agents and detergents like dish & hand washing liquids can cause skin irritation.

• Any substance that is labelled as ‘hazardous’.

Protecting your Skin

• The simplest way to protect your skin would of course be to avoid its exposure to hazards but this of course is not always practical. The easiest way to prevent damage is to use gloves which were designed to protect against a wide range of physical and chemical hazards. Take into account however that your choice will depend on the hazard, length of exposure and the amount of dexterity required when undertaking a task.

• Creams marketed as pre-work barrier creams have a somewhat limited role in protecting the skin from coming into contact with hazardous substances and they are no substitute for gloves. They should not considered reliable as despite their name many chemicals can easily penetrate them. Pre-work creams will however make it easier to remove dirt when cleansing, thereby reducing the necessity for abrasive scrubs and powerful detergents.

• Vanishing Creams – trap contaminants such as resins and dyes

• Water resistant creams -repel water based chemicals

• Oil and organic solvent resistant creams – protect against oils and tars.

Cleansing

• Proper cleansing will remove irritants and help to maintain healthy skin. After a task is completed your hands should be promptly cleaned with a suitable cleanser. Water alone is insufficient and may in fact spread contaminants rather than removing them.

The 4 main contents of skin cleansers are …

• Surfactants - contained in hand soaps should remove insoluble particles but be aware that different types of surfactants will vary vis a vis their skin compatibility. Some will be mild and only effective for mild soiling whilst others will contain an anti-microbial agent and might even cause skin damage when used repeatedly.

• Scrubbing agents - mechanically remove contaminants which might have adhered to the skin. Their abrasive action can damage the skin’s integrity and should be used sparingly.

• Organic solvents – will dissolve substances such as paint but all organic solvents will result in a de-fatting of the skin to some degree and milder solvents such as acetates and alkanes are preferred.

• Alcohol Gels - are used to remove micro-biological contaminants for infection control in hospital settings since they reduce the need for frequent hand washing. The gel must be allowed to dry completely before putting on gloves or resuming contact with patients.

• It is essential to thoroughly dry hands after cleansing since damp hands transmit bacteria 500 times faster than dry hands and drying hands on high quality paper towels is the best solution.

Restoring moisture

• Emollients (moisturisers) reduce water loss from the outer layer of the skin by covering it with a protective film and this helps to retain the skin’s moisture .

• Emollients are very safe as they are not active drugs and do not get absorbed through the skin into the body. There are many types and brands of emollients on the market ranging from runny lotions to thick ointments.

How to choose an appropriate emollient

• In general the best emollient is of course the one that suits the individual and different emollients may be necessary depending on the dryness of the skin. Emollients vary from being very greasy (ointments) to less greasy (creams) and the main difference between lotions, creams and ointments is the proportion of lipid (oil) to water. The lipid content is lowest in lotions, intermediate in creams and highest in ointments. The higher the lipid content, the greasier and the stickier it feels and the shinier it looks on the skin. As a general rule, the higher the lipid content the better and the longer it will works but it will also be the messiest to use.

• If only mild skin dryness is being experienced then a simple lotion or cream may be the best option. A thicker cream or an ointment is normally the best when there is moderate to severe dryness. Creams are usually less messy but you’ll need to put them on more frequently than you would the ointments.  If you have hairy hands then a lotion would most probably be the best solution.

• Emollients that are recommended for the workplace should be mild and non-perfumed. Some people will at times become allergic to an ingredient and this will often make a skin inflammation worse rather than better.  There are extensive ongoing discussions about Lanolin allergy and it is very commonly used in emollients because it is a good emulsifier. It binds well with water and is easily absorbed into the skin.

• Although lanolin is a relatively weak sensitizer, allergies to it are not uncommon because of its frequent use on broken and inflamed skin and individuals that feel that they are perhaps susceptible to skin allergies should check the ingredients of their chosen emollient.

When should emollients be applied?

• This will vary between individuals and will also depend on how bad the skin dryness has become. A good starting point would be to apply it 2-3 times a day but some people may need to increase this to up to every hour if the skin remains very dry.

• A frequent error is to stop using emollients simply because the skin appears to be in good condition.

What to do if improvements do not occur or a condition worsens?

• There are many different types of emollients with a variety of ingredients and change to a different type will often solve any problems that may be experienced. On the other hand a switch to an ointment would be another option as ointments do not usually contain preservatives.

• Finally, if a condition looks serious and appears to be worsening, visit a health professional.