It is imperative that we follow the guidelines laid down by the World Health Organisation (WHO) and the government with respect to personal protection against novel coronavirus disease (COVID-19). Part of this is practising hand hygiene -- frequently washing hands with soap and water or application of sanitisers.
While hand hygiene is an excellent method to prevent the infection from spreading, it is also important to protect our skin from adverse reaction to frequent hand-washing or use of alcohol-based rubs. Even though COVID-19 is not skin loving, the pandemic has affected dermatology specialty in more ways than one.
Dermatologists are noticing an increase in patients showing up with hand eczema/dermatitis caused due to irritation by exaggerated hand washing with soaps, predominantly made of chemicals. As we cannot shy away from frequent hand washing, it is highly recommended that such patients apply a moisturiser cream after every hand wash. Also, there have been instances where a few patients have mistakenly wiped their faces with alcohol-based sanitisers, resulting in irritation of the facial skin or aggravation of an existing skin condition.
Stress and anxiety
These problems are common in people with dry skin and with an atopic (skin allergy) background. During the pandemic, it is likely that we are under continuous stress and anxiety at a subconscious level. Since, skin disorders also have a co-relation with emotional/mental stress, the current scenario is expected to exacerbate the existing skin conditions in patients. Patients with chronic skin condition and who are on long-term medication for the same are advised to consult their dermatologists on continuing the medicines.
Health care professionals, including doctors, nurses and other paramedical staff, too develop skin problems due to prolonged use of personal protection equipment (PPE).
Continuously wearing gloves can cause hand dermatitis and wearing of occlusive masks, goggles for long hours has led to facial itching, rash, and dermatitis and use of protective caps has led to itching, folliculitis, and seborrheic dermatitis of scalp in some professionals. Therefore, it is important to continue using PPE along with skin emollients, barrier creams, moisturisers, and skin-friendly soaps/shampoos.
With regard to direct manifestation of COVID-19, there have been reports about skin changes in patients. The skin changes were seen in 20.4% of the 88 patients in a study from Lombardy region of Italy (published in the Journal of European Academy of Dermatology & Venereology by Relcalcati S.). Another study from China by Guan W J. et al., in the New England Journal of Medicine noted rash in only 0.2% of 1,099 COVID-19 patients.
Use teledermatology
Some skin disorders worsen with stress requiring immediate attention of dermatologists. With lockdown in force, patients are unable to access dermatological care, since most clinics are temporarily closed as a precautionary measure. This problem can be solved by using telemedicine/teledermatology practice.
It is prudent to provide teledermatology care to non-emergency skin conditions and the dermatologist will be the right person to decide whether a patient needs in-person consultation.
There are some general ways to keep your skin and body in good health during this period. People should maintain a proper schedule with respect to food, sleep and moderate physical activity. One should engage in a constructive activity (like yoga, meditation, reading, other hobbies), regulate their news feed, stay positive and practise social distancing.
