What are the effects of frequent hand-washing on hands and nails?

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Combating the effects of frequent hand-washing on hands and nails

Healthylife Pharmacy25 August 2020|4 min read

With frequent hand washing and the use of antibacterial soaps, hands can become dry and nails weaken. Nails can break or split and the skin on the hands and around the nails may crack or develop dermatitis from the frequent contact with harsh chemicals resulting in dry, red and itchy skin. Open skin offers an opportunity for bacteria and pathogens to enter the body. Whilst it is incredibly important to follow strict hand washing hygiene measures, there are some strategies and supplements which may help combat the damage being done to the hands.

The skin on the hands, like the skin on the rest of the body, is an organ system made to protect the body from outside invaders, it acts as a temperature regulator (thermoregulation), a blood reservoir (housing an extensive network of blood vessels), is involved to some extent the excretion of substances from the body, and absorption of external substances to the cells allows us to experience tactile sensations – touch, pressure, vibration, tickling, hot and cold.

The Skin

The skin contains two main parts, the outer layer being the epidermis (meaning above) and the deeper layer is the dermis. This layer contains connective tissue. A subcutaneous layer of areolar and adipose tissue, the hypodermis, lays below the dermis and is not considered part of the skin. this gives skin its plump, cushion feel.

The skin of the body is structurally the same, with variations to thickness, strength and flexibility. The palms, surfaces of the digits (fingers and toes) and soles of feet are composed of thicker skin.

Protection is provided by:

  • Keratin - a fibrous protein which protects the underlying tissue from microbes, abrasion, heat and chemicals.
  • Lipids which retard the evaporation of water from the skin surface.
  • Sebum from sebaceous glands stops hair and skin from drying and contains bactericidal chemicals which kill surface bacteria. Although these are absent in thicker skin (palms and fingertips).
  • Sudoriferous glands (sweat glands). Acidic pH from perspiration retards the growth of some microbes (numerous in thicker skin).
  • Melanin, a skin pigment, helps protect against the damaging effect of UV light.
  • Sensory receptors protect from harm through pain, heat and cold sensations
  • Langerhans cells in the epidermis alert the immune system to potential harmful microbial invaders, recognising and processing them.
  • Macrophages in the dermis phagocytize bacteria and viruses which have managed to bypass the Langerhans cells.

Nails

The nails are made of hard tightly packed, dead keratinized epidermal cells which form a clear and solid covering over the distal portion of the digits (fingers and toes). A nail root attaches the nail to a layer of epidermal and dermal cells deep in the nail matrix. Blood, supplied by capillaries, gives nails a pink glow. Nails grow from cell division (mitosis) at the nail matrix (located at the proximal portion of the nail). Nail growth is determined by the rate of mitosis which is influenced by age, health and nutrition.

Clearing away germs

Hand washing is most important in preventing the spread of viruses and bacteria which can cause diseases such as viral infection and diarrhoea. Frequent handwashing, using soap and water to lather and scrub the hands and nails for at least 20 seconds, is considered one of the best ways to stay healthy. 


Hand sanitizer is recommended when soap and water is unavailable and is very effective in removing most germs from the skin, but not so good at cleaning dirt, grease, pesticides and heavy metals.

Frequent hand-washing though can remove the natural oils and moisture from the skin leaving it dry and in some cases cracking. Hand sanitizers and disinfectants can cause skin irritation, especially for those susceptible to eczema and dermatitis.

Aging skin and nails

Aging skin can become noticeable usually from late in the fourth decade of life. As skin becomes older there is a decline in the immune response. Skin heals poorly and becomes more susceptible to pathological conditions. Decreased sebaceous gland secretion leads to dry and broken skin more susceptible to infection. The production of sweat reduces making thermoregulation less efficient. Blood vessels thicken and become less permeable and adipose tissue reduces (skin plumbness). The dermis level becomes thinner and the migration of new cells to the epidermal surface slows.

The growth of nails slows down earlier, around the second or third decade of life. Nails can become brittle with age and dehydration. Nail polish removers and cuticle removers can also cause this affect.

Strategies for reducing skin irritation

Frequent hand-washing disrupts the natural protective layer of the skin resulting in dry and irritated skin.

Wear gloves where possible - cleaning, food preparation and dishwashing

Choose the right soap – choose soap which is hypoallergenic, free from perfumes and irritants

Water temperature – use cool or warm water, not HOT

Pat dry rather than rubbing

Moisturise – choose a hypoallergenic, allergy-free lotion, cream or ointment. In severe conditions apply moisturiser under cotton gloves and wear over-night.

  • Lotions contain more water content so are not as effective in moisturising
  • Creams contain less water and are thicker
  • Ointments are effective as they sit on the skin and prevent or slow the natural evaporation of moisture from the skin

Aloe vera, coconut oil, almond oil and shea butter are some effective ingredients in moisturisers. Calendula, manuka honey and zinc oxide offer healing support for skin which is cracked.

Good nutrition. A healthy diet supplies many nutrients needed for skin maintenance, nail growth and strength, and immune function. Supplements which may help include:

Minerals - zinc, calcium and iron

Vitamins - B complex, biotin and Vitamin C

Essential fatty acids - evening primrose and flaxseed oil

References

  1. Tortora, Gerald J and Derrickson, Bryan 2006 Principles of Anatomy and Physiology 11th edition, John Wiley and sons, Inc, USA
  2. https://www.cdc.gov/handwashing/when-how-handwashing.html
  3. https://www.who.int/gpsc/clean_hands_protection/en/
  4. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-skin-protection-with-excessive-hand-washing-masking/
  5. https://theconversation.com/my-skins-dry-with-all-this-hand-washing-what-can-i-do-134146
  6. Hair, Nails, and Skin: Differentiating Cutaneous Manifestations of Micronutrient Deficiency https://onlinelibrary.wiley.com/doi/10.1002/ncp.10321