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Affects on skin washed with soap

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In an investigation, the effect on skin of repeated use of two washing agents, all skin function tests (stratum corneum capacitative resistance, lipids, transepidermal water loss, pH, laser Doppler flow, and skin reddening), were markedly changed after a single wash, and after 1-week further damage was noted (52). 

In a study of irritant skin reactions induced by three soap surfactants, damage lasted for several days; complete skin repair was not achieved for 17 days (53). 

Soaps and detergents have been described as the most damaging of all substances routinely applied to skin (43). 

Anionic and cationic detergents are more harmful than nonionic detergents (54), and increased concentrations of surfactant result in more rapid, severe damage (55). Each time the skin is washed, it undergoes profound changes, most of them transient. However, among persons in occupations such as health care in which frequent handwashing is required, long-term changes in the skin can result in chronic damage, irritant contact dermatitis and eczema, and concomitant changes in flora. 

Irritant contact dermatitis, which is associated with frequent handwashing, is an occupational risk for healthcare professionals, with a prevalence of 10% to 45% (56-58). The prevalence of damaged skin on the hands of 410 nurses was reported to be 25.9% in one survey, with 85.6% of nurses reported to have problems at some time. 

Skin damage was correlated with frequency of glove use and handwashing (56). Washing with plain soap may actually increase the potential for microbial transmission because of a 17-fold increase in the dispersal of bacterial colonies from the skin of the hands (59). Skin condition clearly plays a major role in risk for transmission.

Microbiology of Hands of Health-Care Professionals damaged skin more often harbors increased numbers of pathogens. Moreover, washing damaged skin is less effective at reducing numbers of bacteria than washing normal skin, and numbers of organisms shed from damaged skin are often higher than from healthy skin (60,61).

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