Skin Health on the Frontline: Protecting Healthcare Workers from Occupational Dermatitis

Occupational contact dermatitis (OCD) is one of the most prevalent work-related skin conditions among healthcare workers, affecting an estimated 10–30% of nurses and other clinical staff. Paradoxically, this condition — caused in large part by the very infection prevention measures healthcare workers are required to perform — can itself increase infection transmission risk. Damaged skin loses its integrity as a physical barrier, harbouring more pathogenic organisms and shedding more organisms during patient care.

Healthcare workers with symptomatic dermatitis are also significantly less likely to perform hand hygiene at the required frequency, creating a vicious cycle of reduced compliance and increased infection risk. Understanding and preventing OCD is therefore not merely an occupational health issue — it is an IPC imperative.

Types and Causes

Irritant contact dermatitis (ICD) is the most common form, caused by cumulative exposure to water, detergents, and chemical irritants. It typically presents as redness, dryness, cracking, and fissuring of the hands and wrists. Allergic contact dermatitis (ACD) is an immune-mediated reaction to specific allergens — most commonly latex proteins (from latex gloves), preservatives in ABHR products, and fragrances in skincare products. ACD causes more intense inflammation and requires identification and avoidance of the specific allergen.

Evidence-Based Prevention

Effective prevention strategies include: selecting ABHR products with added emollients (most modern products contain these — check the formulation); providing skin moisturiser containing dimethicone or glycerin in all clinical areas and encouraging use after each shift; switching to nitrile latex-free gloves facility-wide to eliminate latex sensitisation; avoiding antibacterial soaps with triclosan or high concentrations of iodine for routine hand hygiene; and providing occupational health assessment for any healthcare worker with persistent symptoms. Early identification and management of OCD prevents progression to chronic disease and supports sustained hand hygiene compliance.