INTRODUCTION
The COVID-19 pandemic represented an unprecedented global health emergency. Initially categorized as primarily a respiratory disease, the disease can involve other organ systems and may have direct skin manifestations, including exanthems, morbilliform eruption, generalized urticaria, or pseudo-chilblains -- commonly called "COVID Toes".1-3
These safety strategies have given rise to indirect skin manifestations of COVID, particularly among healthcare workers.4 In fact, the effects on the facial skin from long-term mask-wearing have been popularly termed "maskne." "Maskne" and handwashing dermatitis are particularly common among healthcare workers.5
However, excessive washing of hands, often a compulsive behavior by some individuals in their everyday life beyond what is reasonable and practical, is fraught with adverse effects on skin primarily related to significant skin barrier damage and the potential for adverse effects on the skin microbiome. Once the skin is affected with marked xerosis and dermatitis, handwashing and mask-wearing may become painful, leading to the potential for individuals to become lax regarding safety measures and thus putting themselves and others at risk for exposure to infection.
Millions of people around the world wore face masks and shields for prolonged periods in efforts to minimize transmission of SARS-CoV-2, the novel coronavirus that causes COVID. Additional risk mitigation strategies included frequent handwashing and glove-wearing. Although the height of the pandemic has long passed, many individuals, organizations, and healthcare facilities still continue the practice of wearing face masks.
These safety strategies have given rise to indirect skin manifestations of COVID, particularly among healthcare workers.4 In fact, the effects on the facial skin from long-term mask-wearing have been popularly termed "maskne." "Maskne" and handwashing dermatitis are particularly common among healthcare workers.5
The skin signs of maskne can be consequential for affected individuals. It is interesting to note that another risk mitigation strategy common in the era of COVID-19, frequent handwashing, is also associated with a skin manifestation in the form of hand dermatitis, characterized by excessive dryness, scaling, erythema, and even skin tears and fissures. Handwashing is important in healthcare facilities to prevent infection, and such preventative measures are important to carry out consistently.6
However, excessive washing of hands, often a compulsive behavior by some individuals in their everyday life beyond what is reasonable and practical, is fraught with adverse effects on skin primarily related to significant skin barrier damage and the potential for adverse effects on the skin microbiome. Once the skin is affected with marked xerosis and dermatitis, handwashing and mask-wearing may become painful, leading to the potential for individuals to become lax regarding safety measures and thus putting themselves and others at risk for exposure to infection.
