Content » Vol 101, September

Investigative Report

Skin Exposures, Hand Eczema and Facial Skin Disease in Healthcare Workers During the COVID-19 Pandemic: A Cross-sectional Study

Nils Hamnerius, Ann Pontén, Ola Bergendorff, Magnus Bruze, Jonas Björk, Cecilia Svedman
DOI: 10.2340/00015555-3904


The COVID-19 pandemic has led to enhanced hygiene procedures and use of personal protective equipment, but also to increased attention to occupational skin disease in healthcare workers. The occurrence of hand and facial skin disease in > 5,000 Swedish healthcare workers was investigated in a questionnaire survey. Levels of skin exposure related to hygiene procedures and personal protective equipment were recorded. Caring for patients with COVID-19 entailed higher levels of wet work and face mask exposures, and was associated with higher 1-year prevalence of both hand eczema (36%) and facial skin disease (32%) compared with not being directly engaged in COVID-19 care (28% and 22%, respectively). Acne and eczema were the most common facial skin diseases; for both, a dose-dependent association with face mask use was found. Dose-dependent associations could be shown between hand eczema and exposure to soap and gloves, but not to alcohol-based hand disinfectants.


Occupational skin disease was investigated in more than 5,000 healthcare workers. Wearing a face mask for more than 3 h daily was associated with facial skin disease, most commonly eczema and acne. Washing hands with soap more than 20 times daily and wearing gloves for more than 3 h daily was associated with hand eczema. Healthcare workers caring for COVID-19 patients were more exposed to face masks, soap, and gloves, and more often had face and hand skin disease. This indicates that the specific work routines related to the care of patients with COVID-19 increases the risk of occupational skin disease.

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