Year 2021
October 2021


Abstract Title
Impact of hand hygiene and mask-wearing practices on hand eczema and facial acne incidence in healthcare workers during COVID-19 outbreak



NHG1, National University Hospital2 

Background & Hypothesis

Healthcare professionals (HCP) in Singapore were mandated to wear masks and perform frequent hand hygiene since the COVID-19 outbreak. We aim to investigate whether increased hand hygiene measures lead to increased incidence or worsening severity of hand eczema, and investigate the relationship between prolonged mask-wearing and acne.


An electronic survey with questions regarding hand hygiene practices, mask-wearing habits and development or worsening of eczema or acne symptoms was distributed to HCP in National University Hospital (NUH) between 14 April 2020 and 21 May 2020. The study was approved by the institution review board.


515 HCP answered the survey.  Of 88 participants with existing hand eczema, 49 (55.7%) reported worsening symptoms. 242 (46.9%) participants without previous eczema reported new hand eczema-related symptoms. Of 165 participants with existing acne, 111 (67.3%) expressed worsening. 212 participants without prior acne reported new acne-related symptoms. Multivariable logistic regression analysis showed that female gender and increased frequency of handwashing at work was associated with worsening/new hand eczema-related symptoms. Female gender, younger age, and being a pharmacist were associated with worsening/new acne-related symptoms.

Discussion & Conclusion

Prevalence of worsening hand eczema or new hand eczema-related symptoms increased with hand hygiene frequency. No consistent association between duration of mask-wearing and worsening/new acne-related symptoms was found.

The impact of increased hand hygiene and mask-wearing practices are evident among HCP, and likely extends to the general population. Change of hygiene practices and pro-active measures and treatment may help to mitigate the consequences and encourage compliance to hand hygiene and mask-wearing.