Hand hygiene without compromise

Ego Pharmaceuticals Pty Ltd
By Josh Townley PhD, Senior Scientific Writer – Projects
Saturday, 02 March, 2024

Hand hygiene without compromise

Improving skin hydration as an outcome of good hand hygiene practice

According to the World Health Organization (WHO), proper hand hygiene is the single most effective action to stop the spread of infection.[1] But for many healthcare workers, hand hygiene compliance can mean washing their hands 20 times or more per day, and as Loh and Yew showed in a recent systematic review and meta-analysis, this carries an increased risk of Occupational Contact Dermatitis (OCD).[2]

New Aqium Moisturising Gel, containing 70 percent w/w ethanol - absolute, is clinically proven to kill germs without compromising skin hydration, pH or barrier integrity over repeated use.[3]

OCD is a common skin condition among healthcare workers, with symptoms including redness, itching, dryness, and cracking of the skin.[4] These symptoms can be caused or exacerbated by frequent hand washing and exposure to irritants such as harsh soaps or disinfectants.[5]

A 2014 survey of healthcare workers found a one-year prevalence of around 21 percent, which increased to 28 percent during the COVID-19 pandemic[6] and OCD accounts for 90–95 percent of all occupational skin disease.[7]

Given the critical role that healthcare workers play in patient care, it is vital to address this occupational hazard and provide evidence-based recommendations to minimise nosocomial transmission of infections, without compromising skin health.

Clinical Study


While many different hand sanitiser formulations contain moisturising ingredients to offset the drying effect of alcohol, including the WHO hand rub formulations,[8] very few are backed up with clinical evidence that demonstrates their impact on the skin with repeated use.

A Dermal Tolerability Study using Aqium Moisturising Antibacterial Hand Gel was commissioned by Ego Pharmaceuticals under conditions that mimic typical use of disinfectant hand sanitisers by hospital staff — sanitising hands around 20 times per day over a period of two weeks (n = 33). The test product was also used on one forearm, according to normal use conditions.

Skin hydration, Transepidermal Water Loss (TEWL) and skin pH were measured on Day 1 (baseline) and Day 15 (treated forearm only). Dermatological assessments were performed on both hands by a physician at baseline and at Day 15. Participants also completed a subjective questionnaire after two weeks (Day 15).


By measuring skin hydration and TEWL (forearm) at the start and end of the study, it was clear that Aqium Moisturising Antibacterial Hand Gel significantly improved skin hydration after two weeks of daily use (Figure 1). While TEWL also increased at the end of two weeks, the values were still in the range of normal healthy skin (Figure 2). Therefore, no negative impact on skin barrier was observed. Skin pH (forearm) was also unchanged by using the product — an important consideration, since some alcohol hand gels have been shown to disrupt skin pH,[9] and this can contribute to the development of OCD.[10]

Key results

  • 14 percent increase in skin hydration
  • Minor increase in TEWL but still within the range of normal healthy skin
  • No effect on skin pH, which remained within normal levels
  • Dermatological assessments of the hands by physicians reported no negative impact to skin
  • 94 percent of participants felt Aqium Moisturising Antibacterial Hand Gel cared for their skin
  • 93 percent of participants felt it was gentler than their usual hand sanitiser
  • 91 percent of participants felt their skin was well hydrated and felt good after repeated use


OCD can have both personal and economic consequences for healthcare professionals including impaired quality of life and an inability to work.[11–13] For medical facilities, impacts include the costs of medical care and sick leave, lost productivity and in some cases, workers’ compensation claims.

Frequent application of Aqium Moisturising Antibacterial Hand Gel has been clinically proven to improve skin hydration overall. Aqium Moisturising Antibacterial Hand Gel has high clinical acceptance and no negative impacts on hand health.

To request a sample pack of Aqium Moisturising Gel » click here


* Note Figures 1 & 2:
Some data was excluded due to implausibly high or low values. Data outliers were identified and excluded by the investigating laboratory and may be the result of data measurement errors or unknown environmental variables.


1. World Health Organization. Key facts and figures [Internet]. 2021 [cited 2024 Feb 16]; Available from: https://www.who.int/campaigns/world-hand-hygiene-day/2021/key-facts-and-figures

2. Loh EDW, Yew YW. Hand hygiene and hand eczema: A systematic review and meta-analysis. Contact Dermatitis 2022;87(4):303–14.

3. Ego Pharmaceuticals. Commissioned external study. Average increase in skin hydration (corneometer), average change in TEWL (Teawameter), average change in pH (skin pH meter) over 14 days using Aqium Moisturising Antibacterial Hand Gel, 20 ±2 applications per day. Physician and participant assessments. n=3 2023;

4. Sasseville D. Occupational contact dermatitis. Allergy Asthma Clin Immunol 2008;4(2):59–65.

5. Kampf G, Loffler H. Prevention of irritant contact dermatitis among health care workers by using evidence-based hand hygiene practices: A review. Ind Health 2007;45:645–52.

6. Hamnerius N, Pontén A, Bergendorff O, Bruze M, Björk J, Svedman C. Skin exposures, hand eczema and facial skin disease in healthcare workers during the COVID-19 pandemic: a cross-sectional study. Acta Derm Venereol 2021;101(9):adv00543.

7. Lushniak BD. Occupational contact dermatitis. Dermatol Ther 2004;17(3):272–7

8. World Health Organization. WHO-recommended handrub formulations [Internet]. In: WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. World Health Organization; 2009 [cited 2024 Feb 21]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK144054/

9. Jansen van Rensburg S, Franken A, Du Plessis JL. Measurement of transepidermal water loss, stratum corneum hydration and skin surface pH in occupational settings: A review. Skin Res Technol 2019;25(5):595–605.

10. Japundžić I, Novak-Hlebar I, Špiljak B, Kuna M, Yale K, Lugović-Mihić L. Skin features important for the occurrence of contact dermatitis in healthcare workers. Acta Clin Croat 2022;61:692–702.

11. Higgins CL, Palmer AM, Cahill JL, Nixon RL. Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014: OSD IN AUSTRALIAN HEALTHCARE WORKERS 1993-2014. Contact Dermatitis 2016;75(4):213–22.

12. Lau MYZ, Burgess JA, Nixon R, Dharmage SC, Matheson MC. A review of the impact of occupational contact dermatitis on quality of life. J Allergy 2011;2011:112

13. Smedley J, Williams S, Peel P, Pedersen K. Management of occupational dermatitis in healthcare workers: a systematic review. Occup Environ Med 2012;69(4):276–9.

Image credit: iStock.com/miniseries

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