Ask the Ecz-perts: the latest about COVID-19 and eczema

A woman applies hand sanitizer
Ask the Ecz-perts

By Jose Torres

Published On: Aug 4, 2020

Last Updated On: Aug 24, 2020

Ask the Ecz-perts gives leading medical experts an opportunity to answer your most pressing questions about eczema and its related health conditions. 

We’re looking for non-stinging or drying hand sanitizer to send to school that will protect against COVID. Any suggestions?

With respect to hand sanitizers, the issue is that only sanitizers with a 60% or greater alcohol content are effective. Some sanitizers add moisturizer or aloe to them, which can be helpful. The alternative is a good handwashing. Remember that soap-free cleansers are fine and that we don’t need irritating detergents to wash. Just do the gentle rubbing for 20 seconds, rinse, pat dry and then apply a good moisturizer.

Some people have chosen to wear gloves and change them frequently, applying sanitizers to the gloves. All of these techniques are more difficult to manage with children. If the hands get worse with the washing and sanitizing, be sure to talk with your doctor to get some effective treatment for the dermatitis. Perhaps you will need to ramp up the potency during this period.

What effect if any does Dupixent have on COVID-19?

Dupixent theoretically should not impair your ability to fight off COVID-19 (nor should having eczema). It works be suppressing a very specific arm of the immune system called TH2 immunity, which is only known to be helpful in handling parasite infection. We know of no issue in handling viral infections. As such, it may be the safest “systemic”/non-topical medicine out there during this pandemic.

In contrast, some of the oral or injectable “immunosuppressants” have broader effects on our immunity and could be an issue. Fortunately, to date, only taking steroids by mouth or injection appear to increase the risk, but we do not recommend these steroids anyway for treating eczema other than for very infrequent special situations (topical steroids are fine for limited amounts of time).

When I’m outside of my home I use disposable food gloves to cover my hands and then throw them away once I’m back in my clean environment. If I’m not able to wash my hands due to a severe flare, is this effective for protecting myself from COVID-19?

Just as if you had hands without gloves, you can transfer from gloves to your face (don’t touch your face!) or transfer something you pick up to a doorknob, food, etc. That said, we are more worried these days about what we breathe in (wear that mask) and have contact our mucous membranes (mouth and nose). So, it’s fine to wear gloves as long as you wash them repeatedly like you would your hands and remember that they can have the virus on them.

Any recommendations on masks for children with severe facial eczema as they go back to school?

Yes, these are big challenges. Although “N95s” and “procedural masks” are the best out there, the materials that they are made of are paper and rough. I think that soft cloth with a tight weave is among the softest and is fine for children. The other issue is the moisture from our breath that accumulates and can be irritating, in addition to the rubbing. So, I do recommend that the face be protected by a good moisturizer before putting on the mask.

Amy Paller, MD, chair of the department of dermatology at Northwestern University Feinberg School of Medicine and pediatric dermatologist at the Ann and Robert H Lurie Children’s Hospital of Chicago