Maintaining Healthy Skin During the Pandemic… and Beyond

While hand washing has always been important in terms of both health and cleanliness, there has been greater focus placed on hand hygiene during the COVID-19 outbreak.

Professor Ganna Pogrebna of the Birmingham Business School confirms that countries with typically low levels of hand washing and cleanliness have, on average, seen higher rates of COVID-19 transmission compared to regions where hand washing habits are much more common.

Dr. Alex Kharlamov from the Birmingham Law School states that “many factors may have contributed to the spread of COVID-19 around the globe, but handwashing culture alone appears to be an important factor in explaining why some countries have been hit harder by the outbreak”, showing the importance of washing.

How to Wash Hands

To reduce the presence of germs and other pathogens on the skin, experts are advising that people should wash their hands in a certain way. The optimal process involves:

  1. Washing hands for at least 20 seconds, and ideally for 40 seconds
  2. Washing hands aggressively, taking care to wash thumbs and between fingers
  3. Washing hands in warm or hot water
  4. Avoiding hand sanitiser unless hand washing facilities are unavailable
  5. Washing hands frequently

‘Frequently’, in this instance, means very frequently. The Centers for Disease Control (CDC) in the United States recommends washing hands in the following situations:

  • Before, during, and after food preparation (including animal/pet food)
  • Before eating
  • Before tending to the needs of a dependent (including baby changes)
  • Before and after wound care
  • After using the toilet
  • After sneezing, coughing, or blowing the nose
  • After feeding, touching, or stroking a pet or animal
  • After touching rubbish or taking the bin out
  • After being outside in a public place
  • After touching items or surfaces that may be touched by others
  • Before touching the face, eyes, nose, or mouth

While the 5-step washing technique – employed within the above scenarios – can help to reduce the spread of germs, excessive hand washing can result in skin damage.

Protecting the Skin

Unfortunately, the use of antibacterial soaps, alcohol-based sanitisers, hot water, and frequent rubbing can cause the skin on the hands to become dry, rough, and cracked. However, it is vital to adopt good hand washing habits, not only during the pandemic, but beyond. The good news is that there are many different ways to protect the skin.

For many people, the obvious solution to this is to focus on external methods of protection. This may include applying a moisturiser or hand cream after washing to replace lost moisture, or wearing soft cotton gloves overnight to keep moisture locked away within the skin and prevent rubbing. Another option is to gently dab or blot the hands dry after washing with a soft paper towel, rather than using abrasive towels.

What’s often overlooked, however, are the internal factors that could help to protect the skin. As the skin tissues have high cellular turnover, it’s natural to look at solutions at the very foundation of all cells, and that solution is Nicotinamide adenine dinucleotide.

Nicotinamide Adenine Dinucleotide & Skin Protection

Nicotinamide adenine dinucleotide, or NAD for short, is a coenzyme that can be found in every living cell, in every living thing. It’s responsible for a huge range of cellular processes including DNA repair and tissue protection, and as the skin has a remarkably high cellular turnover rate, it naturally uses more NAD than many other types of tissue.

But how can NAD help to protect the skin? Here are a few studies of interest:

  • Studies have found that low levels of NAD in the body can increase the skin’s sensitivity to the sun, resulting in symptoms of UV damage including wrinkles, leathery skin, rough patches, and raised bumps. It’s understood that the reason for this is that the NAD-dependent keratinocyte skin cells are unable to repair DNA following photodamage without optimal NAD levels, leading to cell death. This may explain why over 55s are most likely to be diagnosed with melanoma.
  • When exploring potential treatment options for pellagra – a condition which causes dermatitis along with other symptoms such as gastrointestinal problems and dementia – researchers have identified NAD as a solution to pellagra-related skin complaints. As pellagra is often caused by a nicotinamide deficiency, topical application of NAD has been shown to be effective at treating dermatitis. Other studies have found oral nicotinamide to be beneficial, too.
  • NAD is most commonly of interest to scientists as a contributor in delaying the ageing process, with low levels promoting cellular senescence. In terms of the skin in particular, NAD boosts the activity of the SIR1 gene – a part of the sirtuin protein family – which plays a ‘critical’ role in skin ageing. As aged skin is more susceptible to dryness, thinning, and sensitivity, slowing down the ageing process can be an excellent form of protection from the downsides of hand washing.
  • One way to protect the skin from the effect of harsh soaps and frequent washing is by strengthening the natural barrier function. Topical creams can help with this, but research suggests that NAD can also play a role. NAD is essential for the synthesis of fatty acids and waxy ceramides which both create a ‘barrier’ to protect the skin from external factors. This barrier prevents potentially harmful substances from being absorbed while locking moisture away inside the skin.

The question is, if the body is able to offer inherent skin protection through its own internal coenzyme stores, why did so many people suffer with dry skin and eczema flare ups during the COVID-19 pandemic? The answer lies in the natural depletion of NAD.

NAD levels in the body naturally decline with age, which is understood to play a big role in the development of age-related conditions such as cardiovascular disease and diabetes. Fortunately, however, NAD levels can be restored – easily – simply by including NAD supplements as part of the daily diet, and eating more NAD-rich foods such as fish, milk and green vegetables.

A Healthy New Normal

Although many people have long exhibited good hand washing habits, it is likely that the majority have taken to washing their hands more thoroughly and more frequently since the new coronavirus emerged. And while this is essential to minimise the spread not only of COVID-19 but other viruses and other pathogens, the ‘new normal’ looks set to spark a notable rise in skin complaints. Now is the time to start thinking about how a healthy new normal can be facilitated, through improved protection of the skin.