Skin and Allergic Conditions Linked to Personal Protective Equipment inHealthcare Workers: Burden, Prevention, and Care

Abstract

Background:
Personal protective equipment is essential in healthcare, yet sustained use can provoke irritant and allergic skin conditions that impair comfort, adherence, and work ability. A synthesis focused on burden, prevention, and care is needed to guide procurement and practice.
Methods:
A protocol driven search of PubMed identified studies from inception to March 2025. Eligible designs were clinical trials and cohort studies that evaluated healthcare workers using gloves, masks, respirators, goggles, or face shields, and reported dermatologic outcomes with explicit definitions. Screening and extraction were performed in duplicate, risk of bias was appraised by design specific tools. No metaanalysis was performed.
Results:
Fourteen studies met criteria, seven cohorts and three trials, sample sizes ranged from 17 to 2,053, follow up ranged from 3 days to 10 years. In a hospital cohort, hand rub applied on wet skin increased hand eczema risk, odds ratio 1.78, 95 percent confidence interval 1.11 to 2.87. Apprentice cohorts reported new onset eczema with frequent washing, odds ratio 1.5, 90 percent confidence interval 1.0 to 2.3. Longitudinal glove programs still detected latex sensitization at 1.0 per 1,000 person years and allergic contact dermatitis at 2.50 per 1,000 person years. Consecutive respirator wear increased facial transepidermal water loss and corneocyte fragility over three shifts, consistent with early barrier injury. A cluster trial showed greater reduction in Hand Eczema Severity Index with a structured skincare program versus control, while a randomized cross over trial suggested fewer facial reactions with skin protectants under respirators, fit preserved under monitored conditions.
Conclusions:
Evidence supported modifiable risks, avoid hand rub on wet skin, reduce accelerator and latex exposure, optimize respirator fit and relief schedules, implement moisturization programs compatible with infection prevention.