End-of-Day Hand Repair for Hygienists and Assistants

By the last patient of the day, a lot of hygienists and assistants have hands that feel tight, rough and sore. The knuckles are red. The skin around the nails is splitting. Then you go home, do the dishes, and start again at 7 a.m.

The routine that keeps patients safe is hard on your hands. You can’t skip it. But you can change what you do at the end of the shift so your hands come back in better shape the next morning. Here’s a routine for the chapped hands dental hygienists and assistants know too well.

What a day chairside does to your skin

Think of the outer layer of your skin like a brick wall. The skin cells are the bricks. Natural oils and lipids are the mortar that holds moisture in and keeps irritants out.

A dental shift wears down that mortar from three sides:

• Constant hand hygiene. Washing and hand rub before and after every patient and every glove change. Each round takes a little of the skin’s oil with it.
• Gloves all day. Gloves trap sweat and heat against the skin for hours. Then they come off, and the damp skin dries out fast.
• Water and chemicals. Rinsing, instrument handling and cleaning products add more.

AAD notes that frequent handwashing can leave skin dry and chapped. NIOSH counts wet work, with hands wet or gloved for long stretches, as one of the main causes of work-related skin problems.

Why the timing matters

CDC recommends hand lotion to help prevent the dryness that comes with frequent hand hygiene. It also gives a timing rule. Petroleum-based lotions can weaken latex gloves and make them more permeable. So lotions with petroleum or other oil emollients should be used only at the end of the workday. During the day, CDC’s training says to use a water-based product and check with the maker about how it works with your gloves.

That gives you a two-part routine:

• During the day: a light, water-based lotion that’s made to go under gloves.
• At the end of the day: a richer hand cream, once the gloves are done for the day.

During the shift: keep it light

I.C. Lotion, Fragrance Free is built for this part. It has a purified DI water base and no silicones, lanolin, glycerin, mineral oils, fragrance or dye. It’s made for use before nitrile, latex or vinyl gloves and dries with no oily residue. It’s NSF registered (E4).

Use a small amount on clean, dry hands at the start of the day and at lunch. Let it dry completely before you glove. If your office provides a specific lotion, use that one. CDC advises using only lotions your facility approves.

End of the day: a routine for chapped hands

Once your last glove is off and your last wash is done, this is when to put something heavier on.

I.C. Advanced Repair Hand Cream is a dimethicone skin protectant (dimethicone 4%) that helps prevent and temporarily protects chafed, chapped or cracked skin. It’s fragrance-free and dermatologist tested: a 50-subject patch test with zero reactions (ALS / BioScreen, Study 22-522A, 2022). Because it’s a richer cream with oils in the base, it’s for after the shift, not under your gloves.

Here’s the routine:

1. Last wash of the day. Use lukewarm water, not hot. Hot water strips more oil.
2. Pat dry. Leave your hands a little damp. AAD says to put cream on damp skin, including the fingertips and nails.
3. Work the cream in. Focus on the knuckles, the backs of the hands, the skin around the nails and the webs between your fingers. Those are where cracks start.
4. Again before bed. A second layer at night gives the skin hours to settle without washing.
5. Glove up at home. Wear household gloves for dishes and cleaning so your hands get a real break.

Small changes that help

• Dry hands fully before you glove. Damp skin under a glove stays wet all procedure long.
• Change gloves when they get sweaty, if your procedure allows it, and clean your hands each time.
• Pick fragrance-free products. AAD suggests moisturizers labeled fragrance-free and dye-free for dry, chapped skin.
• Don’t pick at splits. Torn skin around the nails is an easy way in for germs.

What to watch for

Hand cream helps with dry, chapped skin. It doesn’t treat a rash or an allergy. See a clinician if:

• Your hands crack and bleed, or stay red and sore even after a weekend off.
• You get itchy bumps, blisters or a rash where your gloves sit.
• Your skin reacts to a product every time you use it.

Some people react to glove materials or to ingredients in hand products. A clinician can help you figure out the cause. Tell your office manager too, so the practice can look at glove and product options.

For more on hand care in the practice, see our dentistry page.

FAQ

Can I use hand cream under my gloves?

Save the richer cream for the end of the day. CDC says lotions with petroleum or other oil emollients should be used only at the end of the workday. During the day, use a water-based lotion that’s made to go under gloves, such as I.C. Lotion, Fragrance Free.

When is the best time to put on hand cream?

Right after your last wash, while your hands are still a little damp, and again before bed.

My hands are cracked. Will hand cream fix them?

I.C. Advanced Repair Hand Cream helps prevent and temporarily protects chafed, chapped or cracked skin. If your hands bleed, blister or don’t get better, see a clinician.

Sources

• CDC, Dental Infection Control Basics, Module 2: Hand Hygiene (lotion and glove compatibility): https://www.cdc.gov/dental-infection-control/media/pdfs/besc2_handhygienescript-508.pdf
• CDC, Guidelines for Infection Control in Dental Health-Care Settings, 2003 (MMWR): https://www.cdc.gov/mmwr/pdf/rr/rr5217.pdf
• CDC, Clinical Safety: Hand Hygiene for Healthcare Workers (lotions approved by your facility): https://www.cdc.gov/clean-hands/hcp/clinical-safety/index.html
• American Academy of Dermatology, Dry skin relief from handwashing: https://www.aad.org/public/everyday-care/skin-care-basics/dry/coronavirus-handwashing
• American Academy of Dermatology, Dermatologists’ top tips for relieving dry skin: https://www.aad.org/public/everyday-care/skin-care-basics/dry/dermatologists-tips-relieve-dry-skin
• CDC/NIOSH, Skin Exposures and Effects: https://www.cdc.gov/niosh/skin-exposure/about/index.html