What should I do if I have the new coronavirus on my skin?

This is the 4190th article of Da Yi Xiao Hu

The cancellation of routine nucleic acid testing, the removal of the State Council's travel code, and the sudden relaxation of policies have suddenly made everyone panic about being surrounded by "little yang people". It seems that our eyes have automatically acquired microscopic superpowers, and can see the new coronavirus in the air, on cartons, on plastic bags... everywhere. This makes us feel helpless - can our skin be infected with the new coronavirus? !

Can the new coronavirus exist on our skin?

The answer is yes. The new coronavirus is very tenacious. The original strain of the new coronavirus in 2019 can survive on the surface of plastic objects for 56 hours at room temperature and on the surface of the skin for an average of 8.6 hours. After three years of mutation, its infectiousness has been further enhanced. In the era when the Omicron variant was rampant, it survived on the surface of the skin for an average of 21.1 hours and on the surface of plastic objects for up to 8 days (Omicron Survives Longer on Plastic, Skin Than Prior Variants; Nose Swabbing Found Best for Rapid Tests (usnews.com)). Therefore, any surface may carry living new coronaviruses and cause new infections, and human skin is no exception.

Our skin is infected with the coronavirus.

Can infection be transmitted through direct contact?

This is not the case. The new coronavirus mainly enters the human body and reproduces through the mucous membranes. Mucous membranes are mainly found on the surface of organs such as the eyes, mouth, respiratory tract, stomach, intestines, urinary tract and reproductive tract [1]. Our skin surface is not covered with mucous membrane tissue. Therefore, human skin will not be directly infected after contact with the new coronavirus, so there is no need to panic. However, if the skin on the hands that is contaminated with the new coronavirus is then rubbed on the eyes, mouth, nose and other parts with mucous membranes, there is a high probability of infection. Therefore, paying attention to skin hygiene and washing and disinfecting exposed skin such as hands and face after contact with objects or people is still the most effective way to prevent it. And reducing habitual actions such as rubbing your eyes with your hands can also greatly reduce the risk of infection when you forget to wash your hands.

As for broken skin, no studies have shown that the new coronavirus can infect directly through broken skin. However, broken skin greatly weakens the skin's defense function, and viruses or various pathogens can enter human tissues or blood through the broken parts, leading to a series of skin infections. Therefore, after the skin is broken, it is necessary to disinfect and bandage it in time, and do not use this as an opportunity to "test the poison on yourself" and challenge the virus's ability to infect.

As we all know, the new coronavirus is also a bully. It is very sensitive to disinfectants. Hand sanitizers containing 75% alcohol, hydrogen peroxide and other ingredients can easily inactivate it. Therefore, after contact with suspected contaminants, we first recommend the seven-step hand washing method of running water + hand sanitizer (soap). If the corresponding conditions are not met or there are no obvious contaminants, it is also recommended to use running water or disinfection products such as disposable gel and alcohol spray to disinfect hands using the seven-step hand washing method after contact with objects. In addition to the main ingredients of these detergents that contain suspected virus inactivating ingredients such as alcohol and chlorhexidine, the surfactants they contain can also remove moisture, lipids and even moisturizing factors on the skin surface while removing pathogenic microorganisms on the skin surface[2]. Therefore, frequent use of detergents for skin cleaning will cause damage to the skin barrier, affect the skin's pH, lead to poor skin tolerance, and even affect the changes in the skin flora, reducing beneficial bacteria and increasing harmful bacteria, thereby causing skin inflammation[3]. In addition, excessive skin cleaning can cause symptoms such as dryness, itching, and tingling. Studies have shown that if you clean your skin with water more than 10 times a day, the risk of dry skin will increase significantly [4]. Therefore, it is very necessary to avoid excessive skin cleansing. While cleansing the skin, using mild non-ionic surfactants can minimize skin damage [3]. In addition, using some cleaning products with weak acid or neutral pH values, or cleaning products containing beta glucan, mannitol, licorice extract, bisabolol and other moisturizing and anti-inflammatory effects can also reduce damage to the skin barrier [3]. After cleansing, use more moisturizers containing ingredients such as glycerin, petrolatum, and ceramide to replenish skin moisture, enhance skin moisturizing ability, repair the skin barrier, and reduce damage to the skin caused by detergents [2].

The earliest Chinese medical belief that the skin has a barrier function can be traced back to the Yellow Emperor's Internal Classic. The Suwen · Tiaojing Lunpian says: "When wind and rain hurt people, they first attack the skin." The Suwen · Pibu Lunpian says: "Therefore, when all diseases begin to occur, they must first attack the skin." Wei Qi protects the skin surface, controls the opening and closing of the pores, enables normal metabolism of the skin, and resists external pathogens. This is similar to the modern skin barrier function [5]. For example, the Lingshu · Forbidden Food says: "Examine Wei Qi as the mother of all diseases and regulate its deficiency and excess. Zhang Weibao [6] proved through experiments that Wei Qi is the tissue fluid that runs in the epidermis. When the evil Qi breaks through the mucosal barrier and enters the superficial layer of the skin, it will first contact the mucosal tissue fluid dominated by Wei Qi and mobilize its immune function to defend against external pathogens. As the Lingshu · Benzang says: "When Wei Qi is harmonious, the flesh is divided and the skin is softened, and the pores are dense." Therefore, protecting the skin barrier is of great significance in resisting the invasion of external pathogens.

References:

[1] CHILAMAKURI R, AGARWAL S. COVID-19: Characteristics and Therapeutics [J]. Cells, 2021, 10(2).

[2] Li Xueying, Liu Lei, He Congfen. Effects of excessive cleansing on skin and classification of product protective ingredients[J]. Chinese Cosmetics, 2020, (03): 113-5.

[3] Zheng Zhizhong, Li Li, Liu Wei, et al. Proper skin cleansing and skin barrier protection[J]. Journal of Clinical Dermatology, 2017, 46(11): 824-6.

[4] MEDING B, GRONHAGEN CM, BERGSTROM A, et al. Water Exposure on the Hands in Adolescents: A Report from the BAMSE Cohort [J]. Acta Derm Venereol, 2017, 97(2): 188-92.

[5] Wang Yanchun, Gong Jian, Jing Fangyi, et al. Research progress on the correlation between spleen, Yingwei and skin barrier in traditional Chinese medicine[J]. Chinese Journal of Traditional Chinese Medicine, 2022, 35(02): 61-6.

[6] Zhang Weibo. Analysis of the concept of Qi, blood and meridians in Huangdi Neijing [J]. Chinese Acupuncture, 2013, 33(08): 708-16.

Author: Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine

Cheng Linyan, Li Fulun