How to Care for Your Skin During Long Nursing Shifts

Recently, we spoke with Dr. Francisca Kartono, DO, FAAD, FAOCD about the effects of long nursing shifts (especially those wearing masks and other PPE) on your skin, and what you can do to alleviate the negative effects.

She began her discussion by focusing on the effects of PPE on the skin before moving on to sun protection and overall skincare. You can read a brief summary below or check the full video recording here! 
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Your Skin and PPE

We’ve all seen (or experienced firsthand) the photos of doctors and nurses with skin imprints, markings, rashes, and bruising following the extended donning of PPE.

Hours of wearing masks and face equipment can lead to friction, bruising, and even exacerbate existing acne, rosacea, or other skin conditions. So what can you do to prevent this?

1. Apply barrier creams such as Vaseline, zinc oxide, or Duoderm.
2. Apply wound creams such as Stratamed, Arnicare, Dermend, or Alastin nectar.
3. Utilize wound dressing such as Tegaderm or Mepitac.
4. Make sure to use gentle washing solutions before and after wearing masks: Cerave Hydrating Wash, Cetaphil Gentle Cleanser, Neutrogena Hydroboost, or CLN wash.
5. Do your best to avoid irritants (especially if your skin is painful), such as toners, astringents, antioxidants, and retinols.
6. Also make sure to clean and clear infections, such as Staph, MRSA, and yeast infections.
7. Lastly, some prescriptions—antibacterials, mild retinoids, oral antibiotics, steroid creams, and NSAIDs—may be useful; please consult with your dermatologist on this one!
   

Many of these moisturizers can also be used for hands, and it is also recommended that you routinely use a strong moisturizing cream (i.e. Cerave Moisturizing Cream) on your hands after repeated hand washing.
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Sun Protection

I’m sure you all know how important sun protection is, and you’ve read or heard “Wear Sunscreen,” then you know all about this one.

Some important steps to take on a daily basis in preventing sun damage:

1. Use physical blockers (aside from hats and long sleeves), such as zinc and titanium dioxide as well as DNA repair enzymes (ISDIN brand); note that tinted is better for fighting hyperpigmentation.
2. Use chemical blockers such as octocrylene, salicylates, and avobenzone.
3. And again, don’t forget extra clothing, hats, and sunglasses (check out coolibar.com and uvskinz.com).
4. For your lips, try Colorscience lip shine, Elta MD.
5. If you’re worried about skin cancer, you can try Heliocare niacinamide oral supplements, which can reduce the change of squamous skin cancer but nearly 23%.
6. Reapply sun protection every two hours when outside, or at least every morning if remaining indoors the majority of the day.
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Skincare Principles

1. Sun Protection
2. Anti-aging
3. Antioxidant
4. Moisturizer
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Sun Protection and Anti-aging

Sunscreen can prevent most sources of photoaging. You should have a “daily” sunscreen as well as an “activity” one for outdoor activities, swimming, etc. Sunscreen reduces the destruction of collagen and can—and should—be used daily in addition to SPF helpers niacinamide, retinol, and vitamin C.
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Antioxidants

While many antioxidants are dietary, there are also plenty of topical applications that you can take advantage of: caffeine (topical, not dietary), vitamin C, vitamin E, ferulic acid, niacinamide, green tea, and bakuchiol. All of these are great at reducing inflammation, having a brightening effect, increasing collagen, and are especially effective in high quality eye creams. They can help prevent skin cancer as well as clean up free radicals from UV light and pollution, allowing for greater skin repair.
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Moisturizers

With moisturizers, don’t be afraid to keep it simple. Their main job is to reduce water loss in the skin by trapping moisture and encouraging things that can moisturize the skin. You can pair them with gentle cleansers up to twice per day. They pair very well with retinols or ascorbic acid. Also, be sure to go for “light” moisturizers, as heavy ones can clog your pores. 

‍In summary:

1. SPF > 30
2. Retinols, peptides, and bakuchiol
3. Vitamin B, C, ferulic acid, and caffeine
4. Hyaluronic acid, ceramides, and alpha hydroxy acids
   

While sun exposure is crucial to good health, too much of a good thing can be a bad thing. So limit exposure where necessary and be consistent with your sun protection!
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