Covid 19, palmar flora modification and facial dermatological lesions

There is a frangible balance between skin health and disease. Fomite interaction is a source of microbiome heterogeneity, in regions which have a relatively stable commensal microbiome, and in communion with skin fragility can sway the balance between the commensal and pathogenic microorganisms in favour of the pathogenic microbes. With the prolonged use of alcohol-based hand sanitizers in the current context of COVID 19, causing skin irritation and increasing the chances of transient pathogenic microbes colonizing the hand/palmar surfaces. Also given that the face is on average the most touched region among the hair, face, neck and shoulders (HFNS) regions both in terms of frequency and duration. This could facilitate the increase of facial dermatological lesions specifically and dermatological and mucosal infections generally. More worryingly, this increase microbial transmission could include SARS-COV2 and hence increase COVID 19 infections even though the fomite route of transmission of COVID 19 is reported to be low.