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A Guide to Occupational Skin Disease and Skin Assessment

Updated: Feb 27

Occupational skin disease may be caused by exposure to a physical, chemical, or biological substances or repetitive mechanical force and lead to temporary skin irritation or permanent skin damage. Symptoms caused by irritants, chemicals, wet work (even just water), airborne particles and/or contaminated clothing may include redness, pain, cracking, flaking or scaly skin, swelling, blistering and/or allergic skin reactions. Where symptoms are not effectively managed, this may result in employees being unable to undertake some or all aspects of their role in the workplace.


Work related dermatitis or eczema account for about 80% of all occupational skin diseases.


Employers have a legal duty to undertake a risk assessment relating to any potential skin irritants, and should ensure that they identify appropriate control measures to protect their employees, they should also provide employees with training and/or personal protective equipment (PPE) as required and record all information relating to the management of the risks in line with the Control of Substances Hazardous to Health (COSHH) - COSHH (hse.gov.uk)


Skin health surveillance focuses on identifying whether an employee is exposed to substance(s) which may cause skin damage, establishing a baseline of any current or underlying skin issues (prior to or as soon as practicable after starting within a new role), frequent re-assessment by examination and questioning to establish the extent of symptoms (normally on an annual basis), referring employees to speak with their GP or specialists for treatment as required and to the occupational health advisor (OHA – nurse) or occupational health physician (OHP – doctor) for further workplace guidance as necessary.


Employers may wish to provide additional training for ‘competent persons’ to undertake skin checks in between periodic health surveillance appointments.


Adjustments may include:

  • Provision of additional pre or after work creams, or alternative hand washing facilities

  • Provision of hand hygiene/skin care training

  • Provision of alternative PPE

  • Permanent removal from a role where exposure to skin irritants is likely

  • Replacing the workplace skin irritant with an alternative substance (where possible) which is less harmful


Cases of Occupational Dermatitis (and some other skin conditions) are RIDDOR reportable once the diagnosis has been confirmed by an OH Physician.


Fitness standard and interpretation


  • No signs or symptoms of skin disease: Employee fit for undertaking all aspects of their role without any additional workplace adjustments/restrictions.

  • Signs or symptoms of skin disease reported BUT currently well managed with over the counter medication, hand hygiene/self-care and the provision of appropriate PPE as required: Employee may be fit for work without any additional workplace adjustments/restrictions.

  • Signs or symptoms of skin disease reported BUT currently well managed with over the counter medication, hand hygiene/self-care and the provision of appropriate PPE as required AND under the care of their GP or Consultant Dermatologist: Employee may be fit for work but may benefit from the provision of additional workplace adjustments/ restrictions to maintain their skin health; a referral to OHA review may be of benefit.

  • Signs or symptoms of skin disease reported BUT not currently managed effectively and/or impacting upon their day to day work: Employee may be fit for work with additional workplace adjustments/restrictions; a referral to OHA for review is recommended.

Discussion of the case with an OHA is appropriate for further advice.


Signs or symptoms of skin disease reported BUT not currently managed effectively and potentially exacerbated by exposure to substances within the workplace: Employee may not be fit for work, workplace adjustments are likely to be required; a referral to OHA or OHP for review is likely to be essential.

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