Hand Sanitizer: The Good, the Bad, and the Ugly

Staying health may be as simple as keeping your hands clean. In fact, experts say remembering to wash your hands frequently and thoroughly is the single most important way to stay health. Researchers estimate that routine hand washing is so effective it could prevent a million deaths per year since about 80 percent of infections are spread through hand contact.

Harmful germs are ubiquitous and prevalent in kitchens and bathrooms, on floors, faucets (especially school drinking fountains), keyboards, ATM machines, cell phones, and doorknobs.  Antibiotic-resistant staphylococcus (a common cause of skin infections) has been found on yoga mats, wrestling mats, and cardio resistance machines. Cramped and heavily trafficked airplane bathrooms are one of the best places to get contaminated.

The importance of hand washing can't be overstated. To reduce your risk of picking up unwanted micro organisms, the Centers for Disease Control and Prevention (CDC) recommends hand washing—preferably using soap and water—in the following circumstances:

  • Before, during, and after food preparation
  • Before eating food
  • Before and after caring for someone who is sick
  • Before and after treating a cut
  • After using the toilet
  • After changing diapers
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal waste, or handling pet food and treats
  • After touching garbage

Soap or Sanitizer?

Soap and clean water is best but if they aren't available (for example, during car travel), an alcohol-based hand sanitizer—containing at least 60 percent alcohol—is an acceptable alternative. Health officials have found that hand sanitizers containing less than 60 percent alcohol is not enough to kill most harmful bacteria and viruses.

However, buyers beware! Don't assume all hand sanitizers are created equal. Read labels and look for products with between 60 and 95 percent alcohol listed as ethyl alcohol, ethanol, or isopropanol.

One of the problems with hand sanitizers is that they don't cut through grime well. The alcohol in the gels kills bacteria and viruses, but health officials say soap—any soap—used properly removes them. High-tech soap (a.k.a hand sanitizers) is not recommended for use on visible dirt and is not an effective agent for bacteria associated blood, feces, bodily fluid, and animal fat (attention food service workers) unless they are wiped off first.

The U.S. Food and Drug Administration (FDA) and other health agencies have also expressed concerns that the overuse of sanitizers may cause germs to develop resistance. In addition, be wary of false and unproven product claims. Hand sanitizer and antiseptics cannot prevent infection from MRSA (methicillin-resistant Staphylococcus aureus)—a deadly strain of bacteria—according to the FDA. Any claims that a product kills MRSA, staph, and strep should be disregarded and the agency strongly urges consumers not to buy over-the-counter hand sanitizers or other products that allegedly prevent infection from MRSA, E. coli, Salmonella, flu, other bacteria, or viruses. On the plus side, hand sanitizers are quick and easy to use and cause less skin irritation than soap and water.

One caveat: the alcohol in hand sanitizers will shorten the life of your manicure. Alcohol dries out nails and cuticles and causes nail polish to chip and peel. Switching from polish to a gel or shellac costs more but will last longer.

Germ Busting Basics

To wash hands properly, the CDC recommends lathering up with soap and washing for at least 20 seconds—the time it takes to sing "Happy Birthday" twice. In the agency's video, "Put Your Hands Together," CDC epidemiologist Michael Beach, PhD offers the following instructions:

"Focus on washing the front of your hands, the back, in between the fingers, and around the nails and so on. Then rinse everything off," says Beach in the video. "Use something to wipe your hands after that—preferably something disposable, like a paper towel and then use that to turn off the tap as well."

When soap and water are not available, squeeze a dime-size amount of hand sanitizer—containing at least 60 percent alcohol—into your hands and rub until solution is completely absorbed. Safeguard yourself in the gym or at work by wiping workout mats, machines, desktops, and computer keyboards with an antiseptic wipe.

Dr. Rafael Pajaro reviewed this article.



U.S. Food and Drug Administration

The New York Times

The Centers for Disease Control and Prevention