Hand Sanitizers Versus Soap and Water – What You Need to Know

by Dr. Wael Bazzi

Hand sanitizers are everywhere; perhaps you carry a small bottle with you or keep one on your desk. They are generally used to kill bacteria and thus maintain hygiene when soap and water are not readily available. Available in gels, foams, sprays, and wipes these products are convenient. However, certain experts recommend them while others have reservations. So, how effective are they and are they harmful in any way?

How do hand sanitizers work?

The alcohol in hand sanitizers kills bacterial cells – not human cells. They disrupt the cell membranes of bacteria and, in the case of a virus, its outer coat. Choose a product with at least 60% alcohol as usually, these sanitizers are more effective than non-alcohol containing antiseptics present in the market.

Although hand sanitizers that contain at least 60% alcohol (usually listed as ethyl alcohol) kill most bacteria and viruses on contact and work well against fungi, they do not eliminate all pathogens on hands. For example, they don’t work well against bacterial spores such as those the C. difficile bacteria. According to the U.S.’s Centers for Disease Control and Prevention (CDC), soap and water are better in this case, especially for reducing Clostridium, Cryptosporidium, norovirus.

Having greasy or dirty hands makes these products less effective as the dirt acts as a barrier to them.

How to use hand sanitizers

  • Make sure all organic matter like dirt and grease are removed from your hands.
  • Apply a dime-size amount to the palm of one of your hand
  • Rub your hands together and cover all surfaces of both hands – also between your fingers and around your fingertips and nails.
  • Rub your hands together for 30 seconds to allow them to fully absorb the product and dry.

Are hand sanitizers really effective?

Many studies highlight the importance of hand sanitizers. In addition to them killing common non-resistant bacteria and viruses, the number of bacteria tends to remain lower for a longer period of time when hand sanitizers as used, as compared to when water and soap are used.

On the other hand, excessive use of hand sanitizers may damage the skin. Although many contain emollients which make the skin more comfortable and less itchy, the hand sanitizers used in hospitals  contain additives that fasten skin dryness to prevent rapid transfer of bacteria among staff and patients. In general, people who work in health care and use sanitizers excessively may experience cracks in their skin which makes them more prone to bacterial infections.

The effects of hand sanitizers on health and environment

New studies indicate that hand sanitizers are harmful to the environment and to human health due to the presence of antimicrobial additives, including chemicals such as triclocarban (TCC) and triclosan (TCS). A study performed by the director of the U.S.’s Center for Environmental Security shows that TCC and TCS are not easily degraded; they comprise 60% of the mass of sewage and wastewater and are also present in remarkable amounts in rivers and lakes which impacts aquatic life.

In humans, TCC and TCS can induce antimicrobial resistance and disrupt hormonal levels in adults. The U.S. Food and Drug Administration (FDA) indicated that new data highlights that long-term exposure to hand sanitizers harboring antimicrobial additives may induce health risks that outweigh the benefits.

Benefits of Soap and Water

According to the CDC, soap and water are more effective than hand sanitizers at removing certain types of germs and do a better job of preserving the good bacteria, or flora, on your hands.

Whenever you do have soap and water available, just wash your hands – for at least 20 seconds – with warm water and non-bacterial soap.

Use a commonsense approach and remember that good hygiene is the most effective way to combat bacterial infections. Using hand sanitizers is important but should not replace the use of water and soap as, in the long-run, hand sanitizers may have detrimental effects on the environment and our health. So, opt for good old water and soap whenever you can.

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