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Are Hand Sanitizers Actually Harmful?

Infectious disease expert weighs in on hand sanitizers

Should we use hand sanitizers designed to kill microbes, such as bacteria and viruses, with the potential to make us sick?

Companies that market these products (which are sometimes labeled "antibacterial" or "antimicrobial") say yes, but some consumer advocates say no, arguing that they aren't effective and have the potential to engender bacterial strains that resist antibiotics.

Gordon Trenholme, MD, director of the Section of Infectious Diseases at Rush University Medical Center, thinks the best answer is a common-sense approach. Here's what Trenholme has to say on the subject:

How useful are hand sanitizers?

They're useful in the hospital, to help prevent the transfer of viruses and bacteria from one patient to another by hospital personnel. But beyond that, it's very difficult to show that any of them are useful.

Outside of the hospital most people catch respiratory viruses from direct contact with people who already have them, and hand sanitizers won't do anything in those circumstances.

In any case, they certainly haven't been shown to do anything more than just washing your hands.   

Convenient cleaning.

The portable hand sanitizers do have a role during peak respiratory virus season [roughly November to April] because they make it much easier to clean your hands.

It's much more difficult when you sneeze to wash your hands than it is to use a hand sanitizer, especially when you are outdoors or in a car. The hand sanitizers are much more convenient, so they make it more likely that people will clean their hands, and that's better than not cleaning at all.

Drawbacks of hand sanitizers

According to the Centers for Diseae Control (CDC), however, for hand sanitizer to be effective it must be used correctly. That means using the proper amount (read the label to see how much you should use), and rubbing it all over the surfaces of both hands until your hands are dry. Do not wipe your hands or wash them after applying.

You should always clean with soap and water if your hands are visibly dirty, or if you've touched chemicals. When hands are heavily soiled or greasy — such as after playing outdoor sports or working at a construction site — the CDC cautions that hand sanitizers may not work well at all.

Are all hand sanitizers created equal?

It's important to make sure any hand sanitizer you do use contains at least 60 percent alcohol. 

Studies have found that sanitizers with lower concentrations or non-alcohol-based hand sanitizers are not as effective at killing germs as those with 60 to 95 percent alcohol.

In particular, non-alcohol-based sanitizers may not work equally well on different types of germs and could cause some germs to develop resistance to the sanitizer.

The benefits of soap and water.

Whenever you can, just wash your hands — for at least 20 seconds — with non-bacterial soap and warm water.

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

Your whole body is covered with bacteria, and if you remove those good bacteria, they can be replaced by other, potentially harmful, bacteria. Natural bacteria are there for a reason. 

The portable hand sanitizers do have a role during peak respiratory virus season [roughly November to April] because they make it much easier to clean your hands.

Are hand sanitizers and other antimicrobial products harmful?

There is no proof that alcohol-based hand sanitizers and other antimicrobial products are harmful.

They could theoretically lead to antibacterial resistance. That's the reason most often used to argue against using hand sanitizers. But that hasn't been proven. In the hospital we don't see much resistance to alcohol-based hand sanitizers at all.

However, while there aren't any studies showing that hand sanitizers definitely pose a threat, there also isn't any evidence that they do a better job of protecting you from harmful bacteria than soap.

So while hand sanitizers have their place — in hospitals or when you can't get to a sink — washing with soap and warm water is almost always a better choice. 

The best defense: cleanliness.

What does your room look like? What does the bathroom look like? There's a good chance it needs to be cleaned! It's not necessary to use antimicrobial products when cleaning your home or office: The important thing is just to keep things clean.

On the other hand, some people are concerned about hygiene to an extreme extent. We try to assure them that if they do the usual things — rather than take extraordinary measures — they'll be fine.

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