Does Hand Sanitizer Work? It Can Be Harmful to Your Health
Consider these downsides before you douse your hands in Purell.
Germaphobes rarely leave the house without a bottle of hand sanitizer in tow—and it's easy to see why: Virtually everything we touch on a daily basis is teeming with bacteria. In fact, one 2017 study published in the journal Germs assessed 27 cell phones and found a median of 17,000 bacterial gene copies per phone. In 2020 in particular, there's also the active threat of contracting the coronavirus COVID-19 that has people reaching for those potent gels and sprays. And while hand sanitizer may seem like an effective on-the-go solution for ridding yourself of germs, using it too frequently can do more harm than good. Actually, it's because hand sanitizer is so effective at killing bacteria that it's not ideal for everyday use.
Triclosan, or TCS, is the active ingredient in some hand sanitizers. And while this ingredient does effectively strip away a myriad of microbes, one 2018 study published in the journal Environment International found that it's just as successful at spurring the development of antibiotic-resistant bacteria. Just 30 days of exposure to 0.2mg/L TCS can cause multi-drug resistance to E. coli.
"The triclosan found in personal care products that we use daily is accelerating the spread of antibiotic resistance," study author Jianhua Guo explained in a press release.
So what about hand sanitizers that count ethyl alcohol, rather than triclosan, as their active ingredient (which is most hand sanitizers)? While these are the most potent sanitizers on the market and are recommended by the Centers for Disease Control and Prevention (CDC), alcohol-based hand sanitizers have some serious downsides as well.
"Repeated use of anything, including hand sanitizer, can cause chronic irritation, skin breakdown, and damage," says Trevan Fischer, MD, surgical oncologist and assistant professor of surgical oncology at John Wayne Cancer Institute at Providence Saint John's Health Center in Santa Monica, California.
"If you're using very high concentrations of alcohol, it can cause dryness and cracks in the skin. Not only does it not feel good when the alcohol hits the skin, but then the skin won't heal as well," says Fischer. That's why it's especially important not to use alcohol-based sanitizers on injured skin.
Additionally, Fischer points to alcohol's ability to kill off beneficial bacteria on the skin's surface as a potential source of harm. "If you're beating down a natural defense the body has, you could be causing some chronic risk over time," he says.
That's not the only problem with overusing alcohol-based sanitizers, however: Per one 2008 meta-analysis published in the Journal of Occupational Medicine and Toxicology, the topical application of ethyl alcohol can "lower the skin barrier function and render the membrane more permeable" to harmful chemicals like nitrosamines from cosmetics.
Though there are numerous downsides to using both triclosan- and alcohol-based sanitizers, none of this is to say that you can't use these products every once in a while. Yes, washing your hands with soap and water removes debris that hand sanitizer leaves behind (including allergens like peanut proteins) with the fewest side effects. But if you're in a pinch and need to get rid of germs ASAP, then it's A-OK to use an emergency bottle of hand sanitizer. The CDC's official guidelines for protecting yourself from the coronavirus prioritize a full hand-washing, but stipulate that an alcohol-based hand sanitizer can suffice for certain instances when soap and water isn't readily available.
According to a 2004 study published in Clinical Microbiology Reviews, the sanitizer capable of killing the broadest range of pathogens contains 60 to 85 percent ethanol or 60 to 80 percent isopropanol or n-propanol. However, if you want to avoid the skin-damaging effects of alcohol-based sanitizers, you can always use an alcohol-free option, like Germ-X's Alcohol-Free Foaming Sanitizer. Be forewarned, though: While alcohol-free hand sanitizers are largely effective, they are slightly less potent than their alcohol-based counterparts and (again) not recommended by the CDC.
Additional reporting by Sage Young.