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Are Hand Sanitizers Actually Harmful?

Infectious disease expert weighs in on hand sanitizers

Hand sanitizerShould 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:

Q: How useful are hand sanitizers?

Trenholme: 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. And, in any case, they certainly haven't been shown to do anything more than just washing your hands. So while hand sanitizers have their place, washing with soap and water is almost always a better choice.

Q: So they're not useful in daily life?

Trenholme: 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 someone sneezes to have them go wash their hands than it is to use a hand sanitizer. The hand sanitizers are much more convenient, so they make it more likely that people will clean their hands.

Q: On a day-to-day basis, then, what's the best thing people can do to prevent the spread of infection?

Trenholme: Whenever you can, just wash your hands — for at least 20 seconds — with regular soap. It does a better job of preserving the flora, or 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.

Q: Is it harmful to use antimicrobial products?

Trenholme: No, there's no proof that it's harmful. They could theoretically lead to antibacterial resistance. But that hasn't been proven. In the hospital we don't see much resistance to alcohol-based hand sanitizers at all.

Q: When it comes to preventing infection, what are the most common mistakes people make?

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: 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.

November 2010