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Hand Sanitizers: Understanding the Good, the Bad, and the Ugly

Posted by Jennifer Leatherbarrow, RN, BSN, RAC-CT, IPCO, QCP, CIC on Nov 26, 2019 10:45:00 AM

Topics: News & Events, Clinical Consulting

Human hand extended to display something - isolated over a white background

With flu season now upon us, it’s more important than ever to keep your hands clean and free of germs to the extent possible. In that respect, many people turn to hand sanitizers to get the job done. But are they the safest and most effective means of accomplishing that?

According to the Centers for Disease Control (CDC), the best strategy is also the most time-tested one: washing hands with soap and water. Hand-washing has been proven to reduce the amounts of all types of germs and chemicals on hands. Moreover, hand-washing with soap and water is a more effective way than hand sanitizers to remove germs such as Cryptosporidiumnorovirus, and Clostridium difficile. Hand-washing with soap and water also removes debris that hand sanitizer leaves behind (including allergens like peanut proteins)—and it does so with the fewest side effects.

The truth behind alcohol-based hand sanitizers

Alcohol-based hand sanitizers are designed to quickly reduce the number of microbes on hands in certain situations. That said, they do not eliminate all types of germs. The reasons for this are varied, but generally speaking, people may ignore the instructions on the sanitizer container by not using a large enough amount of sanitizing gel, or by wiping it off before it has completely dried. In situations where soap and water are not available for sanitizing your hands, studies have shown that using a hand sanitizer with at least a 60 percent alcohol content can help you avoid certain illnesses and spread germs to others.

After completing my research regarding the use of hand sanitizers in health care settings, I was alarmed at what I learned. There are numerous downsides to using both triclosan and alcohol-based sanitizers. While I am not opposed to using sanitizers when there is no other option, nothing beats good old-fashioned hot water and soap, and here are the reasons why:

  1. The overuse of hand sanitizer can cause irritation and even damage to the skin. Furthermore, the use of high-alcohol-concentration sanitizer can cause dryness and cracks in the skin, placing the skin at risk from bacteria.
  2. Alcohol in sanitizer also kills off good bacteria from the surface of the skin. 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.
  3. Hand sanitizer lowers the skin barrier function and renders the skin membrane more permeable to harmful chemicals.
  4. Over time, use of alcohol-based hand sanitizers can cause the skin on your hands to age more rapidly than it would naturally, as dry skin is prone to developing wrinkles and other blemishes. If you do need to use an alcohol-based hand sanitizer, make sure to use some kind of hand lotion soon afterward.
  5. If your hand sanitizer doesn’t contain alcohol, then it likely contains triclosan, which is a powerful antibacterial agent. While this ingredient does effectively strip away a myriad of microbes, 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  coli.
  6. Using triclosan may negatively affect your immune system, leaving you more vulnerable to more traditional illnesses (like the common cold).
  7. Synthetic fragrances used in sanitizer normally consist of phthalates which, at their worst, can cause abnormalities in hormone production.
  8. Parabens are essentially preservatives meant to prolong the shelf-life of your sanitizer. Parabens are absorbed into your skin each time you use your hand sanitizer.
  9. Hand sanitizer is unsafe around small children and some adults. Swallowing alcohol-based hand sanitizers can cause alcohol poisoning. Ethyl alcohol (ethanol)-based hand sanitizers are safe when used as directed, but they can cause alcohol poisoning if a person swallows more than a couple of mouthfuls.
  10. Bisphenol A, or BPA, is a chemical found in plastic products. BPA is dangerous because it can cause numerous hormone disorders, cancer and a litany of other bodily issues. Using hand sanitizer right before touching anything containing a high amount of BPA can increase the amount of BPA absorbed through your skin by up to a hundred times. A thin layer of BPA will remain on your skin even after it has been absorbed. This means that if you use hand sanitizer, get BPA on your hands and then eat something, you’re essentially consuming a bit of that dangerous chemical with every bite.
Homemade hand sanitizer-1


    1. Create a homemade hand sanitizer, which keeps your hands clean without the negative side effects (see recipe to the left).
    2. You can also wear thin gloves if you happen to be somewhere with a lot of germs, like an airport or a public bus. Just be sure not to rub your face with your gloves.
    3. Use natural/organic hand sanitizers that don’t contain alcohol or triclosan.


I hope this article has given you something to think about. As mentioned, I’ve included a recipe for homemade hand sanitizer above, and I implore you to share this information with friends and family before the microscopic world takes over.

Contact Richter

Do you have questions about hand sanitizer, or LTPAC clinical challenges? Call Richter’s clinical education consultants at 866-806-0799 to schedule a free consultation.

Jennifer Leatherbarrow RN, BSN, RAC-CT, IPCO, QCP, CIC, is Manager of Clinical Consulting Services for Richter.


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