Hand Sanitizers Should Kill Germs, Not Your Hands!
Updated: Jun 25, 2020
Hand sanitizers have become a modern necessity, but not without a cost. I‘m not referring to the financial cost as much as the dry, cracked and irritated condition of my skin from its use. A little research has helped me understand that it doesn’t really have to be this way.
Social distancing and quarantines created a mad rush to buy up hand sanitizers, and every manufacturer with access to alcohol and bottling equipment set out to meet that demand. And, the fastest and easiest way to do that was to use high levels of alcohol and not much care for anything else. I too purchased 80-Proof bottles from local distilleries that turned into personal care manufacturers overnight, but after a few uses I laid them aside and there they sit, half full (or is it half empty?). The fact is that, in order to be great, a hand sanitizer has to meet 3 basic requirements.
First, it has to work. Most brands do a good job meeting this requirement but selecting the right hand sanitizer and alcohol concentration can be tricky. Most people assume that the higher the alcohol content the better it is, and that is not necessarily the case. Hand sanitizer efficacy is measured by Time Kill studies (how long it takes to kill germs), which essentially have shown that alcohol at a concentration of 60% or more quickly kills up to 99.9% of germs. Make sure to get a brand with approved types of alcohol. The FDA recently called out a foreign brand selling in the USA for using non-approved forms of alcohol like Methanol. Ethyl alcohol is the FDA's recommended form. Also, it is important to use a hand sanitizer that does not evaporate too quickly, it takes 15-30 seconds of usage to effectively kill 99.9% of germs on your hands. Many brands refer to the CDC guidelines which state the following:
"CDC recommends using ABHR (Alcohol Based Hand Rub) with greater than 60% ethanol or 70% isopropanol..." (https://www.cdc.gov/coronavirus/2019-ncov/hcp/hand-hygiene.html).
Most sanitizers have an alcohol concentration of 75% or more driven by FDA guidelines that mirror those of the WHO. By following stricter guidelines brands are free to make claims of killing 99.9% of germs without having to provide a separate Time Kill study. However, many brands with lower alcohol concentrations (60 to 70%) bear the expense of running the studies by independent labs to prove what everyone already knows to be true, that the kill rate efficacy is comparable even at lower concentrations of alcohol. Any health care professional will tell you that active ingredients in drug should be used at their lowest effective dose, not their highest, in order to minimize the potential for adverse events, which in this case can be severe skin dryness and irritation. For hand sanitizers, the best range to look out for is around 65%. Slightly above the minimum but less irritating than the standard 70-80% out there.
The second requirement for a hand sanitizer to be worth keeping around is that it has to have the right aesthetic qualities, including masking the scent of alcohol and not damaging the skin. That's hard to find with any formula containing more than 70% alcohol. Look for sanitizers with natural essential oils such as citrus or lavender, which in my opinion cover up the smell of the alcohol better than Vitamin E or Aloe. That’s a lesson that perhaps extends beyond the scope of hand sanitizers. Gels seem to be the easiest forms to use because they hold the alcohol suspended and tend to last longer than sprays or liquids. Lavender and other essential oils also help moisturize and protect the skin from drying, which is a direct consequence of using hand sanitizers frequently. Just ask any healthcare provider.
Third, it has to be handy and available when I need it most. A gallon of hand sanitizer is useless to me if it’s sitting at home and I’m about to grab a shopping cart at the store, or in my car after going through a drive-thru window. I need it to be portable and easy. Not so small that I’m having to refill it every day, but small enough to carry around in my bag or pocket. I recommend a 4 oz up to a 10 oz bottle. Flip cap is preferable.
So, if you’re like me and know that hand sanitizers are here to stay, you may as well pick a great one to have around that does the job while smelling good and is always there when you need it.