Before 2020, I rarely thought about hand sanitizer, except to be grateful to have a bottle on me after touching a grimy subway pole. But this year, it’s taken on an increasingly important role in my life. I have a favourite type (which smells like a lemon spritz), I store them on a designated shelf, and I never, ever leave home without a bottle. But sometimes I wonder: Is using hand sanitizer really as effective as washing your hands with soap and water?
Not exactly. Sudsing up at a sink should be your first choice when it comes to cleansing, according to the Centers For Disease Control and Prevention (CDC). While both options fulfill their ultimate goal of nixing bacteria and viruses, hand sanitizer (which uses alcohol to kill germs on contact) does have some limitations.
Since sanitizer doesn’t actually remove anything from your hands, if you've got visible dirt or grime then soap and water is always the way to go. That's true for obvious reasons (gross), but also because dirt or debris could theoretically prevent hand sanitizer from reaching and covering the skin before it dries, which limits its effectiveness. “Hand sanitizer only works if it comes into direct contact with the virus that causes COVID-19,” says J.D. Zipkin, MD, a Chief Medical Officer at GoHealth Urgent Care. What's more, he adds, while hand sanitizers kill the virus that causes COVID-19, they can't be used against all germs, such as spore-forming bacteria.
Still, in certain situations, hand sanitizer is preferable. “The portability and access of hand sanitizer allows for easier and more frequent use on the go compared to washing with soap and warm water,” says Dr. Zipkin. In fact, trying to wash with soap and water in a public bathroom can increase the number of surfaces you touch — doorknobs, paper towel dispensers — which is a negative. But, the same can be true of passing around a bottle of sanitizer. “Keep in mind that the hand sanitizer bottle and pump likely has a high concentration of germs, so avoid touching it immediately after hands are cleaned," he adds.
Whatever you choose, some ground rules will help ensure you’re actually removing what you want to — and not stripping away all the beneficial bacteria that also resides on our skin (while drying out your hands in the process). That means adhering to CDC guidance by using a hand sanitizer with at least 60% alcohol and following the manufacturer instructions, which often require using more of the gel or spray than you’d think and washing your hands with soap for a full 20 seconds.
Dr. Zipkin also emphasizes the importance of “strategic moderation” when it comes to cleaning your hands: Yes, we want to reduce the spread of illness-causing germs, but washing too often won’t add any additional protection, and it may even cause cracks and dry skin that put you at an increased risk.
So be smart: “Hands should be cleaned after any event that increases the risk of accumulating germs, such as going to the bathroom, working with trash, coughing, or sneezing. Similarly, we want to ensure they're clean before events that could introduce germs to our body, such as eating or putting in contacts,” Dr. Zipkin says. But there's no need to form a habit of washing your hands or squirting on a dollop of hand sanitizer gel every 30 minutes “just because” — no matter how good that lemon fragrance smells.