Before 2020, I rarely thought about hand sanitiser, 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 sanitiser 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 fulfil their ultimate goal of nixing bacteria and viruses, hand sanitiser (which uses alcohol to kill germs on contact) does have some limitations.
Since sanitiser 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 sanitiser from reaching and covering the skin before it dries, which limits its effectiveness. “Hand sanitiser 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 sanitisers 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 sanitiser is preferable. “The portability and access of hand sanitiser 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 sanitiser. “Keep in mind that the hand sanitiser 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 NHS guidance by using a hand sanitiser 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 emphasises 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 sanitiser gel every 30 minutes “just because” — no matter how good that lemon fragrance smells.