Hand sanitizer

Hand sanitizer
A typical pump bottle dispenser of hand sanitizer gel
Clinical data
Other namesHand sanitizer, hand antiseptic,[1] hand disinfectant, hand rub, handrub[2]

Hand sanitizer (also known as hand antiseptic, hand disinfectant, hand rub, or handrub) is a liquid, gel, or foam used to kill viruses, bacteria, and other microorganisms on the hands.[3][4] It can also come in the form of a cream, spray, or wipe.[5] While hand washing with soap and water is generally preferred,[6] hand sanitizer is a convenient alternative in settings where soap and water are unavailable. However, it is less effective against certain pathogens like norovirus and Clostridioides difficile and cannot physically remove harmful chemicals.[6] Improper use, such as wiping off sanitizer before it dries, can also reduce its effectiveness, and some sanitizers with low alcohol concentrations are less effective.[6] Additionally, frequent use of hand sanitizer may disrupt the skin's microbiome and cause dermatitis.[7]

Alcohol-based hand sanitizers, which contain at least 60% alcohol (ethanol or isopropyl alcohol), are recommended by the United States Centers for Disease Control and Prevention (CDC) when soap and water are not available.[8] In healthcare settings, these sanitizers are often preferred over hand washing with soap and water because they are more effective at reducing bacteria and are better tolerated by the skin.[9][10] However, hand washing should still be performed if contamination is visible or after using the toilet.[11] Non-alcohol-based hand sanitizers, which may contain benzalkonium chloride or triclosan, are less effective and generally not recommended,[9] though they are not flammable.[5]

The formulation of alcohol-based hand sanitizers typically includes a combination of isopropyl alcohol, ethanol, or n-propanol, with alcohol concentrations ranging from 60% to 95% being the most effective.[4] These sanitizers are flammable[9] and work against a wide variety of microorganisms, but not spores.[4] To prevent skin dryness, compounds such as glycerol may be added, and some formulations include fragrances, though these are discouraged due to the risk of allergic reactions.[12] Non-alcohol-based versions are less effective and should be used with caution.[13][14][15]

The use of alcohol as an antiseptic dates back to at least 1363, with evidence supporting its use emerging in the late 1800s.[16] Alcohol-based hand sanitizers became commonly used in Europe by the 1980s[17] and have since been included on the World Health Organization's List of Essential Medicines.[18][19]

  1. ^ "Tentative Final Monograph for Health-Care Antiseptic Drug Products; Proposed Rule" (PDF). United States Federal Food and Drug Administration. March 2009. pp. 12613–12617. Archived (PDF) from the original on 10 March 2010.
  2. ^ Cite error: The named reference WHO-LocalProduction was invoked but never defined (see the help page).
  3. ^ "hand sanitizer - definition of hand sanitizer in English". Oxford Dictionaries. Archived from the original on 18 September 2017. Retrieved 12 July 2017.
  4. ^ a b c Boyce JM, Pittet D (October 2002). "Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America" (PDF). MMWR. Recommendations and Reports. 51 (RR-16): 1–45, quiz CE1–4. PMID 12418624.
  5. ^ a b Jing JL, Pei Yi T, Bose RJ, McCarthy JR, Tharmalingam N, Madheswaran T (May 2020). "Hand Sanitizers: A Review on Formulation Aspects, Adverse Effects, and Regulations". International Journal of Environmental Research and Public Health. 17 (9): 3326. doi:10.3390/ijerph17093326. PMC 7246736. PMID 32403261.
  6. ^ a b c "Show Me the Science – When & How to Use Hand Sanitizer in Community Settings". cdc.gov. 3 March 2020. Retrieved 16 March 2020. CDC recommends washing hands with soap and water whenever possible because hand washing reduces the amounts of all types of germs and chemicals on hands. But if soap and water are not available, using a hand sanitizer with at least 60% alcohol can help... sanitizers do not eliminate all types of germs... Hand sanitizers may not be as effective when hands are visibly dirty or greasy... Hand sanitizers might not remove harmful chemicals
  7. ^ Bhatt S, Patel A, Kesselman MM, Demory ML (June 2024). "Hand Sanitizer: Stopping the Spread of Infection at a Cost". Cureus. 16 (6): e61846. doi:10.7759/cureus.61846. PMC 11227450. PMID 38975405.
  8. ^ "Clean Hands Save Lives!". Centers for Disease Control and Prevention. 11 December 2013. Archived from the original on 18 August 2017.
  9. ^ a b c Bolon MK (September 2016). "Hand Hygiene: An Update". Infectious Disease Clinics of North America. 30 (3): 591–607. doi:10.1016/j.idc.2016.04.007. PMID 27515139. In 2002, the CDC released an updated hand hygiene guideline and, for the first time, endorsed the use of alcohol-based hand rubs for the majority of clinical interactions, provided that hands are not visibly soiled
  10. ^ Hirose R, Nakaya T, Naito Y, Daidoji T, Bandou R, Inoue K, et al. (September 2019). "Situations Leading to Reduced Effectiveness of Current Hand Hygiene against Infectious Mucus from Influenza Virus-Infected Patients". mSphere. 4 (5). doi:10.1128/mSphere.00474-19. PMC 6751490. PMID 31533996. For many reasons, alcohol hand sanitizers are increasingly being used as disinfectants over hand washing with soap and water. Their ease of availability, no need for water or plumbing, and their proven effectiveness in reducing microbial load are just a few.
  11. ^ World Health Organization (2015). The selection and use of essential medicines. Twentieth report of the WHO Expert Committee 2015 (including 19th WHO Model List of Essential Medicines and 5th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization. hdl:10665/189763. ISBN 9789240694941. ISSN 0512-3054. WHO technical report series; no. 994.
  12. ^ "Guide to Local Production: WHO-recommended Handrub Formulations" (PDF). Retrieved 11 April 2020.
  13. ^ Long BW, Rollins JH, Smith BJ (2015). Merrill's Atlas of Radiographic Positioning and Procedures (13th ed.). Elsevier Health Sciences. p. 16. ISBN 9780323319652. Archived from the original on 18 September 2017.
  14. ^ Baki G, Alexander KS (2015). Introduction to Cosmetic Formulation and Technology. John Wiley & Sons. p. 173. ISBN 9781118763780. Archived from the original on 18 September 2017.
  15. ^ "Alcohol-free hand sanitizer prices are skyrocketing, but they don't actually work to prevent the coronavirus, Business Insider - Business Insider Singapore". www.businessinsider.sg. Archived from the original on 11 April 2020. Retrieved 11 April 2020.
  16. ^ Block SS (1977-12-01). "Disinfection, sterilization, and preservation". Soil Science. 124 (6): 378. Bibcode:1977SoilS.124..378B. doi:10.1097/00010694-197712000-00013. ISSN 0038-075X.
  17. ^ Miller CH, Palenik CJ (2016). Infection Control and Management of Hazardous Materials for the Dental Team (5th ed.). Elsevier Health Sciences. p. 269. ISBN 9780323476577. Archived from the original on 18 September 2017.
  18. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  19. ^ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.

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