Regular hand washing, using soap and running water, is one of the best defences against many of the viruses, bacteria and other microbes that can make us sick.1-5 However, when water is not available, in the car or on public transport for example, or when your already clean hands just need an extra boost, hand sanitisers are convenient, portable and effective.

Australian and international hand hygiene guidelines recommend alcohol-based hand sanitisers and hand washing as the best methods for removing microbes.1,6

It is not necessary for the soap or the hand sanitiser to be branded as ‘antibacterial’ to have an effect. Soap works by physically removing organisms from the skin, while alcohol damages proteins in microbes and leaves them unable to survive. Both products target a range of disease-causing microbes that includes bacteria and viruses.

Are all hand sanitisers similar?

Hand sanitisers come in different forms, including gels, creams and foams. Most products contain some form of alcohol, but a few are alcohol-free.

If you are looking to buy a hand sanitiser, there is good evidence showing that alcohol-based products (with 60%–95% ethanol or isopropanol7,8) work well against many of the viruses and bacteria that spread infections like colds, flu and diarrhoea.1,3,4,7-11

Studies have also reported that alcohol-based hand cleaners are actually less irritating and drying to the skin than soap and water.8,12,13 Brands that contain moisturisers can reduce the level of irritation even further. This is good news for people who need to clean their hands frequently.

If you do use alcohol-based hand sanitisers, remember alcohol can be toxic to children,14 so keep the containers out of reach of young ones. Take care around open flames as well, because alcohol, even as part of a hand rub, is highly flammable.

Alcohol-free hand rubs are also available, but current evidence says they may not work as well as soap and water or alcohol-based cleaners, and some may be more irritating to the skin.6-8,15,16

How to use hand sanitisers correctly

To get the best possible protection from your waterless hand sanitiser make sure to apply enough product so you can cover both hands thoroughly, front and back and in between your fingers. Cleaning should take 20–30 seconds.

For step-by-step instructions see the How to Handrub poster.

Visit the Hand Hygiene Australia website for more information.

Using hand sanitisers in hospitals and other clinical places

At home, or at work or school, soap and running water provide an easy and inexpensive option for keeping hands clean and removing potential disease-causing germs.

At medical sites such as hospitals or dental practices, soap and water remain important, however all staff, patients and visitors are also encouraged to use alcohol-based hand rubs regularly, even if their hands look clean.

References

  1. Hand Hygiene Australia. Hand Hygiene. Factsheet for consumers. 2015 [Online] (accessed 20 Nov 2015).
  2. Ejemot-Nwadiaro RI, Ehiri JE, Arikpo D, et al. Hand washing promotion for preventing diarrhoea. Cochrane Database Syst Rev 2015;9:CD004265. [PubMed].
  3. Tuladhar E, Hazeleger WC, Koopmans M, et al. Reducing viral contamination from finger pads: handwashing is more effective than alcohol-based hand disinfectants. J Hosp Infect 2015;90:226-34. [PubMed].
  4. Jefferson T, Del Mar CB, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2011:CD006207. [PubMed].
  5. Grayson ML, Melvani S, Druce J, et al. Efficacy of soap and water and alcohol-based hand-rub preparations against live H1N1 influenza virus on the hands of human volunteers. Clin Infect Dis 2009;48:285-91. [PubMed].
  6. Centers for Disease Control and Prevention. Show me the science - When to use Hand Sanitizer. Handwashing. 2015 [Online] (accessed 20 Nov 2015).
  7. Todd EC, Michaels BS, Holah J, et al. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 10. Alcohol-based antiseptics for hand disinfection and a comparison of their effectiveness with soaps. J Food Prot 2010;73:2128-40. [PubMed].
  8. Kampf G and Kramer A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 2004;17:863-93. [PubMed].
  9. Henriey D, Delmont J and Gautret P. Does the use of alcohol-based hand gel sanitizer reduce travellers' diarrhea and gastrointestinal upset?: A preliminary survey. Travel Med Infect Dis 2014;12:494-8. [PubMed].
  10. Pickering AJ, Boehm AB, Mwanjali M, et al. Efficacy of waterless hand hygiene compared with handwashing with soap: a field study in Dar es Salaam, Tanzania. Am J Trop Med Hyg 2010;82:270-8. [PubMed].
  11. Stebbins S, Cummings DA, Stark JH, et al. Reduction in the incidence of influenza A but not influenza B associated with use of hand sanitizer and cough hygiene in schools: a randomized controlled trial. Pediatr Infect Dis J 2011;30:921-6. [PubMed].
  12. Paulson DS, Fendler EJ, Dolan MJ, et al. A close look at alcohol gel as an antimicrobial sanitizing agent. Am J Infect Control 1999;27:332-8. [PubMed].
  13. Boyce JM, Kelliher S and Vallande N. Skin irritation and dryness associated with two hand-hygiene regimens: soap-and-water hand washing versus hand antisepsis with an alcoholic hand gel. Infect Control Hosp Epidemiol 2000;21:442-8. [PubMed].
  14. Barrett MJ and Babl FE. Alcohol-based hand sanitiser: a potentially fatal toy. Med J Aust 2015;203:43-4. [Online] (accessed 15 April 2016).
  15. Kim SA, Moon H, Lee K, et al. Bactericidal effects of triclosan in soap both in vitro and in vivo. J Antimicrob Chemother 2015;70:3345-52. [PubMed].
  16. Giuliano CA and Rybak MJ. Efficacy of triclosan as an antimicrobial hand soap and its potential impact on antimicrobial resistance: a focused review. Pharmacotherapy 2015;35:328-36. [PubMed].