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The Effectiveness of Hand Sanitizer

Does sanitizer really work? Is washing your hands or sanitizing more effective? What about non-alcohol sanitizers? Here's the background.

Alcohol Sanitizer Effectiveness

The CDC recommends using an alcohol-based sanitizer with at least 60 percent alcohol. The FDA also, recently issued a final ruling on the effectiveness of hand sanitizer, concluding that 28 active ingredients including benzethonium chloride, and strictly essential oils, are not eligible for an antiseptic rub, effective April 12, 2019. [1]

Despite the myth, significant testing shows a sanitizer does not need to be 95% to be effective.Foams containing 62% ethanol are used for hand decontamination in many countries. [3] Furthermore, the application of sanitizer plays a big role in the amount of bacteria reduction, which we can revisit when we look at spray.

Does Hand Sanitizer Kill Viruses?

Hand washing, alcohol sanitizers, essential oils, and other "sanitizing" tactics all have a ceiling because of the dynamics of viruses, bacteria, and fungi. However, studies show the highest antimicrobial efficacy of sanitizer can be achieved with ethanol (60% to 85%) and appears to be the most effective against viruses.  

"According to the Centers for Disease Control and Prevention (CDC), alcohols have excellent in vitro germicidal activity against gram-positive and gram-negative vegetative bacteria, including multidrug-resistant pathogens (MRSA, VRE), Mycobacterium tuberculosis, HIV, influenza virus, RSV, vaccinia, and hepatitis B and C viruses." [3]

Hand Sanitizer Spray vs Hand Sanitizer Gel

In theory, all forms of hand sanitizer with over 60% alcohol are potential effective. However, proper application plays massive role. There are several studies on comparing the amount of alcohol based sanitizer needed to be effective, and how long it needs to be rubbed in. All result in a similar answer - your hands must be fully covered, and the sanitizer must be throughly rubbed in.

For example, dispensers that pump less than 3mL of hand rub only pushed once, would be insufficient to cover hands entirely, or thick enough to be effective. Studies have also showed that application time required to achieve hand disinfections range from 10 to 30 seconds. [3]

So, This makes it very difficult for a spray to be effective as gel, as the solution does not spread as easily, and can dry too quickly.

For a spray to be equally as effective as a gel, you must use significantly more to ensure full coverage, and heavy enough application to rub in and dry in 10 to 30 seconds.

Our take - spray sanitizer doesn't work as well, because as consumers we don't want to have to worry about spraying every last part of our hands down. Not to mention inhale it. Gel works better.

Hand Washing vs. Hand Sanitizer

Recently, in the journal Pediatrics, a research was done testing the effectiveness of hand sanitizer vs washing hands in children's daycare. One group was given a strict sanitizer routine, while the other a hand washing routine. The study found that that the children who used hand sanitizer were less likely to miss day care. 

"There was a 23% reduction in respiratory infections among the students using hand sanitizer compared with those in the control group - and a 31% higher risk of being prescribed antibiotics than those using hand sanitizer" [2]

With that being said, the FDA still recommends washing hands with an antibacterial soap when available as a first defense, and there are many different types of bacteria that handwashing kills, which sanitizer does not.

Our recommendation - wash your hands when you can, but keep a sanitizer in your pocket. A 2017 hospital-wide study, showed that the compliance rate of washing hands was only 54%, and that after introducing bedside antispectic, resulted in hygiene improvement and a reduction of nosocomial infections and MRSA transmission. [3] Moral of the story, there's not always a sink and antimicrobial soap around, and it pays to sanitize in between.

Non-Alcohol Hand Sanitizer

There are many different "alcohol free" sanitizers that claim to kill bacteria. However, there is a strong lack of scientific evidence on the effectiveness of these, and they are not upheld by either the CDC or the FDA. Many companies have even gotten in trouble for claiming to be disinfectant. You can read our side by side comparison to non alcohol sanitizer here 

[1] “Safety and Effectiveness of Consumer Antiseptic Rubs; Topical Antimicrobial Drug Products for Over-the-Counter Human Use.” Federal Register, Federal Drug Administration, 12 Apr. 2019, www.federalregister.gov/documents/2019/04/12/2019-06791/safety-and-effectiveness-of-consumer-antiseptic-rubs-topical-antimicrobial-drug-products-for.

[2] Thomas, Naomi. “Hand Sanitizer Cut Back on Young Children's Sick Days More than Washing, Study Says.” CNN, Cable News Network, 10 Oct. 2018, www.cnn.com/2018/10/08/health/hand-sanitizer-day-care-study/index.html?no-st=1539203414.

[3] Gold, Nina A. “Alcohol Sanitizer.” U.S. National Library of Medicine, Statpearls Publishing, 11 Nov. 2018, www.ncbi.nlm.nih.gov/books/NBK513254/.

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