Hand Sanitizers or Handwashing – Which Is Better for Fighting Germs?

I’ve been fielding questions all week from my patients about hand hygiene — and rightly so, given the current cold and flu season, and concerns about the outbreak of coronavirus disease (or COVID-19). When should you use a hand sanitizer, and when should you wash your hands? What should you look for in a hand sanitizer? Here’s what you need to know.

Is using a hand sanitizer or washing your hands better?

The mistake we make is using alcohol-containing hand rubs as a substitute for washing our hands with soap and water. Generally speaking, the only time to pick a hand sanitizer is when you don’t have access to soap and water. So, it’s about convenience.

While hand sanitizers do help, studies consistently show that handwashing with soap and water is better. For example, one study found that handwashing was better than an application of an ethanol-based hand sanitizer for removing rhinoviruses from the hands. Rhinoviruses cause the common cold.

Another study found that handwashing also worked better than ethanol- and propanol-based hand sanitizers at removing rotavirus and influenza A from the hands. Rotavirus can cause diarrhea. Influenza A is the type of virus that typically causes the seasonal flu.

And yet another study found that handwashing was better than alcohol rubs and antiseptic wipes at removing the bacteria C. difficile from the hands. C. diff is the type of bacteria that can cause symptoms ranging from diarrhea to serious inflammation and damage to the colon.

To sum it up, the evidence largely suggests that washing your hands with soap and water is better than using alcohol-based hand sanitizers for removing viruses and bacteria from the hands.

When might hand sanitizers be a good option?

Hand sanitizers can be helpful when you’re on the go. You can easily carry a bottle of it in your purse or backpack. If you’re traveling, it can tide you over until you find running water. And they do help to remove some of the germs on your hands.

What should you look for in a hand sanitizer?

People most often use alcohol-based hand rubs in the form of gels. But as it turns out, it doesn’t matter whether you pick a foam, gel, or wipe. They all significantly reduce microscopic bugs and germs on your hands.

Alcohol solutions containing 60% to 95% alcohol are generally effective and usually contain ethanol, propanol, or a combination of both. Popular products include Purell (70% ethanol) and Germ-X (63% ethanol).

A good thing to know is that ethanol, the most common alcohol ingredient, appears to be the most effective against viruses. Propanol, another type of alcohol ingredient, is better against bacteria. For that reason, many hand sanitizers contain a combination of both. Look for these ingredients on product labels when you go to choose one.

One downside to alcohol-based hand sanitizers is that they can be very drying to the skin. That’s why many of these products also contain glycerin, an ingredient that can help prevent skin dryness. Emollients or moisturizers, like aloe vera, can also help replace some of the water in your skin that is stripped away by the alcohol.