Here's How to Use Hand Sanitizer Properly

With the spread of coronavirus and seasonal influenza, Americans have been stocking up on hand sanitizer. And with good reason: The Centers of Disease Control and Prevention (CDC) says that hand sanitizer with at least 60 percent alcohol is an effective alternative to hand washing. Here’s the best method for using hand sanitizer—and whether it’s safe for young children and pregnant women.

Does Hand Sanitizer Actually Work?

When it comes to banishing germs, nothing beats washing your hands with soap and water for at least 20 seconds, says Christine Schindler, CEO and founder of PathSpot, a hand hygiene system that protects against food-borne illness. Soap loosens dirt and bacteria off the skin and helps wash it down the drain. But in a pinch, the CDC says you can use an alcohol-based hand sanitizer—as long as it has at least 60 percent alcohol. Anything less might actually encourage bacterial growth.

How to Use Hand Sanitizer

It's not enough to briefly rub sanitizer on your palms and call it a day. Using a nickel- or quarter-size dollop, rub the sanitizer all over your hands—between the fingers, on the fronts and backs, and under your nails by scraping them against your palms. You should keep rubbing until the sanitizer is completely dry, says Schindler. Don't let kids wipe any off on their pants; that reduces effectiveness.

Also keep in mind that hand sanitizer isn’t effective immediately. Research published in mSphere in September 2019 found ethanol-bred disinfectants don’t swiftly destroy the influenza A virus. The study found it takes at least four minutes to kill it, and that’s due to the “stronger than expected” mucus surrounding the virus. Only once the mucus is completely dry will the virus die. Hand washing without soap was found to be more effective—it killed the virus within 30 seconds.

Is Hand Sanitizer Safe for Pregnant Women?

Pregnant women may be especially reliant on hand sanitizer to banish germs. But as it turns out, some ingredients may be unsafe while expecting—although this hasn’t been proven definitively.

Hand sanitizers often contain triclosan, a chemical used for antibacterial purposes that’s also found in antibacterial soaps, fluoride toothpastes, and some cosmetic products. According to an April 2017 study published in the journal Environmental Research, “Triclosan may reduce the levels of thyroid hormones that are important for fetal growth and development.” In particular, it’s associated with lower birth weight and reduced gestational age.

A 2010 study from the University of Florida also found that triclosan interferes with the “metabolism of estrogen.” A disruption could affect how estrogen is moved through the placenta—and it may also impact brain development, gene regulation, and fetal oxygen levels, according to the study.

The Food and Drug Administration (FDA) previously noted that triclosan was found in the urine of 75 percent of Americans, so exposure is very common. But if pregnant women want to avoid it, they can choose a hand sanitizer made without it. Triclosan should be listed on the ingredient label in any product containing it.

How About Young Children?

Babies have thin and delicate skin, so the chance of absorption is high. “Parents need to keep in mind that hand sanitizer contains alcohol,” says Debra M. Langlois, M.D., an assistant professor of pediatrics at the University of Michigan. Also, she notes that young children might accidentally ingest the hand sanitizer, or put their hands in their mouths before the product is fully rubbed in. “Ingestion of hand sanitizer could lead to alcohol poisoning, which is an emergency that requires immediate medical attention. Symptoms include confusion, vomiting, slowed breathing, seizures, and coma,” she says.

The good news is that there are rarely major effects from exposure in kids under 6, according to the American Association of Poison Control Centers. To be safe, though, Dr. Langlois says parents should store hand sanitizer out of children's reach and always monitor usage.