Reports of Adverse Effects of Hand Sanitizer Increased During COVID

Since the COVID-19 pandemic began, the Food and Drug Administration (FDA) has seen an uptick in reports from consumers regarding the adverse events of accidentally being exposed to hand sanitizer vapors.

Most of the symptoms were mild and included nausea, dizziness, and headache. In most cases, the symptoms resulted from using the products in poorly ventilated areas such as in rooms with closed windows. 

When it comes to preventing COVID-19, hand sanitizer is not a substitute for vaccination, wearing a face mask when appropriate, and taking other precautions. However, in a pinch, it can be better than nothing.

“When you don’t have easy access to soap and water, hand sanitizer can be an effective additional step in helping to potentially reduce transmission of some viruses including flu and the coronavirus,” Aaron Glatt, MD, the chief of infectious diseases at Mount Sinai South Nassau Medical Center in Hewlett, NY and a spokesperson for the Infectious Diseases Society of America, tells Verywell. 

The FDA reported—but didn’t specify—that some of the patients with adverse effects from using hand sanitizer needed treatment (which Dr. Glatt says included recommendations such as pain reliever for headache and over-the-counter medications for nausea).

Adverse Effects of Hand Sanitizer Use Increased During COVID

According to the FDA, people experiencing adverse effects of hand sanitizers likely inhaled vapors when using the products in enclosed spaces such as a car with closed windows, or in areas with poor air circulation. 

Courtney Rhodes, an FDA spokesperson, tells Verywell that the agency “received increasing reports of these side effects since the start of the COVID-19 pandemic.” 

Fifty cases of serious adverse events after applying alcohol-based hand sanitizers were reported to the agency FDA between January 1, 2010, and December 31, 2020. All of them were reported after March 2020, which coincided with the marked increase in hand sanitizer use during the pandemic.

Poison control centers throughout the United States also saw an increase in the number of reports of adverse events from hand sanitizer, according to the FDA.

In the three years between January 1, 2018, and December 31, 2020, 299 cases of adverse events were reported. There was a significant increase after March 2020 during the pandemic. Most cases were in adults, with children 5 or younger accounting for 12% of the cases reported. 

Washing Your Hands Is Best 

According to the Centers for Disease Control and Prevention (CDC), the best way to clean your hands is with soap, and water, if available.

The agency also recommends the following practices:

• Wash your hands often with soap and water for at least 20 seconds—especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
• It’s especially important to wash your hands before:
• Before, during, and after eating or preparing food
• Before touching your face
• After using the restroom
• After leaving a public place
• After blowing your nose, coughing, or sneezing
• After handling your mask
• After changing a diaper
• After caring for someone sick
• After touching animals or pets
• Avoid touching your eyes, nose, and mouth with unwashed hands

Safe Hand Sanitizer Use

If soap and water are not available and you are going to use hand sanitizer, the CDC recommends that you:

• Read and follow all directions and warnings on the product label. 
• Use hand sanitizer that contains at least 60 % alcohol (always check the label).
• Cover all surfaces of your hands with the product and rub them together until they feel dry
• Do not use hand sanitizer if your hands are visibly dirty or greasy, as the hand sanitizer will not be able to fully remove the dirt and germs. 
• Avoid breathing in vapors from hand sanitizer. Only use the product only in a well-ventilated area.
• If you are using hand sanitizer in an enclosed area such as a car, open a window to improve ventilation until the hand sanitizer is dry and the vapors have cleared. 
• Make sure that your hands are completely dry and vapors have cleared before doing any activities involving heat, sparks, static electricity, or open flames (hand sanitizer can be flammable). 

Safe Storage

The FDA also points out that there are steps you should take to properly store hand sanitizer to prevent accidental poisoning—particularly if there are kids in your home.

Always store hand sanitizers, along with all other medical products, out of children’s reach and sight. Swallowing even a small amount of hand sanitizer can cause alcohol poisoning in children, which may cause serious illness or death.

Check the FDA's “Do Not Use” List

The FDA maintains a list of hand sanitizers that consumers should not use and continually updates it. Check the list before buying a hand sanitizer brand that you haven’t purchased before.

Ann Marie Pettis, RN, president of the Association for Professionals in Infection Control, tells Verywell that there are a few key points to keep in mind to ensure that you are using hand sanitizer safely.

"If you are using hand sanitizer in your car, open the window," Pettis says. "If you or a family member experience unusual symptoms after applying hand sanitizer, contact your primary care practice or Poison Control. If someone is having difficulty breathing, contact 911 right away. Hand sanitizers can be deadly if swallowed; always keep out of reach of children.” 

Use Hand Sanitizer With Caution

While caution is advised when using hand sanitizers, their use can help prevent infections. That's why knowing how to use these products safely is so important.

Kelly Krisna Johnson-Arbor, MD, a medical toxicologist at the Medstar Health System in Washington, DC, and co-director of the Washington DC Poison Control centers, tells Verywell that, anecdotally, reports of adverse events to the DC center have fallen in 2021 compared with 2020.

While that is good news in terms of accidental poisonings and other health effects, Johnson-Arbor is concerned that it might be because people are being less vigilant about using the products as the pandemic has started to ebb.

“The risk of contracting the virus is still here,” says Johnson-Arbor. “Use soap and water when you can, use hand sanitizer, safely, when soap and water are not available.” 

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.