How to Use Hand Sanitizer

And when it's a good idea

Alcohol-based hand sanitizer is just a part of daily life for a lot of people, but did you know there's a right and wrong way to use it? It's also not the best germy-hand solution in all situations.

When sanitizers first came out, we had little research showing what they did and didn't do, but that has changed. More research needs to be done, but scientists are learning more all the time.

The Science

According to the Centers for Disease Control and Prevention, research shows that hand sanitizer kills germs as effectively as washing your hands with soap and water—unless your hands are visibly dirty or greasy. They also don't remove potentially harmful chemicals.

However, hand sanitizers don't kill some common germs soap and water do eliminate, such as:

  • Cryptosporidium
  • Clostridium difficile
  • Norovirus

One study on long-term healthcare facilities suggested that employee's preference for sanitizers over soap and water may have contributed to norovirus outbreaks.

The U.S. Food and Drug Administration has taken legal action against some hand sanitizer companies for making unproven claims against salmonella, e. Coli, Ebola, rotavirus, influenza, and MRSA (methicillin-resistant Staphylococcus aureus).

At the same time, though, studies are beginning to suggest that alcohol-based hand sanitizers may be effective at killing some of these germs. (Even so, the companies that make them have yet to gain FDA approval for these uses, making their claims illegal.)

For example:

  • A 2019 study on hospital-borne infections shows sanitizers may help slow the spread of MRSA and other infections by providing a quick, easy, and convenient way for healthcare workers to improve their hand hygiene.
  • Research published in 2015 concluded that alcohol-based sanitizers were able to reduce the populations of salmonella and E.coli.
  • Intensive hand-sanitizer use in Japan in response to a flu pandemic may have cut short-term rates of norovirus.
  • In a study on elementary schools, hand sanitizers cut absences due to illness by 26% and reduced confirmed cases of illness from the highly contagious influenza A virus by 52%; It was, however, less effective against the influenza B virus.

Additionally, a 2018 study on daycare centers found a drop in days missed due to overall illness when the center introduced hand sanitizers and educated staff, children, and parents on their proper use.

However, it's important to remember that not of the research is conclusive and washing with soap and water is still superior to hand sanitizer.

Education is key. When hand sanitizers do work, their effectiveness is based on several factors:

  • Which product you use
  • How much you use
  • Proper techniques
  • Consistency

Despite the effectiveness of alcohol-based hand sanitizers, washing with soap and water is still a better option. The CDC recommends soap and water whenever possible supplemented by sanitizers when washing isn't an option.

A Note on Norovirus

It can be confusing when one source says alcohol sanitizers don't kill norovirus and another suggests it does. A study published in 2019 helps clarify the relationship.

Researchers say an ethanol-based hand sanitizer can reduce the norovirus infection risk by 85% when there's short-term contact with the virus. However, under high-contamination conditions, such as those you might find on a cruise ship or in a long-term care facility, the sanitizer offered no protection whatsoever.

What this means for you is that your hand sanitizer might protect you if you happen to touch a doorknob with norovirus on it, but not if you're surrounded by infected people and contaminated objects for hours or days. In these situations, your best bet is to wash your hands often.

How It Works

The active ingredient in hand sanitizers is isopropyl alcohol ("rubbing alcohol"), a similar form of alcohol (ethanol or n-propanol), or a combination of them. Alcohols have long been known to kill microbes by dissolving their protective outer layer of proteins and disrupting their metabolism.

Use Sanitizer When...

  • You can't wash with soap and water

  • You want added protection after washing

Don't Use Sanitizer...

  • In place of washing with soap and water

  • When your hands are visibly soiled

  • When you have chemicals on your hands

What to Look For

The CDC recommends sanitizers with at least 60% alcohol content. Most products contain between 60% and 95%, but don't assume that the higher the percentages are more effective. To work at peak efficiency, they also need to contain some water.

Some products on the market claim to sanitize your hands but contain too little alcohol or no alcohol at all. These products will likely not offer you adequate protection.

You should also take care to keep alcohol-based hand sanitizing gel out of the reach of young children as it can be very dangerous if swallowed. The high alcohol content can be fatal to a young child.

How to Use It

To keep yourself and your family healthy, it's important to clean your hands, especially after you've used the restroom or prepared food. Vigorously washing your hands with warm water and soap for 20 seconds is still a tried and true method.

Alcohol-based hand sanitizers can be a convenient alternative, however, as you can use them on the go after you have been on public transportation, touched an animal or grocery cart, etc. The CDC states that both hand sanitizing wipes and alcohol-based gels are effective at killing germs.

To use hand sanitizer correctly:

  • Place the recommended amount in the palm of one hand. (Read the manufacturer's directions.)
  • Rub hands together.
  • Rub the sanitizer all over your hands and between your fingers until they are dry

Alcohol-based hand sanitizer is a great alternative to washing your hands if you have no access to soap and water and your hands are not visibly soiled.

When NOT to Use It

Hand sanitizer shouldn't be used instead of soap and water when:

  • Washing is convenient
  • Your hands a greasy or visibly dirty
  • You have chemicals on your hands
  • You may have been exposed to infectious agents that aren't killed by hand sanitizer
  • You're in a high-infection situation

Those situations call for proper handwashing. However, you can also use hand sanitizer after washing for an extra measure of protection.

Does Sanitizer Create Superbugs?

Warnings have periodically made the news about certain antibacterial products causing microbes to develop a resistance to antibiotics, turning them into deadly "superbugs" (like MRSA and Clostridium difficile) that we can't stop with drugs.

That warning doesn't include alcohol-based hand sanitizers that are currently on the market. The problem is an antibiotic product named triclosan that was used in soaps, some hand sanitizers, and numerous other products.

The FDA has banned triclosan and similar antibiotics from soaps, and most manufacturers have stopped using it in hand sanitizers due to public pressure. It's legally required to be listed in the ingredients, so it's simple to see if a particular product contains it.

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. U.S. Food and Drug Administration. Hand sanitizers carry unproven claims to prevent MRSA infections. Published April 20, 2011.

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  7. Inaida S, Shobugawa Y, Matsuno S, Saito R, Suzuki H. Delayed norovirus epidemic in the 2009-2010 season in Japan: potential relationship with intensive hand sanitizer use for pandemic influenzaEpidemiol Infect. 2016;144(12):2561–2567. doi:10.1017/S0950268816000984

  8. 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 trialPediatr Infect Dis J. 2011;30(11):921–926. doi:10.1097/INF.0b013e3182218656

  9. Azor-Martinez E, Yui-Hifume R, Muñoz-Vico FJ, et al. Effectiveness of a hand hygiene program at child care centers: A cluster randomized trialPediatrics. 2018;142(5):e20181245. doi:10.1542/peds.2018-1245

  10. National Center for Biotechnology Information, U.S. National Library of Medicine: StatPearls. Alcohol sanitizer. Updated December 16, 2019.

  11. Wilson AM, Reynolds KA, Jaykus LA, Escudero-Abarca B, Gerba CP. Comparison of estimated norovirus infection risk reductions for a single fomite contact scenario with residual and nonresidual hand sanitizers [published online ahead of print, 2019 Oct 29]. Am J Infect Control. 2019;S0196-6553(19)30846-6. doi:10.1016/j.ajic.2019.09.010

  12. Westfall C, Flores-Mireles AL, Robinson JI, et al. The widely used antimicrobial triclosan induces high levels of antibiotic tolerance in vitro and reduces antibiotic efficacy up to 100-fold in vivoAntimicrob Agents Chemother. 2019;63(5):e02312-18. Published 2019 Apr 25. doi:10.1128/AAC.02312-18

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