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Consumer Products

What is hand sanitizer, and does it keep your hands germ-free?

Useful when you don’t have access to a sink and some soap, hand sanitizers have become a hot commodity in the face of COVID-19

by Laura Howes
March 23, 2020 | APPEARED IN VOLUME 98, ISSUE 12

 

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Credit: Shutterstock

In early 2020, as the outbreak of the novel coronavirus, SARS-CoV-2, spread, hand sanitizer sales began to grow. By March 11, the World Health Organization (WHO) officially upgraded the outbreak to a global pandemic. Health agencies everywhere recommended that people refrain from touching their faces and clean their hands after touching public surfaces like door handles and handrails.

The first US case of COVID-19, the disease caused by SARS-CoV-2, was detected Jan. 20. According to market research firm Nielsen, hand sanitizer sales in the US grew 73% in the 4 weeks ending Feb. 22.

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Signs have begun to spring up on storefront doors across the globe explaining that hand sanitizers are sold out. As a result, luxury brand owner LVMH, chemical giant BASF, and chemistry students at different universities across the globe are trying to produce fresh supplies.

Hand sanitizer ingredients
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Sources: Various companies.

But is the popularity of hand sanitizers justified? Although most health officials say that soap and water is the best way to keep your hands virus-free, when you’re not near a sink, the experts say, hand sanitizers are the next best thing. To get the maximum benefit from hand sanitizers, the Centers for Disease Control and Prevention (CDC) recommends that people use a product that contains at least 60% alcohol, cover all surfaces of their hands with the product, and rub them together until dry.

Even before scientists knew that germs existed, doctors made the link between handwashing and health. American medical reformer Oliver Wendell Holmes and the Hungarian “Savior of Mothers,” Ignaz Philipp Semmelweis, both linked poor hand hygiene with increased rates of postpartum infections in the 1840s, almost 20 years before famed French biologist Louis Pasteur published his first germ theory findings. In 1966, while still a nursing student, Lupe Hernandez patented an alcohol-containing, gel-based hand sanitizer for hospitals. And in 1988, the firm Gojo introduced Purell, the first alcohol-containing gel sanitizer for consumers.

Although some hand sanitizers are sold without alcohol, it is the main ingredient in most products currently being snatched from store shelves. That’s because alcohol is a very effective disinfectant that is also safe to put on your skin. Alcohol’s job is to break up the outer coatings of bacteria and viruses.

SARS-CoV-2 is what’s known as an enveloped virus. Some viruses protect themselves with only a cage made of proteins. But as enveloped viruses leave cells they’ve infected, the viruses wrap themselves in a coat made of some of the cells’ lipid-based walls as well as some of their own proteins. According to chemist Pall Thordarson of the University of New South Wales, the lipid bilayers that surround enveloped viruses like SARS-CoV-2 are held together by a combination of hydrogen bonds and hydrophobic interactions. Like the lipids protecting these microorganisms, alcohols have a polar and a nonpolar region, so “ethanol and other alcohols disrupt these supramolecular interactions, effectively ‘dissolving’ the lipid membranes,” Thordarson says. However, he adds, you need a fairly high concentration of alcohol to rapidly break apart the organisms’ protective coating—which is why the CDC recommends using hand sanitizers with at least 60% alcohol.

But rubbing high concentrations of alcohol on your skin is not pleasant. The alcohol can quickly dry out your skin because it will also disrupt the protective layer of oils on your skin. That’s why hand sanitizers contain a moisturizer to counteract this drying.

The WHO offers two simple formulations for making your own hand-sanitizing liquids in resource-limited or remote areas where workers don’t have access to sinks or other hand-cleaning facilities. One of these formulations uses 80% ethanol, and the other, 75% isopropyl alcohol, otherwise known as rubbing alcohol. Both recipes contain a small amount of hydrogen peroxide to prevent microbes from growing in the sanitizer and a bit of glycerol to help moisturize skin and prevent dermatitis. Other moisturizing compounds you might find in liquid hand sanitizers include poly(ethylene glycol) and propylene glycol. When an alcohol-based hand sanitizer is rubbed into the skin, its ethanol evaporates, leaving behind these soothing compounds.

In clinics, runny, liquid hand sanitizers like those you can make from the WHO recipes are easily transferred to the hands of patients, doctors, and visitors from wall-mounted dispensers. For consumers, hand sanitizer gels are a lot easier to carry and dispense on the go because it’s easier to squeeze a gel from the bottle without spilling it everywhere. Gels also slow the evaporation of alcohol, ensuring it has time to cover your hands and work against the microbes that might be present.

People who have tried to make their own gel-based hand sanitizers can tell you that classic gelling agents like gelatin or agar won’t behave when mixed with the high concentrations of alcohol that you need to kill viruses and bacteria. These agents won’t form a gel that’s stable because polar alcohol groups interrupt the intermolecular bonds. Manufacturers get around this obstacle by using high-molecular-weight cross-linked polymers of acrylic acid. The covalent cross-links help make a viscous gel that’s resistant to alcohol’s disruption.

While most hand sanitizers contain either ethyl alcohol or isopropyl alcohol, alcohol-free hand sanitizers are also for sale. These usually contain antimicrobial compounds like benzalkonium chloride that provide a lasting protection against bacteria. But alcohol-free products aren’t recommended by the CDC for fighting the novel coronavirus, because it isn’t yet clear that it can be used successfully against SARS-CoV-2.

So should you keep checking your local store religiously until alcohol-containing hand sanitizers are back in stock or buy up supplies if you see them? According to Rachel McCloy, an expert in behavioral science at the University of Reading, panic buying allows people to regain a feeling of control. But when people are scared, they often don’t make decisions that are rational or proportional to the risks. “It’s key to listen to experts in public health about the most effective actions that you can take at any point,” she says. And the best option is still washing your hands.

Soap and water are still the best option for hand hygiene, Thordarson emphasizes. Soap molecules not only disrupt noncovalent interactions that hold viruses and bacterial cell walls together but can also surround and help detach microbes from the skin. Hand sanitizers can’t remove microbes from the skin and aren’t effective against all germs. For example, noroviruses don't have a lipid membrane coating that can be broken up by alcohol, and the spores of Clostridium difficile have a tough coating of keratin that can protect them for years. Alcohol also doesn’t work as effectively when hands are dirty or greasy.

“Alcohol-based products work,” Thordarson says. “But nothing beats soap.”

CORRECTION

This story was updated on May 26, 2020, to clarify that the alcohol in hand sanitizers evaporates after being applied to skin. It does not dissolve.

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Comments
daliya robson (March 26, 2020 2:27 PM)
More a question. and thanks for your work as well . I have a gallon of propylene glycol and also have chemical sensitivities. How do I use this again this latest human hazard the virus 19 ?
Can I wash floors with it? Does it give off formaldehyde? Do I had a few onz 95% alcohol and use for hands? I bought it by mistake and likely will keep it if it's safe to use ??? my email is daliya@nontoxic.com
Please send recipe for a safe ut effective had wash against virus with this product
Dr. S. Divakaran (April 2, 2020 1:46 PM)
Hand sanitizers are handy. After using a hand sanitizer it is a good idea to wash hands with soap and water prior to handling or eating food that is touched or handled by hand. I have found that hand sanitizers leave a bitter taste and the emollients are better washed off at the earliest opportunity.
Bruce (April 5, 2020 1:50 PM)
I'm wondering if small amounts of detergent mixed with 80%+ alcohol would make it more effective but not leave a too irritating residue after alcohol evaporation. Laundry detergent is made so that residues left after imperfect rinsing are not irritating. I'm wondering if mixing in sime light oil would make it less drying out of flesh and not compromise its effectiveness. After all, oils attract and dissolve lipids just as does alcohol.
jennifer (April 11, 2020 4:02 AM)
Instead of laundry detergents or soaps, I added chlorhexidine gluconate to my sanitizer. It is often added to surgical sanitizers and is used for its microbial residual activity. Chlorhexidine gluconate is the active ingredient in hibiclens soap.
Varun (April 14, 2020 4:46 AM)
Alcohol is fast drying and hydrophillic and hygroscopic compound so it is recommended that for the purpose of hand sanitizer it is mixed with sufficient quantity of water and moisturizing agent. You can use Glycerine, Aloe-Vera gel, essential oils like tea tree oil, coconut oil etc but make sure that the there is at least 70% alcohol present in the final formulation.
Mark (June 11, 2020 2:34 PM)
Can you please explain why distilled water is needed for the WHO hand sanitizer formula. I have read that the hydrogen bonding between alcohol and glycerin greatly increases the boiling point and, thus, slows evaporation, allowing the alcohol to pull apart the virus membrane and render it harmless. What's unclear is why additional water is needed. If alcohol is hydrophilic and easily bonds with water, does this somehow magnify the effect of glycerin? If so, do you really need both glycerin and added water? I assume that the WHO recommended formula has a scientific basis and welcome an explanation. Many news sources quote the need for glycerin solely for its moisturizing effect, so it would be helpful to have accurate, scientific rationale to dispel misinformation. Thank you!
Dr. F. Ortigao (April 10, 2020 11:40 AM)
I know for a fact that the stabilized solution of chlorine dioxide at 50PPM is a far more potent hand disinfectant that ethanol, isopropanol or quaternary ammonium. The data is well established.
Domingo (April 12, 2020 7:02 PM)
when a gel sanitizer is used, don't the gelling material stays on the skin? Doesn't this residue contribute to faster re-soiling of the skin?
Brett Styles (April 16, 2020 8:07 PM)
Just curious since authorities are disinfecting trains etc with sanitizer, does this prevent germs and viruses attaching after its application and for how long. I assumed they killed existing but were not a preventative measure.
Tesfa (April 23, 2020 3:56 AM)
Are there other standard methods of quality checking parameters?
SEZ (April 26, 2020 2:53 PM)
"One of these formulations uses 80% ethanol, and the other, 75% isopropyl alcohol, otherwise known as rubbing alcohol."

No it doesnt use these alcohols, this is the final concentration AFTER making the sanitizer. The formulations use 96% ethanol and the other uses 99.8% isopropyl.
Jennifer (May 6, 2020 9:21 AM)
I have found liquid hand sanitizer. I would like to make it into a gel. Is it safe and still effective? It’s is 80%. I just wasn’t sure if i mixed it with the aloe if it would still have enough % to be effective.
Tiffany (May 6, 2020 6:14 PM)
Can I add a finished (80% alcohol) sanitizer rub solution to an OTC aloe gel (for easy use) without it's effectiveness being diluted?
suhail kamal (May 11, 2020 5:56 AM)
can anyone help me in telling me that what is the equipment/device available in the market for testing the ethanol in sanitizer
thanks
Myra (May 12, 2020 3:15 PM)
This is a completely false assertion based on an unfounded urban legend:
"In 1966, while still a nursing student, Lupe Hernandez patented an alcohol-containing, gel-based hand sanitizer for hospitals."
Journalism relies on in-depth fact-checking beyond Google searches.
Amiee (May 19, 2020 5:00 PM)
The article is incorrect. At no time did the WHO formulations use 75% isopropyl alcohol, nor 80% ethanol. Both formulations rely on much higher concentrations to ensure that after dilution, they are 60% or higher
Riya (May 20, 2020 12:52 AM)
If we use hand sanitizer germs will not enter for 2 hours?
Alpha Arogya (May 21, 2020 6:50 AM)
Thank you for sharing this blog.
I would like to add a few points of mine too.
With the sudden increase in demand, market is flooding with cheap quality hand sanitizers. If you check the labels closely, you will find that IPA, Ethyl Alcohol, and menthol are being used. Applying this cheap sanitizer on hand means poisoning yourself because –
1. Hands start turning white if used 3-4 times a day;
2. Hands begin to crack and you feel the need to wash hands frequently;
3. Due to the use of alcohol alone, antibacterial layer on the foreskin of hands start breaking down.
This cheap alcohol enters are body and starts attacking our Lymphatic system, Therefore, it is recommended that one only uses a hand gel that contains the right grade alcohol and other mentioned contents. (For more information, visit Alpha Arogya).
John (May 29, 2020 2:13 AM)
Just a question since alcohol based hand sanitizer kills germs instantly does drying your hands with a paper towel after use prevent it from working effectively
Irene (June 11, 2020 8:20 AM)
Good Article! Is is safe to use hand sanitizers before food? Also is it safe to use alcohol based hand sanitizers? Does it causes any problem to our hands due to prolonged use?
Gilbert (June 11, 2020 2:45 PM)
Yes, drying your hands out too fast does reduce the effectiveness of the hand sanitizer. The alcohol needs a "dwell time" on your hands to penetrate and kill the germs to be effective. Hand sanitizers with added ingredients create a thin "film" to keep the alcohol on your skin to increase it's effectiveness. While I appreciate the CDC and FDA's intent with the hand sanitizer temporary exception that allows any alcohol compounder to make hand sanitizer, the ingredients they are using evaporate quickly, reducing the germ-killing power, and dry out the hands, making it uncomfortable to use. The best product is a high quality, made in the USA product that is FDA registered, and is the best insurance to make sure you get the safest and most effective hand sanitizer.
Levi Armstrong (August 24, 2020 7:29 AM)
It's great that you said that I should keep a bottle of hand sanitizer in my bag during this pandemic because they are the next best thing if there's not a handwashing station nearby. This pandemic has been making me constantly anxious whenever I go our for necessities because I don't want to bring virus home to my kids and immuno-compromised mother. I've read online that aloe vera balances the harsh drying effects of alcohol, so I'll buy aloe gel hand sanitizers the next time I go out. Thanks! http://earloopmask.life/shop/ols/products/hand-sanitizer-mark3-brand-169oz-mositurizing-aloe-kills-999-bacteria-70-ethyl-alcohol
Dan R (September 2, 2020 10:30 PM)
if using a 75% or 80% IPA liquid hand sanitizer as a sanitizer for desks, CRT screens, equipment etc. how many minutes do you need to leave on if applied through an electrostatic sprayer like the Victory?

Thank you.

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