Hand sanitizer

Hand sanitizer (also known as hand antiseptic, hand disinfectant, hand rub, or handrub) is a liquid, gel or foam generally used to kill many viruses/bacteria/microorganisms on the hands.[3][4] In most settings, hand washing with soap and water is generally preferred.[5][6][7] Hand sanitizer is less effective at killing certain kinds of germs, such as norovirus and Clostridium difficile, and unlike hand washing, it cannot physically remove harmful chemicals.[5] People may incorrectly wipe off hand sanitizer before it has dried,[5] and some are less effective because their alcohol concentrations are too low.[5]

Hand sanitizer
A typical pump bottle dispenser of hand sanitizer gel
Clinical data
Other namesHand sanitizer, hand antiseptic,[1] hand disinfectant, hand rub, handrub[2]

Alcohol-based hand sanitizer that is at least 60% (v/v) alcohol in water (specifically, ethanol or isopropyl alcohol/isopropanol (rubbing alcohol)) is recommended by the United States Centers for Disease Control and Prevention (CDC), but only if soap and water are not available.[8] The CDC recommends the following steps when using an alcohol-based hand sanitizer:

  1. Apply product to the palm of one hand.
  2. Rub hands together.
  3. Rub the product over all surfaces of hands and fingers until hands are dry.[8]
  4. Do not go near flame or gas burner or any burning object during application of hand sanitizer.

In most healthcare settings, alcohol-based hand sanitizers are preferable to hand washing with soap and water,[9][10] because it may be better tolerated and is more effective at reducing bacteria.[4] Hand washing with soap and water, however, should be carried out if contamination can be seen, or following the use of the toilet.[11] The general use of non-alcohol-based hand sanitizers is not recommended.[9]

Alcohol-based versions typically contain some combination of isopropyl alcohol, ethanol (ethyl alcohol), or n-propanol, with versions containing 60% to 95% alcohol the most effective.[4] Care should be taken as they are flammable.[9] Alcohol-based hand sanitizer works against a wide variety of microorganisms but not spores.[4] Compounds such as glycerol may be added to prevent drying of the skin.[4] Some versions contain fragrances; however, these are discouraged due to the risk of allergic reactions.[12] Non-alcohol based versions typically contain benzalkonium chloride or triclosan; but are less effective than alcohol-based ones.[13][14][15]

Alcohol has been used as an antiseptic at least as early as 1363 with evidence to support its use becoming available in the late 1800s.[16] Alcohol-based hand sanitizer has been commonly used in Europe since at least the 1980s.[17] The alcohol-based version is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.[18]