The Dirt on Hand Sanitizer

Woman using hand sanitizer dispenser.
CDC recommends using cleansers, hand sanitizer, and lotions.

Cleanliness is next to godliness. This is especially true in the medical field, where hand hygiene can directly impact the health and wellness of both patients and workers. However, studies have shown actual compliance rates to be less than stellar at below 40-50% (Messina, et al. 1044). Failure to comply with guidelines has been attributed to the inconvenient location of washing stations, insufficient number of sinks, lack of time, and existing skin irritations and conditions.

Fortunately, alternatives to traditional soap and water hand washing, or alcohol-based hand rubs (ABHR), have become increasingly prevalent in recent years and are often lauded for their convenience factor and ease of use. One study found healthcare workers are more likely to comply with hand hygiene requirements when given the option to use hand sanitizer (Messina, et al. 1044).


Ethanol-based formulas have proven to be the most effective type of ABHR. Concentrations of higher than 60-70% ethanol have less water content and are less effective, as the balance between alcohol and water is crucial. Likewise, chlorhexidine concentrations of more than 4% should be avoided to reduce the occurrence of contact dermatitis and skin irritation (Messina, et al. 1046).

Moreover, studies have shown nurses sustained greater skin damage from washing with ordinary soap and water (Messina, et al. 1046). Agents such as chlorhexidine have gained popularity for their mild affect on skin. Triclosan has low irritation potential in addition to anti-inflammatory properties. Newer formulations of hand sanitizers have taken the drying effect of multiple washings into consideration and many now contain moisturizers similar to those found in hand lotions.

In fact, the Centers for Disease Control (CDC) recommends a regimen of cleansers, hand sanitizers, and lotions for optimal hand hygiene and skin conditioning. Furthermore, glove usage plays a significant role in physical barrier protection, while providing an additional moisturizing quality as with aloe vera-coated varieties. In the healthcare industry, where cleanliness is matter a life or death, it is prudent to take extra steps ensuring the safety of patients and staff.


Kaiser, and Newman. “Formulation technology as a key component in improving hand hygiene practices”. American Journal of Infection Control (Dec 2006).

Messina, L. A. Brodell, R. T. Brodell, and Mostow. “Hand hygiene in the dermatologist’s office: To wash or to rub?”. J Am Acad Dermatol (Dec 2008).

Visscher, Davis, and Wickett. “Effect of topical treatments on irritant hand dermatitis in health care workers”. American Journal of Infection Control (Dec 2009).

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