Hand Sanitizers: Convenient Isn't Always Effective
by Paul Barnhill, on December 4,2014
The Unhealthy Habit
There are few items more ubiquitous than the little bottle of hand sanitizer clipped to a purse or student backpack, the big jug of it in the workplace or classroom, and even dispensers in medical offices or supermarkets. However, the dangers of hand sanitizers are not well known, even to the people who depend on them to help stop transmission of some of the most dangerous pathogens known to the medical profession.
The claim that hand sanitizers kill “most” pathogens has some hard limits that might come as a surprise, as these well-known sanitizers may not work equally on all pathogens, such as certain types of gram-positive or gram-negative bacteria, Norovirus, Clostridium difficile, or Cryptosporidium. It’s important to know what hand sanitizers can, can’t and might in order to protect your health.
In fact, alcohol gel sanitizers present some of the same challenges as handwashing compliance– and they are only as good as the user’s technique. Use too little of the product, not cover the entire hand, or not using it long enough and it may not be effective whatsoever. An American Journal of Infection Control study suggests that preferential use of alcohol hand sanitizers over soap and water for routine hand hygiene might be associated with increased Norovirus outbreaks.
The Nurses‘ Allergy
Nurses and other healthcare workers are among the most frequent users of alcohol gel sanitizers, and soap and water for hand hygiene in their day-to-day duties. According to a study published by the American Contact Dermatitis Society, more than 50 percent of nurses at U.S. hospitals suffer from some form of hand dermatitis – specifically contact dermatitis caused by use of alcohol-based hand sanitizers.
The specific hygienic requirements associated with inpatient nursing are often culprits, as hand hygiene is mandatory in order to limit the spread of viral, bacterial, or fungal infections. But harsh soaps and use of alcohol-based hand sanitizers can disrupt the natural protectants and pH balance of the skin, leaving skin unprotected and porous. Allergens and irritants can penetrate below the skin’s surface, which triggers an autoimmune response.
Symptoms of this autoimmune response, as cited by the Mayo Clinic, can include:
• Reddening of the skin.
• Itching and rashes, sometimes accompanied by bumps or blisters that may break and lose fluid.
• Swelling of the affected area.
• Inflammation that causes the affected area to feel hot to the touch.
• Peeling, scaling, and cracking of the skin.
In severe cases, the condition can become chronic, though only a dermatologist can commonly differentiate between contact dermatitis and other skin conditions.
Tips for Healthy Hands
Avoiding or remedying contact dermatitis is not all that difficult. The first step is to avoid the agent that is causing the reaction – whether it’s just dryness and irritation or something that resembles a bad case of poison ivy. In the case of alcohol-based hand sanitizers, the Centers for Disease Control and Prevention states that washing hands with soap and water is the best way remove pathogens from the hands, and alcohol-based sanitizers are not as effective when hands are dirty or greasy.
Washing your hands with soap and water, or using an automated hand washing system, along with hypoallergenic hand lotion, or a topical corticosteroid lotion can help to greatly reduce minor irritation that can lead to full-blown contact dermatitis. For people suffering with contact dermatitis, a study in Pediatric Dermatology showed that the use of topical corticosteroids, even over the long term, does not cause any significant negative effects.