Antiseptic gels—myths and realities

In an age where the war on germs offers no respite, the use of hand sanitizer (or antiseptic gel) is popular. This explains the great number of bottles of this valuable liquid, small and large, that can be found just about everywhere. What are the advantages and risks associated with this widely used product? 

Hand hygiene and disease prevention

You put your hands on your face (eyes, nose, mouth) countless times every day. The hands are virtual germ-carriers, such as viruses and bacteria. In fact, germ contamination often involves the hands. For instance, contact with a contaminated object or a handshake can allow germs to enter your body unbeknownst to you. This is why proper hand hygiene is of pivotal importance.

Hand hygiene includes certain measures, including washing with soap and water, and disinfecting with antiseptic gels, also called hand sanitizers. These two measures are excellent ways to avoid being contaminated or contaminating others. These simple and effective measures will help to protect your health. Moreover, they are currently recommended at large in the general public through infection control programs.

Distinguishing between true and false

When a measure is as widely used as are hand sanitizers, it is normal for a lot of information to flow on the subject. As is often the case in the area of health, hand sanitizers were the subject of controversy. Here are 10 examples of statements, true, false or both true and false, that merit clarification.

1. The use of a hand sanitizer replaces handwashing with soap and water.

Answer: false. Many people mistakenly believe that the use of a hand sanitizer decreases the importance of handwashing with soap and water. Nothing could be further from the truth! Hand sanitizers are not cleansers; consequently, they do not remove dirt, visible or not. Only effective handwashing ensures a thorough cleaning. The use of a hand sanitizer should be viewed as complementary to handwashing, which is part of comprehensive approach to hand hygiene and infection control. That being said, in some situations, if access to soap and water is not possible, the use of a hand sanitizer can be beneficial.

2. All antiseptic gels eliminate 99% of germs.

Answer: false. The effectiveness of hand sanitizers may differ depending on the product. However, it is fair to say that several of them eliminate more than 99% of germs likely to cause the most common respiratory infections, such as a cold or the flu. The use of antiseptic gels prevents hand contamination, but does not inevitably prevent viral or bacterial infections which enter the body via other pathways.

3. The higher the alcohol content, the more effective the hand sanitizer.

Answer: true and false. In order to exercise their disinfectant action, hand sanifizers must consist of a certain concentration (between 60 and 80%) of water and alcohol (ethylic or isopropylic). In lower or higher concentrations, antiseptic activity is reduced. Read the manufacturer's label carefully to obtain the alcohol content of the product that interests you.

4. Disinfection against viruses and bacteria using a hand sanitizer is better than handwashing with soap and water.

Answer: true. Nothing beats a good handwashing with soap and water for dirt. However, several studies have shown that disinfecting hands with hydroalcoholic gel (consisting of water and alcohol) is more effective than handwashing with soap and water to eliminate most viruses and bacteria. It is recommended to rub hands together for about 20 seconds for disinfection to be effective.

5. Hand sanitizers cause the appearance of superbugs.

Answer: false. As mentioned earlier, the active ingredient in hand sanitizers is alcohol, which has the advantage of acting and evaporating quickly. Once it has evaporated, it leaves no residue. There is no current scientific data available which indicates that the use of alcohol-based gels are likely to cause certain germs to become resistant to their action.

6. Hand sanitizers tend to dry out the skin more than soap.

Answer: true and false. Hand sanitizers dry out skin more due to the alcohol they contain. This is why some manufacturers sometimes add an emollient or moisturizer to these products. Furthermore, some added ingredients, such as fragrances for instance, can irritate the skin. It is important to specify that repeated handwashing with soap and water can also cause dryness and irritation to the skin. Of course, these effects depend partly on the soap that is used.

7. Poisoning risks are associated with the use of hand sanitizers.

Answer: true. A number of poisonings related to the use of hand sanitizers are reported in Canada each year. These cases sometimes occur following accidental ingestion, particularly in babies and young children. This is partly explained by easy access to the products and the sometimes pleasant fragrance they sometimes contain. Ingestion of antiseptic gels can also be intentional because of the alcohol they contain. Therefore, there is a real risk of alcohol poisoning, whether it is voluntary or not.

8. Drying or washing your hands after using a hand sanitizer renders it ineffective.

Answer: true. After applying a hand sanitizer, it is important not to rinse or wash hands or to wipe them on a towel or cloth, which will reduce the product's effectiveness. Instead, hands should be rubbed together until they become dry (the alcohol will evaporate). Additionally, hands should not be wet when the hand sanitizer is applied, as this could also compromise the product's optimal action.

9. All hand sanitizers contain triclosan, a harmful chemical compound for health.

Answer: false. Triclosan is a preservative used to make certain consumer goods such as cosmetics, cleansers, toothpaste, mouthwash, health products, etc. It prevents or slows the proliferation of germs and prevents the deterioration of products. Health Canada has set standards for the use of triclosan in commercial products, by imposing maximum quantities or concentrations, among other things, that are much lower than those that could be harmful to health. That being said, hand sanitizers sold in Canada do not contain triclosan, with but few exceptions.

10. The use of hand sanitizers can be harmful to health in the long-term.

Answer: false. Current available scientific data does not suggest that individual or large scale use of hand sanitizers can be hazardous to health. On the contrary, in reality, it is a simple, accessible and low cost health measure that provides protection against infectious agents for all Canadians.

The fight against infections is a significant public health issue. In this regard, prevention is the best strategy to adopt. Much like vaccination, handwashing with soap and water and disinfecting with the use of antiseptic gels are effective measures to prevent the spread of germs which can cause certain diseases. So, don't hesitate to use them, as you hold your health in your hands, literally and figuratively!

For additional information about infection control measures during winter and throughout the year, don't hesitate to speak to your pharmacist.

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Antiseptic gels—myths and realities

In an age where the war on germs offers no respite, the use of hand sanitizer (or antiseptic gel) is popular. This explains the great number of bottles of this valuable liquid, small and large, that can be found just about everywhere. What are the advantages and risks associated with this widely used product? 
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