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Soap not Sanitizer: Why washing with soap and water beats hand sanitizer

Published on Sep. 25, 2021

Hand sanitizer coronavirus Munson Healthcare

We all want to help stop the spread of COVID-19 by keeping our hands clean. But which is better, hand sanitizer or regular soap and water?

Unless you’re a healthcare worker in a clinical setting, washing your hands with soap and clean water for at least 20 seconds is best. Regular hand washing kills more germs than hand sanitizer, and for the general public, it’s more effective than hand sanitizer, according to the Centers for Disease Control and Prevention.

With hospitals facing a nationwide shortage of hand sanitizer and other critical supplies, it’s more important than ever to be smart about our use of alcohol-based rubs.

So if soap and clean water are available, that’s your best option.

Watch this important message about hospital supplies from Mark Deponio, Senior Vice President, System Services, Munson Healthcare.

Here are answers to some key questions about hand sanitizer.

Why is it better to wash with soap and clean water?

Wash hands coronavirus Munson Healthcare

According to the CDC, alcohol-based hand sanitizers are not as effective as soap and water in removing certain kinds of germs, such as norovirus, Cryptosporidium, and Clostridium difficile (also known as C. diff). In addition, some people, other than trained healthcare workers, may not apply it correctly. They also may wipe it off before it dries, or use it on greasy or dirty hands.

What should healthcare workers use?

Healthcare workers are trained to use hand sanitizer correctly as the first line of clinical defense against microbes, which include viruses and bacteria. In response to COVID-19, the CDC continues to recommend that healthcare workers use alcohol-based rubs as the primary method for hand hygiene in clinical settings. Guidelines from the CDC instruct healthcare workers to use hand sanitizer, except after caring for patients with known or suspected diarrhea, which can be caused by the norovirus; after using the restroom, before eating, and when hands are visibly soiled; and after known or suspected exposure to spores such as C. diff.

Resources for Hand Hygiene from the CDC Hand sanitizer soap coronavirus Munson Healthcare

My hands are greasy or dirty. Will hand sanitizer work?

No, alcohol-based rubs are effective only on clean, dry skin. The gel needs contact with skin to kill the microbe cells.

When should I use hand sanitizer?

Use an alcohol-based rub whenever soap and clean water are not readily available, unless you are a healthcare worker in a clinical setting. And remember, to prevent the spread of COVID-19 and to follow the Stay at Home” order of Gov. Gretchen Whitmer, you should only leave home – and your own soap and water -- for essential trips, such as to the grocery store, pharmacy, or gas station.

What kind of hand sanitizer should I use?

Alcohol-based rubs should contain at least 60% ethanol or 70% isopropanol as active ingredients.

What are the CDC guidelines for using alcohol-based hand rubs? Sanitizer coronavirus Munson Healthcare

  • Apply enough product on hands to cover all surfaces.
  • Rub hands together, until hands feel dry. This should take around 20 seconds.
  • Do not rinse or wipe off the hand sanitizer before it’s dry; it may not work as well against germs.
  • Supervise young children to make sure they do not ingest the liquid. Even a few mouthfuls can cause alcohol poisoning.

If soap and clean water are available, here’s how to wash your hands.

Are there alternatives to alcohol-based hand rubs?

The CDC does not have a recommended alternative. Benzalkonium chloride has been approved for use by the Food and Drug Administration for use in hand rubs for healthcare staff. But the CDC reports that benzalkonium chloride has “less reliable activity against coronavirus” than either of the alcohols. 

Can healthcare facilities use unformulated ethanol in concentrations greater than 60% or isopropanol greater than 70% for use as alcohol-based hand rubs?

No, because these alcohols are drying to the skin. Healthcare workers need to perform hand hygiene frequently, and they need to prevent their skin from drying and cracking. So the alcohols must be properly formulated with moisturizing ingredients.

Can I make my own hand sanitizer?

It is not generally recommended. The Food and Drug Administration says it lacks adequate information on DIY hand sanitizer to determine whether it’s safe to use on human skin. You also need to be sure that the hand sanitizer contains at least 60% alcohol to be effective. Tito’s vodka, for example, is warning people not to use their product since it only contains 40% alcohol. Here are the World Health Organization guidelines for making hand sanitizer, a complex set of instructions that require equipment such as an alcoholometer.

Are distilleries and microbreweries really making hand sanitizer?

Yes, the Alcohol and Tobacco Tax and Trade Bureau (TTB) relaxed its regulations in order to allow beverage distillers to make denatured alcohol, which they are using to produce hand sanitizer.

 “I am profoundly grateful for the Michigan distilleries who are putting people before profit and are using their production facilities to make hand sanitizer during this COVID-19 emergency,” Governor Gretchen Whitmer said. Locally, businesses including Mammoth Distillery and Grand Traverse Distillery are producing hand sanitizer.