Understanding Hand Sanitiser: Your Guide

In our ongoing quest for effective hygiene, hand sanitiser has become a ubiquitous item in households and on the go. But what exactly is it, how does it work, and is it always the best option? This comprehensive guide delves into the world of hand sanitisers, exploring their composition, efficacy, and best practices for use.

What Exactly is Hand Sanitiser?

Hand sanitiser, also known as hand rub, alcohol-based hand sanitiser, or simply sanitising spirit, is a liquid, foam, gel, or wipe designed to eliminate many types of germs, primarily bacteria and viruses, from the hands. It's a crucial tool in preventing the spread of infections, especially during peak seasons for illnesses like colds and flu. While incredibly useful, it's important to remember that hand sanitiser is a complement to, not a replacement for, proper handwashing with soap and water.

The Science Behind the Clean: Key Ingredients

The most common and effective active ingredient in hand sanitisers is alcohol. The most frequently used types are:

• Ethanol (C₂H₆O): A widely available and effective disinfectant.
• Isopropanol (C₃H₇OH): Also known as isopropyl alcohol, it's another potent disinfectant.
• Propanol (C₃H₇OH): Less common but also effective.

Most sanitisers contain an alcohol concentration ranging from 60% to 85%. In many regions, including Sweden, a concentration of around 70% is considered optimal for efficacy. For instance, Dax Clinical, a common choice in healthcare settings, boasts a 75% alcohol content. Interestingly, exceeding 80% alcohol concentration doesn't necessarily improve effectiveness and can even be counterproductive. This is because water acts as a catalyst, aiding the alcohol in penetrating and denaturing microbial proteins. Many sanitisers also include a moisturising agent, such as glycerin, to counteract the drying effects of alcohol and make the product easier to apply.

Forms and Formulations: Gel vs. Liquid and More

Hand sanitisers come in various forms to suit different preferences and situations:

• Liquid Hand Sanitiser: A more traditional and often thinner formulation.
• Gel Hand Sanitiser (Alcogel): The most popular form, offering ease of application and less chance of spillage.
• Disinfectant Wipes: Convenient for sanitising hands and surfaces, like doorknobs or mobile phones.
• Foam Sanitisers: Offer a lighter feel and can be a good alternative for those who dislike the sticky sensation of gels.

The choice between these is largely a matter of personal preference. Gels are widely favoured for their user-friendliness, while liquids might be preferred for larger surface areas. Wipes offer the added benefit of being usable on objects.

When is Hand Sanitiser Most Effective?

Hand sanitisers are particularly effective against:

• Bacteria: Though their efficacy against spore-forming bacteria can be limited.
• Enveloped Viruses: These are viruses with an outer lipid (fatty) layer, such as influenza viruses and coronaviruses (including COVID-19). The alcohol in sanitisers disrupts this lipid envelope, rendering the virus inactive.
• Various Microorganisms: With the exception of spores.

It's crucial to understand that hand sanitiser is not effective against all germs. For example, it has little to no effect on non-enveloped viruses like norovirus, which causes winter vomiting bug. Sanitisers containing hydrogen peroxide (H₂O₂) may offer broader protection, including against norovirus.

Understanding Virus Types and Sanitiser Efficacy:

Viruses can be broadly categorised based on their structure, which dictates their susceptibility to alcohol-based sanitisers:

How to Use Hand Sanitiser Correctly: The Proper Technique

To maximise the benefits of hand sanitiser, follow these steps:

1. Assess Hand Cleanliness: If your hands are visibly dirty or have come into contact with bodily fluids (e.g., after using the restroom), always wash them with soap and water first. The same applies before eating. Dry your hands thoroughly with a paper towel or allow them to air dry.
2. Apply Sufficient Sanitiser: Dispense an adequate amount of hand sanitiser onto your palms. Don't be stingy – you need enough to cover all surfaces of your hands.
3. Rub Thoroughly: Rub your hands together, ensuring you cover all areas, including the backs of your hands, between your fingers, and around your thumbs. Mimic the motions you would use when washing your hands. The WHO provides detailed guidance on the correct technique.
4. Air Dry: Allow your hands to air dry completely. Do not wipe them off or rinse them. This ensures the alcohol has sufficient contact time to be effective. Be aware that some sanitisers can discolour fabrics.

Important Tip: While handy for a quick refresh, hand sanitiser should never replace the thorough cleaning that soap and water provide. It's a useful addition to your hygiene routine, not a substitute.

Sanitising Surfaces: When to Use What

If your goal is to disinfect objects like door handles or surfaces, it's often more practical and economical to use a dedicated surface disinfectant or an alcohol-based cleaning spray. This prevents you from using up your precious hand sanitiser. Disinfectant wipes are also a good option for smaller items like mobile phones and public transport handles.

Historical Perspective: The Controversy Around Sanitiser Use

Historically, the widespread use of hand sanitiser outside of healthcare settings was met with some caution. The primary arguments against its casual use included:

• Effectiveness of Soap and Water: The argument that traditional handwashing with soap and water is sufficiently effective against most germs.
• Risk of Poisoning: Concerns that increased availability could lead to accidental ingestion, particularly by children, posing a poisoning risk.
• Fire Hazard: The flammable nature of alcohol-based products raised fire safety concerns.

However, the increased awareness of pandemics and the proven efficacy of alcohol-based sanitisers against specific pathogens have shifted this perspective considerably.

The Surge in Demand: Pandemics and Prevention

The demand for hand sanitiser saw a dramatic increase during outbreaks such as the swine flu pandemic in 2009 and, more significantly, the COVID-19 pandemic starting in late 2019. This surge in demand often led to widespread shortages as consumers sought to protect themselves and their families.

Making Your Own Hand Sanitiser: A DIY Approach

When commercial products are scarce, many turn to making their own hand sanitiser. The World Health Organization (WHO) provides guidelines for this. A basic DIY recipe typically includes:

• Alcohol: Either 96% ethanol or 99.8% isopropyl alcohol.
• Hydrogen Peroxide (3%): To help inactivate any contaminating bacterial spores in the mixture.
• Glycerin (98%): A humectant to keep hands moisturised.
• Distilled or Boiled Water: To reach the desired final concentration.

A simplified recipe, often cited for home use, might involve mixing a high-proof alcohol (like isopropyl alcohol or denatured ethanol) with glycerin and water. For instance, a common DIY recipe in Sweden suggests mixing 80 cl of T-Röd (denatured ethanol) or concentrated screenwash with 1.5 cl of 98% glycerin and then topping up with 18.5 cl of cold tap water to make 1 litre, resulting in approximately 76% alcohol concentration. This concentration is within the effective range of 60-80%.

Important Considerations for DIY Sanitiser:

• Accuracy is Key: Ensure you follow the proportions precisely to achieve the correct alcohol concentration.
• Source of Alcohol: Use pure or denatured alcohol. Be cautious with screenwash as it may contain additional additives and fragrances.
• Safety: Alcohol is flammable, so mix in a well-ventilated area away from open flames. Isopropyl alcohol can be more irritating to the skin than ethanol with frequent use.
• WHO Guidelines: For large batches, adhere to WHO recommendations regarding ventilation and safety precautions.

While DIY sanitiser can be a lifesaver during shortages, it's generally recommended to purchase commercially produced sanitisers when available, as they are manufactured under controlled conditions and tested for efficacy and safety.

Frequently Asked Questions About Hand Sanitiser

Does hand sanitiser kill viruses?

Yes, but primarily enveloped viruses. It is effective against viruses like influenza and coronaviruses but not against non-enveloped viruses like norovirus.

Is hand sanitiser effective against COVID-19?

Yes, alcohol-based hand sanitisers with at least 60% alcohol are effective against coronaviruses, including SARS-CoV-2 (COVID-19).

Can I use hand sanitiser on wounds?

No. Never use hand sanitiser on wounds. It can cause further irritation and damage. Use soap and water or an alcohol-free wound wash instead.

Is it harmful if hand sanitiser gets into the eyes?

Yes, hand sanitiser can be harmful to the eyes. If it enters the eyes, rinse immediately with plenty of cold water for at least 15 minutes and remove contact lenses if present. Seek medical advice if irritation persists.

Can hand sanitiser treat athlete's foot?

No, athlete's foot is protected by multiple layers of skin, and hand sanitiser will not penetrate effectively to treat it.

Can pregnant women use hand sanitiser?

Yes, pregnant women can safely use hand sanitiser. The alcohol is not absorbed into the bloodstream through the skin, even with frequent use.

What happens if hand sanitiser is ingested?

Ingesting hand sanitiser can be dangerous due to its high alcohol content and other potential ingredients like isopropyl alcohol. It can lead to nausea, vomiting, confusion, loss of consciousness, and even respiratory arrest. Seek immediate medical attention if ingested.

Choosing the Best Hand Sanitiser: A Buying Guide

When selecting a hand sanitiser, consider these factors:

Key Considerations for Purchase:

• Alcohol Content: Look for a product with an alcohol concentration of at least 60%, ideally between 60-80%.
• Moisturising Ingredients: Glycerin or other emollients help prevent skin dryness.
• Fragrance: Unscented options are often preferred for sensitive skin or in healthcare settings.
• Formulation: Choose between liquid, gel, wipes, or foam based on your preference.
• Certifications: Look for products that meet relevant standards, such as EN 1500 (European standard for hand antiseptic efficacy).

Top Hand Sanitiser Recommendations (Based on Swedish Market Trends):

When choosing, remember that while scented options like HAAN Pocket Sanitizer offer a pleasant user experience, the primary goal is effective disinfection. Ensure any scented product still meets the minimum alcohol concentration requirement.

Final Thoughts on Hand Hygiene

Hand sanitiser is an invaluable tool in our personal hygiene arsenal, particularly effective against a wide range of bacteria and enveloped viruses. However, it should always be used in conjunction with, not as a replacement for, regular handwashing with soap and water. By understanding how hand sanitisers work and how to use them correctly, we can all contribute to a healthier environment and reduce the spread of infections.