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5 reasons why I hate hand sanitizer

Everyone seems to love hand sanitizer, but I am not a fan. Here are 5 reasons why!

  1. Sanitizer can irritate otherwise healthy skin. Hand sanitizer depending on the ingredients can disturb the ph and barrier function of the skin setting you up for more “dermatitis”, dry skin, inflammation of the skin or eczema. Sanitizer may increase infections of the skin and nail bed this way. 
  2. Sanitizer doesn’t remove dirt and without removing dirt skin can’t really be clean. Hand sanitizer makes my hands so sticky. Children’s hands always are dirtier – marker, sand, dirt, glue, boogers – and hand sanitizer does nothing to remove this debris. In fact sanitizer sometimes appears to attach it more strongly. When there is visible dirt on the hands, sanitizer can’t work as it doesn’t fully penetrate.
  3. Children eat with their hands and eat whatever you put on their hands. For children who use their hands to eat, consider how you feel with them eating all the junk on their hands and then add in the ingredients from hand sanitizer. While hand sanitizers aren’t evaluated by the FDA the most common ingredients in them are generally considered safe. However, I wouldn’t want my child ingesting it daily. For some reason at the playground I have noticed all the super moms whose kids eat organic antibiotic free locally sourced diets have little handy bottles of sanitizer and slather the children’s hands right before eating. Then I watch and the children put it directly in their mouth. If you do continue to use hand sanitizer please know that at least 30 seconds and ideally a minute is required before the sanitizer will work.
  4. Sanitizer doesn’t work against all the pathogens soap and water remove.  Only alcohol based hand sanitizers are recommended by the CDC but even those won’t help with all viruses such as the ones that cause epidemics of diarrhea (norovirus) or the C. difficile bacteria that can cause life threatening diarrhea in a vulnerable person (elderly or child after antibiotics). Alcohol-free hand sanitizers such as the babyganics brand use another chemical which is thought to be safe and is less irritating for skin, but has no trials evaluating efficacy against viruses (in pubmed). I would want to see the data before relying on that for my family.
  5. Sanitizer seems more likely to disturb our healthy gut bacteria than soap and water. We do not know how frequent use of hand sanitizer affects your microbial flora. Your microbial flora seems to be the linked to your mental health, your dental and gut health, your immune system and your risk of diabetes/high blood pressure. So it seems worthwhile to protect it. 

This leaves us with good old soap and water. Hand hygiene needs to be taught like anything else. Kids should roll up their sleeves, soap up, sing happy birthday to you while they scrub for 20 seconds at least and then rinse before they dry. I love it when I hear about schools doing projects to teach kids about hand hygiene, although an enterprising parent could do some of the same projects at home.

Now you know why I make my son go wash his hands instead of lining up for the Purell at the birthday party! Stay well!

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Everything posted is my opinion and doesn’t represent the opinion of my current or prior employer. All patient references in stories are fictionalized (new gender, different issue, etc) to protect privacy. Recommendations are made in a generic way intended for education. The ideas I have may not fit every child or every family. Parents should use their judgment and ask their own doctors if they feel something doesn’t make sense or may not be safe in their specific situation. I am not your child’s doctor, and this is not medical advice.

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