Hand Sanitizer and Skin

What sanitizer is and does

Hand sanitizers come as gels, foams, liquids and sprays. The most common type relies on alcohol, typically in a concentration high enough to be effective against many germs. Public health guidance generally describes alcohol-based sanitizers as useful when soap and water are not available, and soap and water as the better choice when hands are visibly dirty or greasy. Sanitizers are not effective against every kind of germ or contamination, and they do not remove dirt, so guidance is worth checking from your local health authority.

This article is about the skin, not about infection control. The key point is that a product designed to dissolve the outer surface of germs can also affect the oils on your skin.

Why sanitizer can be drying

Alcohol is a solvent, which means it dissolves fats and oils. The surface of your skin relies on a layer of natural lipids to keep water in. Sanitizer removes some of those lipids and also evaporates quickly, taking some moisture with it. For one use, the effect is small, and skin usually recovers. Used many times a day, the loss can add up, particularly if the skin has not had time to rebuild.

Some points to keep in mind:

• Frequency matters more than any single use. Many people who use sanitizer all day, such as retail workers or caregivers, notice dryness.
• Existing dryness makes it sting. Sanitizer on small cracks or cuts can hurt, a sign the skin barrier is already compromised.
• Formulas vary. Gels, foams and liquids differ in how much moisturizing ingredient they contain. Some contain humectants such as glycerin to offset drying, but this does not fully prevent dryness for everyone.
• Fragrance and dyes. Added scent or colorants may irritate sensitive skin, and fragrance sensitivity is a common reason that some products are uncomfortable.
• Cold weather adds to it. During winter skin care months, hands may already be dry, and sanitizer makes things worse.

Sanitizer is not usually a cause of serious skin damage, but it can contribute to irritation in people who already have sensitive or eczema-prone skin. If a rash appears, it can be simple irritation, or less commonly an allergy to a product ingredient, which is a different problem. The difference is explained in discussions of skin allergies and contact dermatitis.

Using it kindly

If you need to use sanitizer often, a few habits can help:

1. Use the amount in the directions. Enough to cover all surfaces of both hands, and rub until it is dry. Using too little may not work well, and using extra is not more effective.
2. Do not wipe it off. Let it air-dry, which is how it is meant to work.
3. Wash with soap and water when hands are dirty. This also avoids layering sanitizer on top of grime. Use lukewarm water and a mild cleanser, then pat dry.
4. Do not stack them. Using sanitizer right after washing, while the hands are still damp, does not add anything useful and may add to dryness.
5. Moisturize afterward. Once the sanitizer has dried, a hand cream can be applied. Carrying a small tube makes this easier. A product with humectants emollients and occlusives in the mix tends to support the skin well.
6. Do the nighttime routine. A thicker cream or ointment before bed gives skin a longer stretch to recover.
7. Keep it off broken skin. If your hands are cracked, sanitizer will likely sting. Washing with a mild cleanser may be a more comfortable choice when practical.

Choosing a product

You do not need to know every ingredient, but a few observations are generally safe:

• Products should state the active ingredient and its concentration on the label.
• Fragrance-free versions are often better tolerated.
• Moisturizing ingredients on the label, such as glycerin, may make the product more comfortable, but it is not a substitute for hand cream.
• Do not make your own sanitizer from household ingredients. Wrong proportions can make it ineffective or irritating.
• Keep sanitizer away from eyes and from young children, who may swallow it. Alcohol-based products are also flammable, so let them dry fully before going near open flames.

If a certain product repeatedly irritates you, trying another formula is reasonable. If you suspect a reaction, patch testing on a small area is one general way to learn about it, though it is not foolproof.

Sanitizer on children and sensitive skin

Children and people with eczema basics concerns may find sanitizer especially uncomfortable. Soap and water, with a gentle moisturizer afterward, is often a more comfortable routine when a sink is available. Adults supervising young children should make sure the product is used properly and not ingested.

When to ask for advice

Seek advice from a doctor, pharmacist or other qualified health professional if:

• Hands remain red, itchy, blistered or painful even after you reduce sanitizer use
• Cracks are deep or bleeding, or appear infected
• You work in a setting where frequent hand hygiene is required and your skin cannot keep up
• You notice a rash that spreads beyond the area where the product was applied

Workplaces often have guidance for people whose hands are damaged by frequent hygiene, and a professional can help work out options. This is general information, not medical advice, and individual responses vary.