# Advisability of hand santiziers **URL:** \ **Category:** Factual Questions\ **Created:** [May 5, 2003, 1:53pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177 "2003-05-05T13:53:19Z")\ **Posts on this page:** 19\ **Page:** 1
**Author:** ![WeRSauron](https://avatars.discourse-cdn.com/v4/letter/w/f19dbf/32.png) [@WeRSauron](https://boards.straightdope.com/u/WeRSauron)\ **Post date:** [May 5, 2003, 1:53pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/1 "2003-05-05T13:53:19Z")
I’ve heard that products such as antibacterial soaps, etc., may be bad because it prevents us from developing immunity to common bacteria. In this age of SARS, how effective and healthy and advisable is the ample use of hand sanitizers? I know the CDC recommends people to wash their hands often, since SARS is transmitted like the common cold. But would I be better off with a nice, big bottle of hand sanitizer? Will that help me not catch illnesses (not just SARS)? We appreciate your kind enlightenment. WRS ---
**Author:** ![urban1a](https://avatars.discourse-cdn.com/v4/letter/u/e47c2d/32.png) [@urban1a](https://boards.straightdope.com/u/urban1a)\ **Post date:** [May 5, 2003, 3:07pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/2 "2003-05-05T15:07:54Z")
I try to avoid the use of anti-bacterial soaps (very difficult), and the hand sanitizers, because I believe that there is evidence that the **bacteria** , develop a resistence to those anti-bacterials and anti-biotics, in general, and that this is **not a good thing**. I could be wrong, of course, but I don’t see too much reason to doubt what I have read. I do, of course, wash my hands when it would seem to be beneficial to do so. Bob ---
**Author:** ![scotandrsn](https://avatars.discourse-cdn.com/v4/letter/s/a4c791/32.png) [@scotandrsn](https://boards.straightdope.com/u/scotandrsn)\ **Post date:** [May 5, 2003, 3:19pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/3 "2003-05-05T15:19:03Z")
An antibacterial soap will not make much of difference against SARS over a regular soap, as SARS has been identified as a virus. (Unless of course, SARS uses some kind of bacteria to reproduce parasitically (I don’t happen to know which cells SARS uses), in which case antibacterial soap might help slow the spread of SARS until the bacteria developed immunity to the soap; see below) There is a great deal of concern over antibacterial products because an antibiotic is never 100% effective. Some bacteria survive, and the ones who survive because some genetic variance granted them immunity to the antibiotic can pass this immunity on to later generations. With each generation having more immune members, you eventually get to the point where the antibiotic is no longer effective. An antibiotic that kills these new, stronger bacteria may have more severe side effects than the older one. With the advent of everyday use of antibacterial personal hygeine products, the rate at which bacteria become immune to various chemical agents is increasing dramatically. When I find a decent internet cite for this, I’ll post it here. ---
**Author:** ![light\_strand](https://avatars.discourse-cdn.com/v4/letter/l/a6a055/32.png) [@light\_strand](https://boards.straightdope.com/u/light_strand)\ **Post date:** [May 5, 2003, 3:25pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/4 "2003-05-05T15:25:22Z")
Hand sanitizers, in general, are a bit different than antibacterial soap. Hand sanitizers are simply alcohol in a gel matrix that allows it to be spread more easily, and be far less messy than liquid alcohol. However, it’s action is the same as rubbing alcohol. It is a non-targeted antibacterial agent. Which is to say, alcohol does not specifically target a component of the bacteria. It kills by dessication. This means that bacteria can not become resistant. So feel free to use hand sanitizers with abandon, or at least until they make your skin do dry that it peels from your body. Antibacterial soaps use, in general, triclosan. This was at first believed to be non-target, but it turned out that this is not true. It is actually targeted to [lipid synthesis](http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=90308) via enoyl-acyl carrier protein reductase. This means that bacteria do gain resistance, and thus not quite as benign as originally believed. ---
**Author:** ![lissener](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lissener/32/6139_2.png) [@lissener](https://boards.straightdope.com/u/lissener)\ **Post date:** [May 5, 2003, 4:04pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/5 "2003-05-05T16:04:58Z")
> [@](#): > > \*Originally posted by light strand \* > \*\*Hand sanitizers, in general, are a bit different than antibacterial soap. Hand sanitizers are simply alcohol in a gel matrix that allows it to be spread more easily, and be far less messy than liquid alcohol. However, it’s action is the same as rubbing alcohol. It is a non-targeted antibacterial agent. Which is to say, alcohol does not specifically target a component of the bacteria. It kills by dessication. This means that bacteria can not become resistant. So feel free to use hand sanitizers with abandon, or at least until they make your skin do dry that it peels from your body. . . . \*\* Do you have a cite to back this up? The doctors I have worked for have told me that hand sanitizers DO act as “evolutionary pressure” on bacteria and contribute to their building resistance. ---
**Author:** ![Dogface](https://avatars.discourse-cdn.com/v4/letter/d/9d8465/32.png) [@Dogface](https://boards.straightdope.com/u/Dogface)\ **Post date:** [May 5, 2003, 4:15pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/6 "2003-05-05T16:15:09Z")
Pray, dear fellow, just where did you “hear” that antiseptic soaps can somehow interfere with the immune system? Was this from a reputable source or one of those crackpot “alternative medicine” screeds? ---
**Author:** ![Papermache\_Prince](https://avatars.discourse-cdn.com/v4/letter/p/f05b48/32.png) [@Papermache\_Prince](https://boards.straightdope.com/u/Papermache_Prince)\ **Post date:** [May 5, 2003, 4:33pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/7 "2003-05-05T16:33:27Z")
Perhaps the ideas of Dr. Stuart Levy, at Tufts University, have become distorted in the telling. [Tufts E-News](http://enews.tufts.edu/stories/050301GermsFightBack.htm) > [@](#): > > According to the Tufts scientist, if children don’t have enough exposure to germs, their immune systems have a harder time fighting pollen or dust. > > “It’s just like a child needs exercise to build strong bones and muscles,” Levy told the Chicago Tribune. “A child’s immune system needs its own workout to develop a normal resistance to infections.” ---
**Author:** ![refusal](https://avatars.discourse-cdn.com/v4/letter/r/ac91a4/32.png) [@refusal](https://boards.straightdope.com/u/refusal)\ **Post date:** [May 5, 2003, 4:34pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/8 "2003-05-05T16:34:44Z")
For more detail than you could believe, see the Food and Drug Administration/Center for Food Safety and Applied Nutrition literature review in: “Evaluation of Risks Related to Microbiological Contamination of Ready-to-eat Food by Food Preparation Workers and the Effectiveness of Interventions to Minimize Those Risks” by JACK GUZEWICH, RS, MPH and MARIANNE P. ROSS, DVM, MPH, 1999. [http://vm.cfsan.fda.gov/~ear/rterisk.html](http://vm.cfsan.fda.gov/~ear/rterisk.html) This analyses the efficacy of various methods of defeating bacterial, viral and other infections in the food industry. On plain vs. antibacterial soaps, it says: > [@](#): > > It is unclear if plain soaps are more effective than antimicrobial soaps, since there is literature to support both types of products. However, the review of the literature seems to indicate that plain soaps are effective for the physical removal of transient organisms and that antimicrobial products are needed for the inhibition of transient and resident flora. As for alcohol, and alcohol gel sanitisers, it is dubious about the latter: > [@](#): > > Alcohol was the most immediately effective product against bacteria but had limited residual activity (Docket C-3; Paulson, 1994; Coates et al., 1987; Larson, 1995; Butz et al., 1990; Ayliffe et al., 1988; Aly and Maibach, 1979; Larson et al., 1986; Paulson,1994; Ly et al.,1997). […] Alcohol gel sanitizers that do not require rinsing may be ineffective on their own due to the fact that there is no mechanical action to wash away bacteria (Paulson, 1994; Miller, 1994;Docket C-8). It also finds Triclosan to be effective, and discusses hand-washing and hand-drying methods. ---
**Author:** ![scotandrsn](https://avatars.discourse-cdn.com/v4/letter/s/a4c791/32.png) [@scotandrsn](https://boards.straightdope.com/u/scotandrsn)\ **Post date:** [May 5, 2003, 4:36pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/9 "2003-05-05T16:36:33Z")
There has been some concern in the scientific community that, since we build up our immune system by exposing it to germs, our realitively clean way of living these days has affected our ability to develop antibodies. Research into this is still relatively new. ---
**Author:** ![BrotherCadfael](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@BrotherCadfael](https://boards.straightdope.com/u/BrotherCadfael)\ **Post date:** [May 5, 2003, 4:52pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/10 "2003-05-05T16:52:37Z")
Reading the thread title, the first thing to jump to my mind was “telephone sanitizers”. Hand sanitizers are probably about as useful. ---
**Author:** ![BobT](https://avatars.discourse-cdn.com/v4/letter/b/8e8cbc/32.png) [@BobT](https://boards.straightdope.com/u/BobT)\ **Post date:** [May 5, 2003, 5:32pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/11 "2003-05-05T17:32:06Z")
I bought some bottles of these sanitizers to take on my trip to Japan, but that was mainly because it’s hard to find paper towels in Japanese bathrooms and I figured it’s a good way to make sure I have a way to keep my hands clean. ---
**Author:** ![light\_strand](https://avatars.discourse-cdn.com/v4/letter/l/a6a055/32.png) [@light\_strand](https://boards.straightdope.com/u/light_strand)\ **Post date:** [May 5, 2003, 5:44pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/12 "2003-05-05T17:44:04Z")
lissener, I’m not sure what you want me to cite, but re-reading my post I did say that alcohol was a desiccant, what I should have said that it is a desiccant/denaturing agent. Either way, it’s still not targeted antibacterial agent, thus a bacteria can not gain resistance sine it it the physics/chemistry of the cells that causes them to be killed by the alcohol, not a specific target. In other words, if one could use an H[sub]2[/sub]SO[sub]4[/sub] safely as a antibacterial agent, there wouldn’t be a whole lot the bacterial cell could do about. Sensitivity to low pH is not a genetic action. Neither is sensitivity to the denaturing/desiccating properties of alcohol. It dries so quickly that the osmotic pressure may cause the cells to burst. While at the same time, it is denaturing the proteins of the cellular membrane. It simply causes the protein and DNA to “unravel”. With a little weaseling, [Infection Control Today](http://www.infectioncontroltoday.com/articles/121topics2.html) says: > [@](#): > > Bacterial resistance to alcohols at high concentrations is extremely low to almost non-existent. As for refusal’s assertion that gel/alcohol hand sanitizers are ineffective, this is untrue according to the the above cite, the [CDC](http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf) (Warning: pdf), and [Infection Control and Hospital Epidemiology](http://www.slackinc.com/general/iche/stor0700/7ed.htm). ---
**Author:** ![Tomcat](https://avatars.discourse-cdn.com/v4/letter/t/8e8cbc/32.png) [@Tomcat](https://boards.straightdope.com/u/Tomcat)\ **Post date:** [May 5, 2003, 6:20pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/13 "2003-05-05T18:20:03Z")
I read that the use of alcohol based sanitizers could cause a problem due to the fact that they dry out your skin, thus providing new routes for transmission of bacteria through cracked skin…No cite. -Tcat ---
**Author:** ![El\_Smasho](https://avatars.discourse-cdn.com/v4/letter/e/f9ae1b/32.png) [@El\_Smasho](https://boards.straightdope.com/u/El_Smasho)\ **Post date:** [May 5, 2003, 7:26pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/14 "2003-05-05T19:26:17Z")
The scare about “overuse” of germ killers is bull. The biggest germ killer is running water, followed by soap, then plain alcohol swabs. They also are the first things recommended when you might be subject to infection. The main things is that the body can deal with all sorts of germs and viruses, but not too many at once. Does use of water mean mankind will no longer have germs that rinse off, but will find all germs are now waterproof? No. ---
**Author:** ![light\_strand](https://avatars.discourse-cdn.com/v4/letter/l/a6a055/32.png) [@light\_strand](https://boards.straightdope.com/u/light_strand)\ **Post date:** [May 5, 2003, 8:48pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/15 "2003-05-05T20:48:42Z")
Smasho, you are really confused with the rational behind the “scare about the ‘overuse’ of germ killers”. The fear of antimicrobial resistance is legitimate, and warranted. Bacterial resistance to antibiotics is a huge issue in the health care field as you find with multiply resistant _M, tuberculosis_, and Methylcillin resistant _Staph. aureus_. The World Health Organization is so concerned about the trend they have a [Global Strategy for Containment of Antimicrobial Resistance](http://www.who.int/csr/resources/publications/drugresist/EGlobal_Strat.pdf) (Warning: pdf). The problem is with the overuse of targeted antimicrobial agents. A targeted agent is on that specifically works against a particular genetic target of the organism. Targeted antibiotics like [ampicillin](http://www.medicine.mcgill.ca/cai/meded/drugdb/ampicillin/ampicillin_omnipen_db.htm), which worked like this: > [@](#): > > Mechanism of Action: Beta-lactam antibiotics such as ampicillin are mainly bactericidal. Like other penicillins, ampicillin inhibits the third and final stage of bacterial cell wall synthesis by preferentially binding to specific penicillin-binding proteins (PBPs) that are located inside the bacterial cell wall. Penicillin-binding proteins are responsible for several steps in the synthesis of the cell wall and are found in quantities of several hundred to several thousand molecules per bacterial cell. Penicillin-binding proteins vary among different bacterial species. Thus, the intrinsic activity of ampicillin, as well as the other penicillins, against a particular organism depends on their ability to gain access to and bind with the necessary PBP. Like all beta-lactam antibiotics, ampicillin’s ability to interfere with PBP-mediated cell wall synthesis ultimately leads to cell lysis. Lysis is mediated by bacterial cell wall autolytic enzymes (i.e., autolysins). The relationship between PBPs and autolysins is unclear, but it is possible that the beta-lactam antibiotic interferes with an autolysin inhibitor. Bactria [overcome](http://biosafety.ihe.be/AR/betalactamases.html) this by > [@](#): > > Resistance to ß-lactams in clinical isolates is primarily due to the hydrolysis of the antibiotic by a ß-lactamase. Mutational events resulting in the modification of PBPs (penicillin binding proteins) or cellular permeability can also lead to ß-lactam resistance. ß-lactamases constitute a heterogenous group of enzymes. This type of generically conferred resistance id dangerous indeed, as in this case any bacterium with the resistance isn’t eliminated by the original cycle of antibiotics, and it continues to grow, with each success generation being a clone of the original resistant bacterium. Now you have a resistant strain, and you need another cycle of antibiotics, which can not be beta-lactams. The additional time needed for the second, third, fourth, treatments can be fatal. And that Smasho, is why the scare isn’t bull. ---
**Author:** ![Mangetout](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mangetout/32/19_2.png) [@Mangetout](https://boards.straightdope.com/u/Mangetout)\ **Post date:** [May 5, 2003, 9:29pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/16 "2003-05-05T21:29:49Z")
Purely anecdotal inpuit here; a couple of years back, I switched to antibacterial washing up liquid; shortly afterward, I developed a hangnail so severe that it needed antibiotics (red streaks appeared in the surrounding skin), then another a week later; the next week, I had two on different fingers…and on it went. Until I ran out of the washing up liquid and my wife bought another (non-antibacterial) brand - the hangnail problem went away. Based on this one piece of flimsy evidence, I have (probably quite unacceptably) theorised that excessive use of antibacterial preparations on the skin might kill off your natural (benign) flora and leave (the resources on) your skin wide open for rapid colonisation by more virulent pathogenic organisms (should you be unlucky enough to contact them before the natural balance is re-established. ---
**Author:** ![WeRSauron](https://avatars.discourse-cdn.com/v4/letter/w/f19dbf/32.png) [@WeRSauron](https://boards.straightdope.com/u/WeRSauron)\ **Post date:** [May 6, 2003, 12:38pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/17 "2003-05-06T12:38:30Z")
**Mengetout** ’s comments brought up a question - are there any protective bacteria on our hands/skin surface? And related to the whole issue of bacteria and resistance - I have read (not aware of any cites right now) that overusing antibiotics can be harmful for the same reason: it allows bacteria more opportunities to develop resistance. So, soap, etc., can kill bacteria. What can kill viruses? WRS ---
**Author:** ![lissener](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lissener/32/6139_2.png) [@lissener](https://boards.straightdope.com/u/lissener)\ **Post date:** [May 7, 2003, 2:19pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/18 "2003-05-07T14:19:29Z")
> [@](#): > > \*Originally posted by light strand \* > **Bacterial resistance to alcohols at high concentrations is extremely low to almost non-existent.** Um, doesn’t this prove my point, and disprove yours? The only antibacterial agent that won’t act as evolutionary pressure is the one that is 100% effective; “extremely low to almost non-existent” doesn’t cut it. The one bacterium left is the one that’s resistant, and the one that will reproduce more resistant bacteria. ---
**Author:** ![yoyodyne](https://avatars.discourse-cdn.com/v4/letter/y/a9a28c/32.png) [@yoyodyne](https://boards.straightdope.com/u/yoyodyne)\ **Post date:** [May 7, 2003, 8:41pm UTC](https://boards.straightdope.com/t/advisability-of-hand-santiziers/173177/19 "2003-05-07T20:41:43Z")
Alcohol and antibiotics do not work the same way. If you shoot a group of people with a machine gun, those that survive will not be resistant to future gunshots, no matter how much the evolutionary pressure.