# Hand Sanitizer **URL:** \ **Category:** Cecil's Columns/Staff Reports\ **Created:** [August 5, 2011, 2:24pm UTC](https://boards.straightdope.com/t/hand-sanitizer/591594 "2011-08-05T14:24:21Z")\ **Posts on this page:** 11\ **Page:** 2
**Author:** ![TSBG](https://avatars.discourse-cdn.com/v4/letter/t/77aa72/32.png) [@TSBG](https://boards.straightdope.com/u/TSBG)\ **Post date:** [August 8, 2011, 11:03pm UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/21 "2011-08-08T23:03:24Z")
I might be paraphrasing badly, but I believe that triclosan disrupts only one site on the cell membrane in the course of killing the cell, thus is easy to adapt to, but alcohol disrupts many sites on the cell membrane and thus is harder to adapt to–though I suppose not impossible. ---
**Author:** ![WarmNPrickly](https://avatars.discourse-cdn.com/v4/letter/w/d78d45/32.png) [@WarmNPrickly](https://boards.straightdope.com/u/WarmNPrickly)\ **Post date:** [August 9, 2011, 12:41am UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/22 "2011-08-09T00:41:03Z")
Triclosan is not an antibiotic. It is an antibacterial. I am not certain that resistance to triclosan has been demonstrated outside the laboratory, and even if it did, that this resistance would translate to methicillin resistance. I’m not a doctor, but methicillin resistance does not usually translate to tetracycline resistance which doesn’t translate to vancomycin resistance. If the antibiotics don’t cause cross resistance between classes, then how likely is it that something different enough to not be classified as an antibiotic, cause resistance to compounds even less related? I do understand though, that MDR bacteria can be facilitated with ABC transport over expression. I think, in this way, resistance can be effective across classes of antibiotics, but when you start including compounds that aren’t even antibiotics, I’d like to see that it’s justified with research. I’m not advocating putting these things in all of our soaps and constantly sanitizing. I’m just questioning the position that it leads to antibiotic resistance. I don’t think it will. ---
**Author:** ![simster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/simster/32/1047_2.png) [@simster](https://boards.straightdope.com/u/simster)\ **Post date:** [August 9, 2011, 5:43pm UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/23 "2011-08-09T17:43:17Z")
> [@WarmNPrickly](#): > > Triclosan is not an antibiotic. It is an antibacterial. I am not certain that resistance to triclosan has been demonstrated outside the laboratory, and even if it did, that this resistance would translate to methicillin resistance. > > I’m not a doctor, but methicillin resistance does not usually translate to tetracycline resistance which doesn’t translate to vancomycin resistance. If the antibiotics don’t cause cross resistance between classes, then how likely is it that something different enough to not be classified as an antibiotic, cause resistance to compounds even less related? > > I do understand though, that MDR bacteria can be facilitated with ABC transport over expression. I think, in this way, resistance can be effective across classes of antibiotics, but when you start including compounds that aren’t even antibiotics, I’d like to see that it’s justified with research. > > I’m not advocating putting these things in all of our soaps and constantly sanitizing. I’m just questioning the position that it leads to antibiotic resistance. I don’t think it will. I see it not so much that we are creating ‘antibiotic resistant germs’ in this case, but moreso that we are not allowing our own immune systems to build resistance to those germs/etc - thereby weakening our own resistance to them. ---
**Author:** ![Irishman](https://avatars.discourse-cdn.com/v4/letter/i/b487fb/32.png) [@Irishman](https://boards.straightdope.com/u/Irishman)\ **Post date:** [August 9, 2011, 6:34pm UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/24 "2011-08-09T18:34:39Z")
I don’t believe anyone is making the claim that triclosan or alcohol rubs will cause increased resistance to antibiotics. Rather, the claim as I understand it is that in the same way that overuse of antibiotics causes resistance to those antibiotics to develop, so overuse of triclosan might cause resistance to triclosan to develop, and overuse of alcohol rubs could cause resistance to alcohol to develop. I read the part about one site vs multiple sites, but need it reparsed for me. What kind of sites? Where are the sites? How do sites matter? Also, a tutorial on how a biocide is different than an antibiotic would be useful. It’s all fine and dandy to say “alcohol and triclosan are antiseptics, not antibiotics”, but if you don’t explain why that makes a difference, you aren’t really addressing the question. One difference that makes some sense to me is that antiseptics (biocides) work by breaking the cell membrane, thus rupturing the cell. The cell dies immediately. Wheras antibiotics attack the “inner workings” of the cells, perhaps at the DNA level, allowing the cells to keep living for a time as they work, kinda like humans and our immune systems. But I’m making that up. Someone who actually knows should explain, please. Because I’m annoyed I can’t find liquid soap that doesn’t have triclosan\*, so I’d like to take comfort in the fact that overabundance of triclosan is not causing future problems to be worse. But right now I can’t, because I don’t know enough. * * * \*Apparently a lot of people don’t like to wash their hands with soap bars. The bars get squishy or dirty or whatever, and it squicks [del]people[/del] certain ladies out. So I accede to the wish to not be squicked out, and lament the overuse of triclosan. ---
**Author:** ![WarmNPrickly](https://avatars.discourse-cdn.com/v4/letter/w/d78d45/32.png) [@WarmNPrickly](https://boards.straightdope.com/u/WarmNPrickly)\ **Post date:** [August 9, 2011, 7:41pm UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/25 "2011-08-09T19:41:46Z")
> [@Irishman](#): > > I read the part about one site vs multiple sites, but need it reparsed for me. What kind of sites? Where are the sites? How do sites matter? Also, a tutorial on how a biocide is different than an antibiotic would be useful. It’s all fine and dandy to say “alcohol and triclosan are antiseptics, not antibiotics”, but if you don’t explain why that makes a difference, you aren’t really addressing the question. This is a good point, and I shouldn’t pretend that I know the actual difference myself. I was kind of hoping someone with better knowledge would step in. > [@](#): > > One difference that makes some sense to me is that antiseptics (biocides) work by breaking the cell membrane, thus rupturing the cell. The cell dies immediately. Wheras antibiotics attack the “inner workings” of the cells, perhaps at the DNA level, allowing the cells to keep living for a time as they work, kinda like humans and our immune systems. This is what I think. I also think that antiseptics tend to be used in higher concentrations. Certainly bleach, as a potent oxidant, will mess with all kinds of systems. Triclosan is a phenol and likely messes with the cell membrane as you suggest. I’m certain that they can develop resistance to these things. After all, they can make bacteria that are extremely resistant to arsenic. I’m not certain that this resistance is a threat. ---
**Author:** ![MacLir](https://avatars.discourse-cdn.com/v4/letter/m/9e8a1a/32.png) [@MacLir](https://boards.straightdope.com/u/MacLir)\ **Post date:** [August 11, 2011, 3:37pm UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/26 "2011-08-11T15:37:18Z")
> [@Bearcat69](#): > > Excuse me if this is slightly off-topic, but I couldn’t resist mentioning the latest in germaphobia: the no-touch soap dispenser. The advertising preys on the fear of germs residing on that nasty pump handle. We got some of those at work. However, in a case of taking logic a little too far, they put one up _right next to the entry door_. Motion activated, remember?. :smack: So as you approached the door, just about the time you were opening it, the unit would greet you by - well - ejaculating at you. :eek: The act of opening the door would line you up just right. Lasted about three days before it was forcibly removed. ---
**Author:** ![TSBG](https://avatars.discourse-cdn.com/v4/letter/t/77aa72/32.png) [@TSBG](https://boards.straightdope.com/u/TSBG)\ **Post date:** [August 11, 2011, 7:32pm UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/27 "2011-08-11T19:32:11Z")
**Irishman,** I buy Dr. Bronner’s or the Trader Joe’s castile soap and use it to refill soap dispensers. I dilute it with an equal amount of water. I do this not because of the Triclosan but because I really dislike the scent of most pump soaps. One can find unscented refills for some brands, sometimes, but I can always get Bronners/TJ’s brand and I don’t mind the mint scent. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [August 11, 2011, 9:05pm UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/28 "2011-08-11T21:05:50Z")
> [@](#): > > We got some of those at work. However, in a case of taking logic a little too far, they put one up right next to the entry door. Motion activated, remember?. > > So as you approached the door, just about the time you were opening it, the unit would greet you by - well - ejaculating at you. The act of opening the door would line you up just right. > > Lasted about three days before it was forcibly removed. Please tell me that it made it onto YouTube in those three days. ---
**Author:** ![debbiemoore](https://avatars.discourse-cdn.com/v4/letter/d/838e76/32.png) [@debbiemoore](https://boards.straightdope.com/u/debbiemoore)\ **Post date:** [August 12, 2011, 10:59am UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/29 "2011-08-12T10:59:14Z")
> [@fgasparini](#): > > Wouldn’t a thorough hand-washing also kill “beneficial” bacteria? And what’s to prevent bacteria from evolving “soap resistance”? The main problem is more to do with the inadequate use of sanitizers together with the hype being built up around a level of sterility which is not achievable (and probably not necessary for good health either…). Sanitizers need time to work on killing bacteria whereas soap alters surface tension of organic matter and just melts bacterial membranes - it is almost instantaneous. But it is killing on a structural plane, not internal where bacteria could resist. There is not much chance of developing resistance to soap, it’s like humans developing immunity against a shotgun. Somehow people have got into the habit of just rubbing sanitizers on their hands for a few seconds and assuming that this is better than soap, and this is simply not true. The average cosmetic hand sanitizer is fairly weak and you would need to rub with lots of gel for about 20 minutes to get the same effect as using soap. If you only kill a percentage of bacteria you tip the balance and give resistance a larger playing field. The biggest problem with sanitizers is that they take out the weak ones first and assumes there is enough on the hands for a long enough period to take out the stronger, resistant strains too, and that just doesn’t happen. Yes with soap the good guys would go down too but the point is they would all have an equal chance of being wiped out and you are more likely to keep the balance healthy. We’re never going to rid the world of bacteria - that would be counterproductive to our health (plus how else would we clean up our oil spills…), but we can at least try to get on with them and keep the balance in check, and that means unless preparing for surgery, we should not being paranoid about the tiniest germ on our hands. ---
**Author:** ![DA\_FUZ](https://avatars.discourse-cdn.com/v4/letter/d/9f8e36/32.png) [@DA\_FUZ](https://boards.straightdope.com/u/DA_FUZ)\ **Post date:** [August 12, 2011, 2:53pm UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/30 "2011-08-12T14:53:26Z")
When you use hand sanitizer it indisciminately kills all the microrganisms on your skin. There are healthy bacteria on your skin that cause no harm but when they are removed it creates an environment in which pathogenic organisms may mulitiply causing disease. ---
**Author:** ![Irishman](https://avatars.discourse-cdn.com/v4/letter/i/b487fb/32.png) [@Irishman](https://boards.straightdope.com/u/Irishman)\ **Post date:** [August 12, 2011, 7:08pm UTC](https://boards.straightdope.com/t/hand-sanitizer/591594/31 "2011-08-12T19:08:18Z")
> [@debbiemoore](#): > > Sanitizers need time to work on killing bacteria whereas soap alters surface tension of organic matter and just melts bacterial membranes - it is almost instantaneous. But it is killing on a structural plane, not internal where bacteria could resist. There is not much chance of developing resistance to soap, it’s like humans developing immunity against a shotgun. Can you provide a cite that soap kills bacteria, and that it does so by melting membranes? It is my understanding that soap does _not_ kill any bacteria. The reason we wash with soap and water is to **dislodge** the bacteria with the dirt through mechanical action. Hands rubbing together knocks stuff off hands. Soap helps remove stuff from hands. Hand sanitizers actually kill germs - if the sanitizer is in contact long enough. From [http://www.learnwell.org//handhygiene.htm](http://www.learnwell.org//handhygiene.htm) > [@](#): > > **3.2 Plain (Non-Antimicrobial) Soap** > Soaps are detergent-based products that contain esterified fatty acids and sodium or potassium hydroxide. They are available in various forms including bar soap, tissue, leaflet, and liquid preparations. Their cleaning activity can be attributed to their detergent properties, which result in removal of dirt, soil, and various organic substances from the hands. Plain soaps have minimal, if any, antimicrobial activity. However, handwashing with plain soap can remove loosely adherent transient flora. For example, handwashing with plain soap and water for 15 seconds reduces bacterial counts on the skin by 0.6–1.1 log10, whereas washing for 30 seconds reduces counts by 1.8–2.8 log10. > [@](#): > > The average cosmetic hand sanitizer is fairly weak and you would need to rub with lots of gel for about 20 minutes to get the same effect as using soap. Please provide a cite that it takes 20 **minutes** for hand sanitizer to kill germs. Even commercial public sanitizer, vs hospital/doctor grade. From same cite above: > [@](#): > > Alcohol-based products are more effective for standard handwashing or hand antisepsis by HCWs than soap or antimicrobial soaps. In all but two of the trials that compared alcohol-based solutions with antimicrobial soaps or detergents, alcohol reduced bacterial counts on hands more than washing hands with soaps or detergents containing hexachlorophene, povidone-iodine, 4% chlorhexidine, or triclosan. In studies examining antimicrobial-resistant organisms, alcohol-based products reduced the number of multidrug-resistant pathogens recovered from the hands of HCWs more effectively than did handwashing with soap and water. > > [snip] > > The efficacy of alcohol-based hand-hygiene products is affected by several factors, including the type of alcohol used, concentration of alcohol, contact time, volume of alcohol used, and whether the hands are wet when the alcohol is applied. Applying small volumes (i.e., 0.2–0.5 mL) of alcohol to the hands is not more effective than washing hands with plain soap and water. One study documented that 1 mL of alcohol was substantially less effective than 3 mL. The ideal volume of product to apply to the hands is not known and may vary for different formulations. However, if hands feel dry after rubbing hands together for **10–15 seconds** , an insufficient volume of product likely was applied. Because alcohol-impregnated towelettes contain a limited amount of alcohol, their effectiveness is comparable to that of soap and water. Bold and underline added. Now they state that 15 seconds is not long enough, but note that they are still discussing _seconds_. Nowhere did minutes even come under consideration. Oh, > [@](#): > > Typically, log reductions of the release of test bacteria from artificially contaminated hands average 3.5 log10 after a 30-second application and 4.0–5.0 log10 after a 1-minute application. That’s 99.9% after 30 seconds, and 99.99% to 99.999% after 1 minute. Nowhere near 20 minutes. > [@](#): > > If you only kill a percentage of bacteria you tip the balance and give resistance a larger playing field. That is the question: do hand sanitizers promote bacteria that are resistant to those sanitizers? So far the evidence says that alcohol versions do not because they are more volatile/reactive/whatever, but triclosan has a more narrow band of action. While there is no evidence shown so far that resistance is developing, it is not impossible. > [@DA\_FUZ](#): > > When you use hand sanitizer it indisciminately kills all the microrganisms on your skin. There are healthy bacteria on your skin that cause no harm but when they are removed it creates an environment in which pathogenic organisms may mulitiply causing disease. From link previously provided by Jackmanii: [http://scienceblog.com/10882/hand-hygiene-truths-myths-and-misinformation/](http://scienceblog.com/10882/hand-hygiene-truths-myths-and-misinformation/) > [@](#): > > 1. Good germs are microorganisms normally found on human skin and bad germs are pathogenic (disease producing) microorganisms. > 2. The numbers of good germs and bad germs on the hands are variable from one person to the next but remains relatively constant for each individual. > 3. Good germs cannot protect you against bad germs. Anyone can become contaminated with bad germs (pathogens). > 4. Bad germs (pathogens) do not always cause infections and good germs in the wrong place can cause infections. [Previous page](https://boards.straightdope.com/t/hand-sanitizer/591594.md?page=1)