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May 7th, 2009
11:39 AM ET

Does hand sanitizer kill bacteria and viruses?

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

From CNN.com blogger, Dick:

"Hand sanitizer has been recommended but the bottles say, "Effective against bacteria," with no mention of viruses. What gives?"

Answer:

That is a good question. There are not a lot of data actually on how effective those sanitizers are against viruses. There have been some studies done over the years and the conclusion is washing your hands with soap and water is still probably the best idea. If you are having a busy day and it is hard to get to a sink, then carrying a bottle of hand sanitizer would be a good idea.

In essence, it makes your hands very inhospitable to viruses. You put it on your hands and viruses simply don't want to cling to it. So it does reduce the amount of a virus that can cling to your hand but it does not kill it. Alternatively, it also can’t harm you in any way. We get a lot of questions from concerned viewers asking if sanitizers could actually cause antibiotic resistance down the road. Many studies have looked into the issue and all evidence points to the answer being no.

At the end of the day, basic principles apply to avoid getting a virus. Avoid touching your mouth, eyes and nose as much as possible. If you cough or sneeze, cover your mouth and nose with a tissue or your sleeve. If you're sick, stay home and avoid close contact with others. Some viruses can live for hours on surfaces such as ATMs, doorknobs, even money.

So be methodical about good hygiene, all year long! Remember that the number of 2009 H1N1 cases will most likely decrease over the summer months because viruses just don't transmit that well in the heat. But in the fall and winter, we're all going to have to remember what the new H1N1 strain was like and be extra vigilant so this doesn't get out of control.


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soundoff (48 Responses)
  1. Ursula Haubrick

    Hand sanitizers should come with a warning.
    Since the concerns over the Swine flu outbreak, the use of these sanitizers have been on the increase.
    It has also been recommended that they contain at least 60% alcohol.
    There have now been cases where people (mostly smokers) have sustained serious burns to the hands because they have foolishly lit up while their hands have been wet with hand sanitizer.
    Our work sites have been instructed to post a flamible warning along side these bottles.
    Perhaps more mention of this side effect when promoting the use of these sanitizers
    Thankyou

    May 14, 2009 at 10:15 | Report abuse | Reply
    • Miraspa

      Alcohol based hand sanitizers get rid of your skins natural oil, so that's why your hand might feel dry and sensitive. Better to swtich to non alcohol based hand santiziers

      http://miraspa.co.uk

      October 10, 2011 at 07:55 | Report abuse |
  2. Sandra Smith

    I learned in microbiology back in the60's whatever kills most organisms makes survivors stronger. How can sanitizers not do same? Bacteria & viruses mutate & adapt.

    May 14, 2009 at 20:20 | Report abuse | Reply
  3. Mario Guerrero

    In high quantities, alcohol is cytotoxic to all organisms, however it does not necessarily affect dormant organisms or viruses which have special protective barriers. The action of alcohol as a disinfectant occurs by disrupting the cellular membrane, essentially inactivating the pathogen by destroying its capacity to infect cells. Dormant organisms may have layers of protein, which act as a shell, protecting the internal components of the pathogen from chemical attack. A good example are the spores generated by anthrax, which are resistant to alcohol. Organisms will never adapt to alcohol treatment, because it is a purely chemical process, much like acid treatment. They do adapt to anti-bacterial compounds which target specific biochemical processes, which are easily altered to circumvent such sensitivities.

    May 21, 2009 at 13:23 | Report abuse | Reply
  4. nelson

    the dental profession has been dealing with this question since the beginning of the aids back in the early 80's. the main problem with hand sanitizers is that they are almost exclusively made with isopropyl alcohol. we have tested many products through the years and isopropyl will not kill viruses. our profession needed something to combat them that was economical and somewhat safe. the best defense for viruses is straight bleach. it is harmful to tissue and a lot of delicate surfaces. what we found was ethanol would kill viruses if the concentration was adequate. isopropyl alcohol is completely different and is quite useless to us. but ethanol at 79% by weight achieves what we call high level hospital disinfection. the short of it is the companies that make these products are short cutting us with an inferior product. lysol used to be 79% ethanol and we used it all the time. they found out we bought it over the counter, changed it to 59% and can out with lysol professional at 79% and charge us double. i make my own hand sanitizer with straight up pure grain alcohol diluted slightly with water to achieve 79% and add some fragrance. i feel confident anywhere i go with this.

    May 21, 2009 at 22:13 | Report abuse | Reply
  5. Jenny Lynn

    Sandra, it says right in the article that sanitizer DOES NOT KILL the virus. It just makes your skin inhospitable to carrying them. Hello, read the article before you ask a question.

    May 22, 2009 at 09:27 | Report abuse | Reply
    • Austin

      Um Hello! Being rude, not okay?! Em Kay

      February 8, 2012 at 19:44 | Report abuse |
  6. Ken

    There are a couple of very important things about viruses that people seem to forget (or never learn). First, a virus is NOT a living thing... at least not in the traditional sense. It is rather a mass of protein and DNA that is pretty much inert until it can find itself a host cell to use for reproductive purposes. Thus, it cannot be expected to respond like a living thing to medications and/or disinfectants.

    Also, antibiotics are effective against bacteria only. They have no effect on viruses! ...none!... zero! ...nada! ...bupkis! Therefore, unless your personal case of the flu or a cold also leaves you with a bacterial infection (like an ear infection or pneunmonia), there no reason whatsoever for you to take antibiotics.

    In fact, individuals who insist on taking antibiotics everytime they have a cold (and the doctors who are dumb enough to prescribe them to "shut their patients up") are a large part of the reason there so many bacterial illnesses that are resistant to antibiotics. It isn't rocket science. Darwin's laws work for bacteria just like they do for large creatures and, because the life and reproductive cycle of a bacteria is a heck of lot shorter than it is for most living things, a bacteria can evolve a heck of lot quicker. It goes without saying that the same goes for use of disinfectants. If you continuously expose bacteria to disinfectants, they WILL evolve to be tolerant to it. There have allegedly been studies that "prove" (and I use quotes because I can't seem to find details online to link to, but they are out there) that, in homes where parents use large amounts of disinfectants to constantly clean surfaces, kids tend to be more susceptible to colds and flu because their home becomes such a bacteria-free zone that kids are unable to build up their immunities, which would happen a matter of course, in a "dirtier" home.

    May 27, 2009 at 13:02 | Report abuse | Reply
  7. chris

    I use hand sanitizer all the time at work as I work at school with over 2,000 students,I think its more a mind over matter thing,you use it therefore you think you wont get sick,so it makes me feel better.well I wash my hands to and never touch my face unless my hands are clean and I still get sick once in a while.vitamins help too

    June 4, 2009 at 11:20 | Report abuse | Reply
  8. Rob

    I use a product called Microdine, I put a dime spot in my palm and rub it all over my hands, it leaves a film of spent iodine upon drying that can rinced off and then it has a persistance of about 5 hours. Microdine containes no alcohol and it is a class 1 FDA approved hand sanitizer and sugical scrub. Check out all the test data at http://www.microdine.com for youself

    July 12, 2009 at 18:57 | Report abuse | Reply
  9. Ivan

    Jenny Lynn, Sandra still has a point. Viruses may mutate in order to adapt to that place where they are "not allowed", even though they do not achieve success in this adaptation.

    July 21, 2009 at 08:19 | Report abuse | Reply
  10. Kevin

    Some basic biology for you...ALL living cells are surrounded by a fat-based plasma membrane. Alcohol disrupts the plasma membrane, as fats are soluable in alcohol. Viruses are NOT cells, and are NOT alive. Many viruses, including influenza, have a fatty envelope surrounding them that facilitate their attachment to target host cells. Alcohol breaks down the envelope IF in high enough concentration and IF used for appropriate time of exposure (15-20 seconds minimum).

    Over-the-counter sanitizer gels are almost always 62%-63% ethyl alcohol, NOT isopropyl alcohol as suggested by Ken above. They are NOT as substitute for handwashing, but are MUCH better than nothing if soap and water are not available.

    While Sandra Smith said in her comment above, bacteria and viruses can mutate if exposed to drugs. Alcohol is not a drug, so resistance via mutation cannot happen with alcohols. This is a basic chemical reaction, not a targeted attack that occurs when using antimicrobial or antiviral drugs...totally different thing.

    Kevin
    Microbiology Instructor

    August 15, 2009 at 21:42 | Report abuse | Reply
  11. Hand_Sanitizer

    My company gives all employees in our office hand sanitizer pumps bottles for desks (Purell) and a delivery service company (UniFirst.com) comes and refills the "touchless" dispensers in our restrooms and in our cafeteria. I imagine it is cheaper than paying for lots of sick time.

    August 26, 2009 at 20:51 | Report abuse | Reply
  12. HCG

    Kevin states: " Over-the-counter sanitizer gels are almost always 62%-63% ethyl alcohol, NOT isopropyl alcohol as suggested by Ken above. "

    Looking at the bottle of Putrell Hand Santizer on my desk, first two ingredients are water and isopropyl alcohol.

    August 27, 2009 at 12:30 | Report abuse | Reply
  13. Kevin

    HCG – Did you mean "Purell?" I've never heard of Putrell and couldn't find it with a Google search. It could be a specialty product, I suppose. It could be that a formulation has changed, but this is what I found on the net. Most over the counter preps are very similar. I cannot speak for all of them.

    From: http://www.raytechcatalog.com/product_info/purell-hand-sanitizer-376.html

    Purell Ingredients:

    Active Ingredients: Contains: Ethyl Alcohol (62%)

    Inactive Ingredients: Water, Glycerin, Isopropyl Myristate, Propylene Glycol, Tocopheryl Acetate, Aminomethyl Propanol, Carbomer, Fragrance (parfum)

    From http://www.brands2liveby.com/purell/content/faq.htm

    1. What is the active ingredient?
    Ethyl alcohol, 62% – "mother nature's disinfectant." According to the American Journal of Infection Control, Aug. 1995, "Alcohols applied to the skin are among the safest known antiseptics."

    2. What are the inactive ingredients used in Purell® products?
    Denaturant/bittering agent – small amount of Isopropyl Alcohol, Moisturizers derived from plant materials, Propylene Glycol, Isopropyl Myristate, Thickener – Carbomer Fragrance

    August 28, 2009 at 09:40 | Report abuse | Reply
  14. veronica s.

    my science partner and i are 14 and we neeeded to find information and yours was the right blog to read =]

    November 9, 2009 at 11:06 | Report abuse | Reply
  15. Alysia

    What I found to be funny was the tangents people strayed off to when the topic is about hand sanitizer.

    Robert, you just attacked Sandra in regards to talking on the phone while driving. lol

    One should not throw stones unless one is 100% pure and we all know that isn't possible or realistic.

    Back to hand sanitizer. We're required to use it when coming in or leaving the office. I see it as a precautionary, but also pretty pointless.

    No one enjoys using this stuff. Granted, it smells like alcohol...however, I guess anything helps...

    November 10, 2009 at 11:51 | Report abuse | Reply
  16. Dasharath Desai

    Sir,
    Can you send me the list of pathogens which can be killed by Alcohol Hand Sanitizer?

    Thanks.

    Desai

    November 16, 2009 at 12:46 | Report abuse | Reply
  17. Mel

    You know the best way to end any pointless debate is for someone who has training in viruses and handling them in a lab setting... get the isolated forms of the different viruses most people are worried about (HIV, Hepatits, H1N1, all the stomach bugs...etc) and just flat out test these santizers on the virus itself. Once the virus has been exposed to alcohol in the santizer, combine it with a small cluster of cells and see if the virus works or not. WHY DOESN'T SOMEONE DO THIS? I would if I had access to the stuff!

    January 4, 2010 at 08:08 | Report abuse | Reply
  18. Ron Gourley

    Regarding Kevin's response, he is very accurate in his description of the actions of organisms to alcohol. Additionally, his descriptions of viral activity and their interactions is also equally on target.
    Alc. under the FDA Guidance must be 62% or greater to be considered a Category 1 Antiseptic (doesn't matter what type of alc.) He is is also accurate in that most of the products on the market are ethyl alc.

    We should all note that because alc. is considered a "drug" by the FDA it is required to be labeled as such. Statements made regarding mutations of bacteria or viruses around drugs is almost exclusively confined to conversations of anti-biotic resistence to synthetic drugs.

    There is one situation of great concern in our hospitals and extended care facilities today and that is Alcohol Resistent C-diff spores.(Clostridium-difficle) this is a highly contagious bacteria and quite deadly. C-diff is competing for the MRSA tilte in HAI's (Hospital Acquired Infections) in Amercia.

    Remeber the CDC recommends wahsing your hands (FIRST) and ONLY using alcohol when soap and water aren't available. We have gone overboard with the alcohol mostly because of ignorance. Once you sterilize your skin with alcohol you have severly compromised your skin's natural defense system, damaged the acid mantle of the skin, and exposed your skin (almost immediately) to colonization of pathogenic bacteria or viruses with the very next touch you make.

    So next time you use alcohol in a restaraunt to clean your hands before eating, and then reach for the salt & pepper shaker, or the ketchup, I want you to think about what else you will be enjoying with your lunch!
    There is a better way!

    January 10, 2010 at 18:14 | Report abuse | Reply
  19. tiffany

    I have to admit that I have sprayed Lysol on my kids hands to keep from catching their colds when we have not been able to wash our hands. Someone told me it was cruel. Does anyone know if I harmed them in some way? And why doesn't Lysol make a hand sanitizer with their active ingredients said to kill viruses?

    January 30, 2010 at 14:01 | Report abuse | Reply
  20. Sydney

    Would someone with knowledge on the subject please e-mail me and tell me if they know which is more effective on bacteria... Lysol wipes versus clorox wipes? I am doing a science fair project on them. I will be testing them both on bacteria that I collect at school. I was just wondering if anyone knew anything about these products prior to my testing them. Thank you.

    February 8, 2010 at 15:23 | Report abuse | Reply
    • Brian

      Sydney,
      To answer your question in simple terms: dead is dead. What this means is that if a product gets government approval as a sanitizer, than it must pass the government approved tests (basically kill 99.999% of organisms in a specified time period). If the lysol and the chlorox wipes both use the same active ingredient, and they both have the same sanitizer claim, then they should work exactly the same. We sell many sanitizers at our company. We must make them the exact same way as our competitors. We can't make ours stronger/weaker or make any changes. The governement regulates this to protect the consumer. So our bleach sanitizer, which is 12.5% active, is the exact same as our competitors, even though we have different names for our products. We also sell quatenary ammonium sanitizers, alcohol hand sanitizers, iodine based sanitizers and many other sanitizers. In short, they all work. Hope this helps. You can look up the efficacy (ability to kill) reports for different sanitizers on the internet. Sometimes one sanitizer may kill faster, or at a more dilute rate, but when used according to the manufacturer's directions they should all kill organisms at the same effectiveness.

      July 21, 2010 at 09:58 | Report abuse |
    • Clint

      http://www.sciencedirect.com/science/article/pii/S0196655307005950

      This journal article contains evidence that hand sanitizers with 60% ethanol will reduce the amount of enveloped viruses (i.e. rotavirus, noravirus) by at least 3 logs. (i.e. If you had 1,000,000 viral bodies on your hand if would reduce it to 1,000 viral bodies). That isn't perfect, but it is proof that viruses can be killed or at least dislodged from the hands using ABHS.

      April 5, 2012 at 22:53 | Report abuse |
  21. Nurse Beatty

    Do you have any information about what is NOT killed with the gel. I know c.diff is not and MRSA. What other things?!?!
    Thanks.

    February 19, 2010 at 15:37 | Report abuse | Reply
  22. Infection Control Nurse

    Nurse Betty,

    you are corect that Cdiff is not killed with alcohol based products and the bipolar action and mechanical scrubbing is the only way to protect your self (other than PPE). MRSA however, is killed with handsanitizers.

    March 10, 2010 at 15:55 | Report abuse | Reply
  23. Infection Control Nurse

    Tiffany-

    Triclosan is the active ingredient in Lysol and it is also the antimicrobial found in bath and body works' fu-fu antimicribial hand soaps. However, they are most likely in differnet concentrations and paired with different ingredients. I would not recomend spraying Lysol on your kids hands... rather, wash them with soap and H20. It is not cruel...just not the best technique. Your intensions are good keep up the work and keep up the research!

    March 10, 2010 at 15:59 | Report abuse | Reply
  24. sy

    can someone clarify whether sodium dichlorocyanurate or even simple chlorox kills bacterias, viruses, fungi and protozoas?

    March 25, 2010 at 23:51 | Report abuse | Reply
  25. Dr. Snyder

    Some of you are talking about viruses like they are bacteria, such as they mate, and reproduce such as. But Viruses are not bacteria, bacteria are living microscopic creatures, many do not even consider viruses living. Viruses work similar to computer viruses, they attach to file (cell), and a trigger like function injects a strand of DNA. This DNA changes the cell to produce these viruses instead of fight them. Because viruses do not reproduce themselves and because they have no life like functions, they are like mini robots, many do not consider them alive. Hand sanitizer is alcohol which raises the PH level of the hands environment therefore killing all living organisms. Viruses are non living therefore it does not affect them. There are some tribulations out that say that the alcohol does help prevent viruses from attaching themselves to cells, but it is not a proven theory.

    April 29, 2010 at 22:55 | Report abuse | Reply
    • some_doctor

      wow, a doctor without a solid education in infectious diseases, that makes me feel good about wherever you practice. Sure, ethanol doesn't "kill" viruses because they aren't "alive" to begin with. However ethanol does dissolve the membrane around enveloped viruses (where the proteins for binding and fusing with host membranes are located) therefore making them useless, so more or less "dead" (even though they can't be dead if they weren't initially alive, how about inactive?). Therefore it is a proven theory and commonly used (maybe you took biology too many decades ago). Pleaes tell me you're 70 years old and don't see patients anymore, you just like to call yourself a doctor to feel important.

      September 2, 2010 at 20:56 | Report abuse |
    • d

      Some-doctor... Your wrong.

      May 8, 2011 at 13:25 | Report abuse |
  26. Bob

    Since ordinary hand sanitizer does not "kill" viruses, and since virus infections such as colds the flu are the most common type of communicable diseases people are exposed to, it would seem that the use of hand sanitizer is just a "feel good" exercise. Wash your hands and use paper towel when you grab the door handle of the wash room.

    July 8, 2010 at 07:13 | Report abuse | Reply
  27. rgfddede

    i dont no if it kills germs im doing a science project

    December 14, 2010 at 18:12 | Report abuse | Reply
  28. rgfddede

    since im doing some thing related to the science tific methody can u tell me about it

    December 14, 2010 at 18:15 | Report abuse | Reply
  29. Rachel O’Connor

    It’s important to keep your mind full with new stuff. I just happened upon your post, and I’m so glad I did. I had so much fun reading this, and I’ll definitely share it with my friends!

    February 1, 2011 at 11:29 | Report abuse | Reply
  30. Lon

    I don't use anything anti-bacterial in my home as it kills the friendly bacteria that we all need. If I get sick I just use NAET procedure which works on virus or germs or anything else.

    February 1, 2011 at 15:50 | Report abuse | Reply
  31. d

    Whoever wrote this has no idea what he/she is talking about. Viruses cannot be "killed" because they are not alive. Viruses are composed of a nucleic acid, such as DNA or RNA, and must take over living cells to reproduce. Everyone is covered in non-harmful bacteria that occupy tiny spaces in the skin. When an individual applies hand sanitizer to his or her hands he or she kills all of the bacteria on his or her hands leaving spaces for foreign (possibly disease causing) bacteria to enter. Since bacteria are everywhere foreign bacteria will be on one's skin as soon as that person "sanitizes" their skin. Just wash your hands with NON anti-bacterial soap.

    May 8, 2011 at 13:22 | Report abuse | Reply
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    April 26, 2012 at 16:32 | Report abuse | Reply
  35. coldfreefor2years

    I used to get 3 or 4 colds per year...BAD ones. Colds have always hit me hard, like mini-flus. I'm typically in bed, sick, for 2 days at least. 2 years ago I started using 70% rubbing alcohol as hand sanitizer. I have not had a cold since October, 2010. I'm posting this comment on Jan 26, 2013. That's TWO AND ONE QUARTER YEARS during which I have not had a cold. Clearly, the sanitizer is WORKING. That's not to say that alcohol works on ALL viruses, but it sure seems to kick the starch out of cold viruses. Try rubbing alcohol...see if it works for YOU!

    January 26, 2013 at 13:06 | Report abuse | Reply
    • coldfreefor2years

      ...and, for the record, I have changed NOTHING else in my life. I've taken vitamin pills all my life, and I've exercised all my life. That did NOTHING to prevent the frequency and severity of my colds. Now it's been over 2 years since I've had a cold, and the ONLY thing I'm doing differently is using rubbing alcohol, 70% strength, for hand sanitizer. It dries your hands out, but a couple of drops of lotion restores the moisture. Don't argue about it...TRY IT!!!

      January 26, 2013 at 13:11 | Report abuse |
  36. JoAnn Black

    As a healthy person ages they get fewer colds (due to exposure over time) in general. I have NEVER used hand sanitizer instead I wash my hands using non-antibacterial soap and water with lots of rubbing, tops of hands, up the wrists and between the fingers. I have not had a "cold" in over 3 years but then I am am a senior citizen!

    March 6, 2013 at 16:02 | Report abuse | Reply
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