The FDA recently told Purell to remove claims that its hand sanitizer can prevent the flu... So should you still be using it?

By Caroline Shannon-Karasik
Feb 04, 2020 @ 6:00 pm
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‘Tis the season for non-stop coughing from your cube mates and getting sneezed on by strangers on public transportation.

And if cold and flu season wasn't enough to make you a complete germaphobe, the coronavirus — a respiratory illness that was first detected in Wuhan, China — has been dominating headlines. The outbreak, which has made its way to the United States, has led the World Health Organization (WHO) to declare the virus a global health emergency. (It's important to note that while coronavirus is certainly top of mind right now, the flu still remains a higher threat to the U.S. At least 19 million people have come down with the flu this season and 10,000 have died.)

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Needless to say, concern about staying healthy is at an all-time high right now. Which brings us to the question of the hour: Does hand sanitizer really work to kill a cold or flu virus? And can using hand sanitizer backfire? 

Despite claims that hand sanitizer kills 99.9 percent of bacteria, you may be cautious about the stuff after seeing the U.S. Food and Drug Administration’s (FDA) recent warning to Purell to remove claims that its hand sanitizer can wipe out Ebola, MRSA, or the flu. The agency noted that the company is positioning its product as a drug by suggesting it can prevent disease, but hand sanitizer is not classified as a drug, nor have their prevention claims been proven. Still, the Centers for Disease Control and Prevention (CDC) recommends alcohol-based hand sanitizer as a possible flu prevention method — which is exactly what Purell is.

Adding to the confusion is the controversy around triclosan, a dangerous ingredient found in some hand sanitizers. In April, the FDA ruled that companies pull all over-the-counter hand sanitizers that include the ingredient, as well as benzethonium chloride. The decision came as a result of studies that showed high doses of triclosan might be linked to a decrease in thyroid hormone levels. Other studies have shown that the ingredient might make bacteria more resistant to antibiotics and could potentially lead toskin cancer, according to the CDC.

News like this makes it much more difficult to trust the efficacy and safety of hand sanitizer, which is why we asked two experts to weigh in on how well they actually work — and how often we should be relying on the stuff this cold and flu season. 

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How Does Hand Sanitizer Work? 

Here’s the gist: Alcohol-based antiseptics (read: everything from Purell to your trusted Bath & Body Works scented hand sanitizer) work by breaking down the tiny microorganisms on your hands, therefore making them noninfectious, says Andres Romero, M.D., an infectious disease specialist at Providence SaintJohn’s Health Center.

A quick science lesson about how that works: The alcohol in hand sanitizer breaks down fat, which is the main component in an organism’s membrane, Dr. Romero explains. To put it simply, that membrane protects the virus, ensuring it will hang around long enough to make you sick. When you use hand sanitizer, that protective bubble pops, killing the germs.

So How Effective Is Hand Sanitizer?

“Alcohol solutions containing 60 to 95 percent alcohol are the most effective,” Dr. Romero says, adding that these hand sanitizers usually carry a water component that also helps to break down the viral and/or bacterial germs on your hands. However, their effect is short-lived — two minutes to be exact. That means by the time your hand sanitizer dries, you basically need to reapply it again to kill new germs.

Plus, hand sanitizers aren’t effective for all bacteria and viruses, explains Christina Wojewoda, M.D., a spokesperson for the College of American Pathologists. For example, bacteria that make spores — like C. diff, which is a bacteria that causes diarrhea and colitis — is not killed by hand sanitizer.

And hand sanitizer can't kill norovirus, a highly contagious stomach bug, either. Instead, the CDC recommends washing your hands before and after each time you come in contact with the virus (say, because you are taking care of a sick kid), as well as disinfecting surfaces that have been exposed to norovirus with a bleach and water solution. For some viruses, you can also try a disinfectant cleaner that is aimed at knocking out a particular virus, Dr. Wojewoda says. For instance, Clorox wipes kill influenza A2, human coronavirus, and strep. 

Another catch: “Hand sanitizers also don’t work if your hands are visibly dirty, if you have been handling contaminated food, or if you have harmful chemicals like pesticides on your hands,” Dr. Wojewoda says. “I would always recommend hand washing with soap and water, and if that isn’t available, then you can turn to hand sanitizer.”

FYI, as a result of the FDA's warning, Purell has changed its website to note that the product helps reduce "transient bacteria," which are germs that are often responsible for making you sick. The company no longer makes claims about viral reduction.

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How Should I Use Hand Sanitizer?

Again, you should only use hand sanitizer if soap and water are not available, Dr. Wojewoda says. “You should wash your hands before, during, and after preparing food, before eating, after taking care of someone who is sick, after using the toilet (or taking care of someonewho went to the bathroom), after blowing your nose, coughing or sneezing, taking care of pets, and touching garbage,” she says. (Makes the world sound gross, right?)

But if you do have to opt for hand sanitizer, it's important to use it the right way. This means applying the product to the palm of one hand and rubbing it all over the surfaces of your hands — the top of your hands, palms, and between your fingers — until your hands are dry, according to the CDC. Make sure you check the label to see how much you should use because amounts vary by brand, Dr. Wojewoda says.

Do Natural Hand Sanitizers Work?

Traditional, alcohol-based hand sanitizers like Purell aren't your only option anymore; some are made with thymol, a botanical oil with natural antimicrobial properties, or with topical antibacterial and antiseptic agents like benzalkonium chloride and cetrimonium chloride.

It's important to note however, that the CDC says alcohol-free products are less effective at killing germs. Our experts agree: The number one thing to keep in mind when choosing a hand sanitizer is that the formula should contain at least 60 percent alcohol, Dr. Wojewoda says.

So, while there are plenty of new products out there that are marketed as 'natural' (alcohol, by the way, is natural) and may contain essential oils or other botanical ingredients, it's best to find one that still contains alcohol to reap the beenefits of using a hand sanitizer. (For example, Honest, which contains skin-soothing, from-the-earth ingredients like aloe vera and chamomile and also contains 62 percent alcohol.)

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    So, Do I Need Hand Sanitizer?

    Let’s not get this mixed up: Hand sanitizer is a solid in-the-moment way to clean your hands after coming in contact with what Dr. Romero calls a “high burden” surface, for instance after you’ve wiped your kid’s snotty nose in the middle of the grocery store.

    Once you’re in a spot where soap and water are available, take a moment to wash your hands, wiping out any germs that may still be hanging around.

    As for hand sanitizer, stash a bottle in your bag for when you’re on the go, or opt for a solid rub down with the stuff after making a fast exit from school drop off or getting off of a plane. Because if there’s anything you’ve learned this (and every) cold and flu season, it’s that being the friend who passes around hand sanitizer after hopping off of a packed subway car will easily make you everyone's favorite.

    The Best Hand Sanitizers to Shop

    Not only does the list include only hand sanitizers that meet the minimum 60 percent alcohol requirement, but it offers a solid mix of options that you can scoop up at your local drug store or add to your cart.