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We all know about the importance of good hand hygiene in reducing harmful microorganisms on the skin, and hence a reduction in infection risks. But what do we do when there is no access to hand washing facilities or not enough time to wash thoroughly? Since soap and water are not always available in out-of-home settings, hand sanitizers serve as an alternative which are portable, convenient, waterless and effective.

The majority of hand sanitizers contain ethanol or isopropanol, or a combination of these two products. The mode of action is, the alcohol disrupts the bacterial cell membrane and also leads to coagulation of cell contents. For alcohol-based hand sanitizers, the Food and Drug Administration (FDA) recommends a concentration of 60% to 95% ethanol or isopropanol, the concentration range of greatest germicidal efficacy. Higher concentrations are less potent because proteins are not denatured easily in the absence of water. While nonhealthcare groups also recommend alcohol-based hand sanitizers, they usually do not specify an appropriate concentration of alcohol. To be most effective, a dime-size dollop of alcohol gel should be rubbed into the hands for 30 seconds. If hands are dry after only 10-15 seconds, it is likely that not enough sanitizer was used. But research has shown that hand sanitizers can be effective only in certain situations because soil, food or anything else can make the sanitizer less effective.
As regards to the safety of such products, the alcohol based gels are safe is used as per the instructions. They should be kept out of the reach of children, smokers (the product is flammable) and those with alcohol dependence. As regards to skin irritation, most alcohol based products available commercially are formulated with appropriate emollients (moisturizers) to minimize irritation to the skin. Recently, some non alcohol based hand sanitizers have come up in the market, containing Benzalkonium Chloride as the active germ killing ingredient.
Hand sanitizers should primarily be used only as an optional follow-up to traditional hand washing with soap and water, except in situations where soap and water are not available. In those instances, use of an alcohol gel is certainly better than nothing at all.
Sources
http://vm.cfsan.fda.gov/~comm/ handhyg.html
www.fda.gov/ohrms/dockets/ac/0 5/slides/2005-4184OPH1_02_A-Bl oomfield.ppt

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