Why You Should Skip Sanitizer, Just Wash Hands

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Research suggests that hand-washing with regular old soap is still your best bet.
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Antibacterial soaps offer an enticing way to destroy bacteria that can make us sick. But triclosan, a common ingredient in many antibacterial products, has come under fire for possible health and environmental hazards.

Now, the Food and Drug Administration is reviewing the research on triclosan and considering a ban on the chemical. That raises questions about how well antibacterial soaps work in the first place and what we'd lose if they're taken off the market.

Does scrubbing with bacteria-destroying products actually prevent illnesses? Or is it making things worse?

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Hand washing remains an important way to stay healthy, experts said, especially during the winter months. But regular soap and water or alcohol-based hand-sanitizers work just as well as triclosan-containing products do, without any of the potential concerns.

"It's clear that triclosan targets some bacteria but not all, but it's not effective against viruses, and viruses cause the majority of illnesses in a community setting,&r" said Allison Aiello, an epidemiologist at the University of Michigan School of Public Health in Ann Arbor.

"It seems strange to support or promote a product that targets specific bacteria but doesn't actually target the viruses that cause most of the illnesses in a household. To me, that doesn't make much sense."

Triclosan was first registered as a pesticide in 1969, according to a fact page maintained by the United States Environmental Protection Agency. Since then, the chemical has been added to toothpastes, hand soaps, body washes, cutting boards, toys, carpets, mattresses, clothes, furniture and a wide variety of other products with the goal of fighting bacteria, fungi and mildew.

At first, triclosan was thought to act as a universal bacteria-killer but beginning in 1998, Stuart Levy and colleagues at Tufts University found that the chemical targets specific bacteria and that bacteria can become resistant to triclosan with a mutation in genes required to build cell walls.

A new class of antibiotics was structured like triclosan, Levy added, raising concerns that the chemical could be contributing to the development of antibiotic-resistant bacteria by favoring the survival and growth of microbes that were immune to the chemical.

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Other research has shown that triclosan acts like a hormone disruptor in animals. Once triclosan moves from bathroom drains to lakes and rivers, it also breaks down into dioxins, which can cause all sorts of health problems, including birth defects and cancer.

And a 2006 study in Sweden found triclosan in breast milk at higher concentrations in women who used soap, deodorant or toothpaste that contained the chemical.

In a review article published in 2007 in the journal Clinical Infectious Disease, Aiello and colleagues looked at 27 studies that compared triclosan-containing products to regular soap and found that people were no less likely to come down with diarrhea, coughs, fevers or skin infections if they used the chemical-laden soap in their homes.

Some studies looked specifically at the bacterial load on hands before and after washing, and likewise, most of those found no difference between the two kinds of soap and their ability to rid bacteria from our hands. There may be some kinds of bacteria that are more effectively killed by triclosan, Aiello added, but not many, and those bacteria are not the ones that cause common illnesses.

Instead of killing bacteria, regular soap simply removes bacteria from the crevices in our hands, allowing them to be washed down the drain, said Levy, director of the Center for Adaptation Genetics and Drug Resistance at Tufts. After washing with soap and water (which works significantly better than just water), he advocates drying with paper towels because bacteria can linger on moist hand towels in the bathroom.

Another good option is to use alcohol-based hand sanitizers, which kill bacteria through dehydration. Bacteria cannot easily acquire resistance to alcohol.

"Start with soap and water, and if you don't have access, go to alcohol-based washes," Levy said. "You don't have to use soaps impregnated with chemicals. Anything that's antibacterial or antimicrobial in my prevue, should be used prudently."