The Risks of Overusing Hand Sanitizer

Applying hand sanitizer to your hands is a quick and effective way to eliminate viruses, bacteria, and other organisms that cause disease. You may not know that using too much hand sanitizer can do more harm than good.

1. Your Skin May Become Irritated

Hand sanitizers that contain alcohol may negatively impact your skin, particularly if you use them frequently or in large quantities. Potential side effects include the following symptoms and diagnoses:

Flaking
Dryness
Cracking
Redness
Tingling
Numbness
Psoriasis
Eczema
Skin infections

Those that contain essential oils may also negatively impact the skin, including:

Skin irritation
Allergic reactions
Hypersensitivity
Sun sensitivity (more common with citrus fruit or bergamot essential oils)

2. Your Immune System May Be Impacted

Your skin is a crucial barrier that helps your immune system function properly by keeping germs and allergens out of the body. Damaged skin lowers your immunity.

Also, keep in mind that hand sanitizer eliminates both good and bad bacteria on hands. Normal bacteria help boost your immune system. If normal, good bacteria are depleted, you may become more susceptible to disease.

3. Your Eyes May Become Irritated

Getting hand sanitizer in your eyes can cause significant damage, especially if it's a large amount. Side effects include the following:

Irritation
Discomfort
Dry eye
Chemical burns
Swelling of the cornea

4. Your Lungs May Become Irritated

Inhaling (breathing in) alcohol-based hand sanitizer, particularly if you are in a poorly-ventilated space, can cause the following side effects:

Headache
Dizziness
Nausea

Studies in animals and human cells also show that inhaling benzalkonium chloride, the active ingredient in alcohol-free hand sanitizers, can be toxic to the lungs. Benzalkonium chloride may build up in your lungs and cause the following adverse effects:

Lung injury
Lung inflammation
Coughing
Wheezing
Chest tightness

5. You May Be Exposed to Higher Amounts of Unwanted Ingredients

Some hand sanitizer products contain ingredients that have been proven harmful, especially at high dosages. These ingredients include the following:

Benzene: This compound can cause blood disorders and cancers, including leukemia.
Methanol: Products contaminated with methanol (also called wood alcohol) are very dangerous when applied to the skin or consumed. Methanol can cause blindness, seizures, nerve damage, and death.
Triclosan: This disinfectant may damage the reproductive system, kidneys, liver, thyroid, and more.

For more details, check out the U.S. Food and Drug Administration's list of specific hand sanitizer products that are not recommended due to potential safety risks.

Types of Hand Sanitizer

Hand sanitizers are available in many forms, such as the following:

Gels
Liquids
Foams
Wipes
Sprays

They are classified as alcohol-based or alcohol-free depending on their active ingredient.

Alcohol-Based Hand Sanitizer

The Centers for Disease Control and Prevention (CDC) recommends using hand sanitizers that contain at least 60% alcohol when soap and water are unavailable.

Here are the highlights of alcohol-based hand sanitizers.

Active ingredients: Alcohol-based hand sanitizers contain 60% to 95% alcohol, as the name suggests. In the United States, these sanitizers typically use grain alcohol (ethanol) or rubbing alcohol (isopropyl alcohol).
Inactive ingredients: Inactive ingredients (excipients) make up 5% to 40% of a hand sanitizer. They help improve product stability and effectiveness and reduce skin dryness. These may include water and humectants to retain moisture.
How they work: Alcohol-based sanitizers kill most bacteria, fungi, and enveloped viruses like COVID-19 by disrupting cell membrane proteins and inactivating viruses.
Advantages: More effective, low cost, fast-acting.
Disadvantages: May cause skin irritation, headaches, nausea, dizziness, and more.

Alcohol-Free Hand Sanitizer

The other primary type of hand sanitizer is alcohol-free, or non-alcohol-based. This category of hand sanitizer is distinguished by the following:

Active ingredients: Benzalkonium chloride
Inactive ingredients: These can include water, vitamin E, and humectants.
How they work: Alcohol-free hand sanitizers are most effective against gram-positive bacteria and viruses with an outer layer.
Advantages: Less skin irritation, safer for children, flame-resistant, and does not cause alcohol poisoning.
Disadvantages: It may cause antibiotic resistance (bacteria can resist or outsmart the medicines designed to eliminate them). It has also caused allergic contact dermatitis or lung irritation (ex., from spray products).

Hand Sanitizer vs. Soap and Water

Washing your hands with soap and water is still your best bet for germ protection.

Keep in mind that soap eliminates more germs than hand sanitizers, including those that cause diarrhea, such as:

Norovirus, an extremely contagious virus that causes vomiting and diarrhea, and
Clostridium difficile, a bacterium that can cause gastrointestinal infection

Tips for Using Hand Sanitizer

Follow these guidelines to optimize your health when using hand sanitizer:

Storage: Store hand sanitizer out of the reach of children. Store alcohol-based sanitizers away from flames and out of extreme heat (more than 105 degrees).
Application: Rub two pumps of hand sanitizer into hands and fingers until they are dry, about 25 to 30 seconds. Keep out of your eyes and mouth.
Preventing side effects: To minimize side effects, avoid using an alcohol-based hand sanitizer on irritated or broken skin. Moisturize your hands after using hand sanitizer. If you accidentally get hand sanitizer in your eyes, flush (rinse) them immediately with water.
Supervise use by children: Children are most likely to experience side effects from overusing or improperly using hand sanitizer. Closely supervise children under six to ensure proper use and prevent accidental ingestion. Follow the manufacturer's guidelines.
Avoid unintended use: If swallowed, alcohol-based hand sanitizers can cause alcohol poisoning. Contact 911 or Poison Control at 1-800-222-1222 immediately if ingested.