Why Hand-washing Beats Hand Sanitizer Hands Down!

soapy hands — Health experts say hand-washing kills more germs than using hand sanitizer, but you have to do it correctly. Isabel Pavia/Getty Images

If you've been following the news (or just visited a grocery store in the U.S.), you're probably aware that with the coronavirus outbreak, hand sanitizer has gotten very hard to find. However, soap still seems to be in good supply.

Yet, to keep yourself safe from this virus, the Centers for Disease Control and Prevention (CDC) recommends hand-washing first – and using hand sanitizer only as a backup if you can't wash your hands.

"Proper hand-washing is the safest, most efficacious, least expensive and readily available method to prevent disease," says Dr. Greg Poland, representative for the Infectious Diseases Society of America (IDSA) and professor of medicine and infectious diseases at the Mayo Clinic in Rochester, Minnesota.

So, why would plain old soap and water be more effective against germs than an alcohol-based hand sanitizer?

"When you are physically washing your hands you're doing three things," Poland explains. "You're removing visible dirt and mucus, you're using a soap that decreases surface tension and you're physically, by friction, loosening, removing and washing away whatever is on your hand." Which would include germs you cannot see.

The CDC points out that studies have shown that soap and water is more effective than hand sanitizer at removing certain bugs like Cryptosporidium, norovirus and Clostridium difficile, all of which cause diarrhea.

And hand-washing is especially effective for very dirty hands, such as those you get from gardening, playing sports or wiping a runny nose with the back of your hand. "If your hands are visibly soiled, hand sanitizer can't get to all the skin's surfaces," Poland says. "And if your hands have mucus on them hand sanitizer cannot penetrate." Remember, if you have flu, the flu virus is in that mucus. Several studies have shown that hand-washing got rid of the flu virus from hands much faster than hand sanitizer did.

How to Hand-Wash Properly

OK, so we've spent some time explaining why hand-washing trumps hand-sanitizing, but in order for hand-washing to work, you have to do it properly. "Everybody thinks they know how to do it [wash hands], nobody does, and nobody knows how to do it properly," says Poland.

So, let's review the steps for everyone's sake. There are a whole bunch of times people should be washing their hands, but probably the most important are before you eat/prepare food, after using the bathroom and before you touch your face. Here's the protocol according to the CDC:

Wet hands with clean, running water. Warm or cold water will do. Then, turn off the tap and apply soap.
Lather hands by rubbing them together with the soap. Any soap works – it doesn't have to be antibacterial. Make sure to get at all the parts of your hands – the backs, palms, between the fingers and under fingernails. Start at your fingertips and work backward.
Scrub hands for at least 20 seconds (hum or sing the "Happy Birthday" tune twice or some other ditty if counting doesn't do it for you). The five seconds most people take to wash their hands doesn't get many microbes off.
Rinse hands well under running water.
Dry hands using a clean towel or by air-drying them.

Use a paper towel to turn the faucet off and be sure to open the bathroom door with the paper towel as well.

If you're more of a visual person, check out this video of Dr. Poland teaching Jimmy Kimmel how to properly wash hands.

A lot of publicity has gone into educating people that they're not washing long enough. But many also are missing the mark by not thoroughly scrubbing all parts of the hand. "Think of how we transfer viruses, bacteria, etc. into our body. It's with the area of the hand that nobody washes properly, i.e., the fingertips," Dr. Poland says. "[People] wash the palm, they wash the back of their hand, they wash the bottom third of the fingers. But have you ever seen someone wash fingernails or tips?" So, the next time you're washing up, make a point to pay extra attention to these oft-neglected appendages, OK?

How to Use Hand Sanitizer Properly

There will be times when hand sanitizer just makes more sense than hand-washing. Let's say you were in the bathroom at your office, followed all the steps we outlined above, so now you have perfectly clean hands, but wait, you need to open the door that leads from the hallway (where the bathroom is) back to your office. Dozens of people are opening and closing that door all day, so it might be pretty dirty. Even though applying a dollop of hand sanitizer might seem easier to do than hand-washing, a lot of people mess up that procedure as well.

woman applying hand sanitizier — If you're using hand sanitizer, you should put on a dollop the size of at least a quarter. And let it air-dry after you've finish applying.
Glasshouse Images/Getty Images

Here's the correct way to do it:

Make sure you're applying enough. About a quarter to a half dollar-sized amount of hand sanitizer is necessary, says Poland. The sanitizer should be at least 60 percent alcohol-based.
Rub it over all the parts of your hand, starting from the fingertips and working your way back to disinfect (don't forget in between the fingers). "Keep doing that until it's dry," he says. "That way you know you've had enough exposure time for that disinfectant to kill."
Resist the urge to wipe your hands on a paper towel or your pants to speed up the drying process.
Since hand sanitizer can be very drying, keep some hand lotion or hand cream nearby to apply once your hands are dry.