Alcohol-free vs. alcohol-based sanitizer
Alcohol-free hand sanitizers sound gentler and safer. Here’s how they actually compare, and why the guidance still points to alcohol.
Why alcohol is the standard
Alcohol kills a wide range of bacteria and many viruses within seconds. CDC recommends hand sanitizers with at least 60% alcohol, and its guideline notes that solutions with 60% to 95% alcohol work best. That speed matters in healthcare, where staff clean their hands dozens of times a shift.
What alcohol doesn’t do
An update from our original 2008 article: alcohol does not keep protecting your hands once it dries. Surgical hand rubs often add chlorhexidine for that reason, because chlorhexidine keeps working on the skin for hours. Alcohol also doesn’t reliably remove norovirus, C. difficile spores or Cryptosporidium, and it can’t cut through dirt or grease. For those, wash with soap and water.
What about alcohol-free sanitizers?
Most alcohol-free sanitizers use benzalkonium chloride. When the FDA finalized its rule on healthcare antiseptics in 2017, it set benzalkonium chloride aside for more safety and effectiveness data rather than clearing it. CDC’s hand sanitizer recommendations are built on alcohol-based products. If you’re evaluating an alcohol-free product for a facility, ask the manufacturer for efficacy data and compare it against alcohol.
Are alcohol sanitizers safe?
Used as directed, yes. Two things to know:
- Children: swallowing hand sanitizer can cause alcohol poisoning. CDC advises supervising young children when they use it and keeping it out of reach.
- Bad products: since 2020, the FDA has warned about hand sanitizers contaminated with methanol, a toxic alcohol, and keeps a list of products not to use.
And your skin?
It seems backward, but alcohol rub is usually easier on skin than frequent soap-and-water washing. Most products contain moisturizers, and CDC notes that alcohol rub causes less irritation.