Hand Sanitizer: What's the real story?
The bottom line
Hand sanitizers most often contain alcohols that have been FDA-approved for use on the skin. A taste or sip usually does not cause serious symptoms, but ingestion of larger quantities can be hazardous.
Prevention Tips
Supervise young children when they use hand sanitizer.
Between uses, keep hand sanitizers out of sight and reach of young children.
Keep hand sanitizer containers tightly closed when not in use to prevent children from opening them and to minimize the evaporation of the antimicrobial alcohol.
This Really Happened
Case 1. A 3-year-old girl had a 16-oz pump dispenser bottle of hand sanitizer (68% alcohol) in her hands. She had squirted it on her hands, face, clothing, and hair. Her mother called her poison center, concerned that the girl might have swallowed some. The girl didn't remove the pump attachment and had only about a minute to swallow anything. She appeared fine. The poison center reviewed the concerns with alcohol ingestion in small children but reassured the mother that the small amount the girl might have swallowed would not poison her. The poison center recommended a bath, sweet fluids, and a snack. Two hours later, in a follow-up call to the home by the poison center, her mom reported that she had followed the poison center's advice, and the girl was fine.
Case 2. A 2-year-old boy tasted what his mother estimated was a dime-sized amount of hand sanitizer (62% alcohol). His mother called their poison center and was told to keep him awake for an hour, to give sweet fluids and a snack, and to watch for symptoms of inebriation (acting drunk), although no symptoms were expected with this amount. In a follow-up call from the poison center an hour later, the mother reported that the boy was a little sleepy, but it was past his bedtime. He had had some juice and appeared to be his normal self.
What is hand sanitizer?
Hand sanitizers are intended to kill microbes on the skin. While hand sanitizers have been around for a long time, their use has increased dramatically since the start of the COVID-19 pandemic. Hand sanitizers usually contain alcohols that have been approved by the FDA for use on the skin, such as ethanol (ethyl alcohol) and isopropanol (isopropyl alcohol). To be effective, hand sanitizer should contain at least 60% alcohol. Hand sanitizer products can also include ingredients to improve their feel and reduce drying of the skin.
Is hand sanitizer toxic? Can it make you drunk?
Hand sanitizer exposure is as dangerous as exposure to other sources of alcohol. A hand sanitizer product with 60% ethanol is as potent as 120-proof liquor. If swallowed, hand sanitizer can lower blood sugar. In extreme, untreated situations, it can lead to a coma and seizures. That's why the first treatment instruction for an awake child who has consumed alcohol from any source is to give the child something sweet to drink.
Some adults abuse hand sanitizer to try to become intoxicated or drunk. Alcohol-based hand sanitizers can also make kids drunk. That doesn't just mean woozy; it means slow heart rate and slow breathing and possibly even coma. Another issue with all hand sanitizers is that they can be irritating to the stomach, causing nausea or vomiting if swallowed. But a lick of hand sanitizer should not do this.
In June 2020, the FDA announced that some popular hand sanitizers were contaminated with methanol (methyl alcohol), the same alcohol found in windshield washer fluid. Methanol is more dangerous than ethanol or isopropanol. Too much methanol can cause permanent blindness and death due to severe changes in body chemistry that happen as methanol is metabolized. One report described 4 deaths and 3 cases of permanent vision impairment resulting from the ingestion of hand sanitizer containing methanol.
In March 2021, benzene was detected in several hand sanitizer brands. Benzene is a chemical known to cause leukemia. Check to make sure your hand sanitizer is not one of the contaminated products.
Is hand sanitizer flammable?
Hand sanitizer is flammable and should never be used near an open flame or other source of ignition, including cigarettes. Burning alcohol does not make an obvious flame or smoke, but it can still severely damage skin or other tissues.
Does hand sanitizer kill COVID-19?
Hand sanitizer with at least 60% alcohol can kill the COVID-19 virus. However, dirt and oils on the skin can reduce its effectiveness. The best way to prevent the spread of COVID-19 is old-fashioned hand washing with soap and water.
Does hand sanitizer kill norovirus?
Norovirus is a common cause of nausea, vomiting, and diarrhea. It is typically spread by eating food that has been handled unsafely. Norovirus outbreaks usually involve multiple people and present a major threat in situations where many people eat from the same food source, like on cruise ships and in dormitories. Unfortunately, hand sanitizer does not kill norovirus, so handwashing remains the best method for reducing the risk of norovirus spread.
Can you use hand sanitizer to clean a wound?
While it might seem logical to try to disinfect a cut or scrape with hand sanitizer, it’s actually better to use soap and lots of water. The alcohols in hand sanitizer may harm tissues and even delay healing. Depending on the specific formulation, other hand-sanitizer ingredients might also do more harm than good when applied to open wounds.
Does hand sanitizer expire?
Hand sanitizer products are supposed to be labeled with an expiration date, although you do not have to look very far to find products without one. The product should retain 90% of its effectiveness until that date; however, this assumes ideal storage and use. The alcohol in a hand sanitizer can evaporate if the product is left open. Buying small amounts of hand sanitizer frequently rather than one large container to last a long time will provide the best assurance that the product is at full strength.
What to do if you swallow hand sanitizer.
If a person swallows hand sanitizer, don’t wait until symptoms develop. Use the webPOISONCONTROL® online tool to get help or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
