Clean Hands, Hidden Risks: What You Should Know About Alcohol Based Hand Sanitizer Use

Hand sanitizers, particularly alcohol-based formulations, have become an essential tool in infection control, especially in situations where soap and water are not readily available. By rapidly killing most bacteria, viruses, and fungi on the hands, they offer a convenient and effective method of reducing the spread of infectious diseases. During public health emergencies such as the COVID-19 pandemic, hand sanitizers played a critical role in minimizing transmission, making them a cornerstone of modern hand hygiene practices.

Recent reports and scientific studies have raised concerns about the effects of frequent alcohol-based hand sanitizer use. Experts urge a balanced approach to hand hygiene to avoid damaging the skin barrier.

In an Instagram post on his profile,  Dr. Kunal Sood, a double-board-certified anesthesiology and interventional pain medicine physician practicing in Maryland, USA, explains that excessive application of alcohol-based sanitizer can strip the skin of its natural oils and beneficial bacteria. This disruption may lead to dryness, cracking, irritation, eczema, or dermatitis and weaken the skin’s resilience to environmental allergens.

A randomized study in Contact Dermatitis evaluated four alcohol-based virucidal hand sanitizers (ABVHRs) across several days. All formulas caused increased skin irritation and transepidermal water loss. The most severe effects appeared with ABVHR-D. A formulation containing lower alcohol levels and phosphoric acid (ABVHR-C) performed slightly better in preserving skin hydration. ^[1]

A broader review of hand sanitiser use published in PubMed notes that alcohol disrupts the lipid layer and natural pH of the skin. This breakdown alters the skin’s microbiome and can cause inflammation, redness, blisters, or itching. Additives like fragrances or preservatives may also trigger allergic reactions and contact dermatitis. ^[2]

Large-scale studies confirm similar findings. Research in Annals of Allergy, Asthma & Immunology measured skin barrier damage in healthcare workers and non-healthcare users after sanitizer use. Results undermined hand hygiene efforts by showing that frequent use can cause skin barrier disruption even among healthy individuals.

In an FDA drug safety podcast, experts caution that sanitizer vapors in poorly ventilated spaces can cause symptoms such as headaches, nausea, and dizziness, especially if frequent applications occur in enclosed areas. ^[3]

Maintaining effective hand hygiene remains vital to prevent infection. However, recognizing and mitigating its adverse effects on skin health is necessary. Following informed practices—washing with soap when possible, using well-formulated sanitizers, and maintaining skin hydration—ensures that hygiene does not come at the cost of healthy skin.

References:

1. Dermatology Times. 2021. “The Impact of Alcohol-Based Hand Sanitizers on Skin Barrier Function.” Dermatology Times. Accessed September 3, 2025. https://www.dermatologytimes.com/view/the-impact-of-alcohol-based-hand-sanitizers-on-skin-barrier-function.

2. Sitohang, Viviana, Rizky Amalia, Ayu Putri Larasati, Aida Rosita Tan, and Umi S. Khairani. 2023. “The Impact of Alcohol Hand Sanitizer Use on Skin Health between Healthcare Workers: Cross-Sectional Study.” Journal of Public Health Research 12 (2): 22799036231162336. https://pmc.ncbi.nlm.nih.gov/articles/PMC10772474/.

3. U.S. Food and Drug Administration (FDA). 2021. “FDA Warns That Vapors from Alcohol-Based Hand Sanitizers Can Have Side Effects.” FDA Drug Safety Podcasts. February 17, 2021. https://www.fda.gov/drugs/fda-drug-safety-podcasts/fda-warns-vapors-alcohol-based-hand-sanitizers-can-have-side-effects.

(Rh/Eth/TL/MSM)