Hand sanitizers don’t always work
Hand sanitizer is useful, but its benefits are narrower than the habit can make it seem. The key distinction is between reducing risk and eliminating it. Alcohol-based sanitizers work well for many everyday germs when used correctly, yet they are not equally effective against all infectious agents. That matters because people often treat sanitizer as a substitute for handwashing in every situation, when the evidence supports a more conditional use.
The practical question is not whether sanitizer “works,” but when it is the right tool. In routine settings, it can be a fast, accessible option when soap and water are unavailable. But contamination with vomiting/diarrheal pathogens, visible dirt, or certain chemicals changes the calculation. In those cases, washing is not just a backup plan; it is the more appropriate mechanism because physical removal helps where disinfection alone may fall short.
There is also a behavioral trade-off. Frequent cleaning can dry the skin, and irritated hands may make people less likely to keep up the habit over time. That makes moisturising more than a comfort measure: it can support adherence to hygiene routines. For prevention, the most reliable approach is usually layered—hand hygiene matched to the exposure, plus respiratory etiquette and vaccination where relevant—rather than any single product doing all the work.
Where sanitizers fall short
Anyone who has ever spent time with kids knows they’re germ magnets. Lately, my own girls have proved that. As soon as the weather cooled they contracted what felt like an endless series of colds and contagious bugs. I’ve been working on ways to keep from catching the viruses myself, which has involved lots of hot tea and tubs of hand sanitizer.
Recently, I spoke to Lisa Maragakis, a physician and senior director of infection prevention for the Johns Hopkins Health System, about my virus-avoidance strategies. She reinforced some things I knew, and taught me a few things I didn’t.
First, washing your hands is absolutely a good idea. Hospital workers who are exposed to many more pathogens a day than I am — even in my house of germy toddlers — constantly keep their hands clean. They have sanitizer dispensers all over the place, so they can quickly and efficiently disinfect their hands between tasks.
Hand sanitizer is not a cure-all, though. While one to two pumps, just enough to cover the hands, applied correctly is “extremely effective at killing most germs,” it doesn’t kill everything, Maragakis says. Sanitizer actually falls short against certain pathogens, like the norovirus bug, which the US Centers for Disease Control and Prevention calls “the leading cause of vomiting and diarrhea.”
Clostridioides difficile and Cryptosporidium, two other germs that cause diarrhea, are also resistant to hand sanitizer. Maragakis recommends washing your hands with soap and water to prevent those infections. You should also head to the sink to remove chemicals and other substances, including hand sanitizer residue.
Of course, no good deed goes unpunished. It’s possible that all this cleanliness can lead to skin dryness and irritation. “Moisturizers are an important step to mitigate the drying effect of hand sanitizer, soap and water,” Maragakis says.
As the holidays approach and families gather, it’s important to put hand cleanliness strategies to use. Maragakis also recommends keeping surfaces clean (follow the instructions on your Clorox wipes, she says) and covering your mouth when you sneeze and cough. If you don’t want to miss the festivities but have respiratory symptoms, wear a mask.
And there’s one more thing. “Vaccines are one of the best protections during the respiratory virus season,” Maragakis says. Talk to your health-care provider about whether it makes sense for you to receive the latest flu, Covid and RSV shots. — Kelly Gilblom