Did you know, your Hand Sanitiser has the ability to save the human race? No, I am not exaggerating! We live in a time where keeping your hands clean is the only way to regain stability in society. Simply washing your hands can help reduce viruses from developing and spreading. But what do we do when we are out? We possibly cannot carry our sinks and soaps with us! Using public toilets and spaces is a big no-no! The best alternative is to use a portable Hand Sanitiser. Due to the absence of medications and vaccines developed to combat the coronavirus disease 19 (COVID – 19), hand hygiene is the most important precautionary step to take to prevent its spread. Tests have confirmed that two hand Sanitiser formulations recommended by the World Health Organization inactivate the virus that causes COVID - 19.  We cannot emphasise enough on the various good it can do. So without further ado let’s get right to it. 

What is a Hand Sanitiser and what are its benefits?

A Hand Sanitiser is an anti-bacterial liquid or gel used to inactivate the virus by breaking down the lipid layers. It is recommended to use water and soap to wash your hands however in the absence or unavailability of the same, using a hand Sanitiser is a viable alternative to get rid of the dirt and germs present. It is mainly used in hospitals, schools, daycare centres, workplaces, clinics however can be used by individuals as well. Even though it is not as effective as washing our hands, there are several benefits of using a Sanitiser that include: 

1.  Kills the microorganisms present on skin surfaces within seconds preventing the spread of infections and diseases.
2. It is more accessible to use than finding access to a washbasin. It can be used on – the – go and easy to carry around due to its compact packaging.
3. Some sanitiser has moisturising properties, which can nourish your hands rather than using soap and water that can dry the skin by excessive washing and cause irritations.
4. Can avoid the increase of infection spreading in public spaces. Anytime you use public areas, you are exposed to bacteria by touching door handles, elevator buttons, handrails etc. 
5. Using a Hand Sanitiser helps to reduce viruses from spreading by inactivating active microbes that come in contact with your skin surface.

What are the different types of Hand Sanitisers available in the market? 

Sanitisers can be broadly classified based on their form and compositions/ingredients. No notable difference can be found based on the form and consistency. They are all equally effective and the only differentiator is the amount of time it takes to dry. It can be divided into the following types:

1. Liquid form
2. Gel form
3. Foam form
4. Spray form

Gel may also be slower to dry than liquid hand Sanitisers. Liquid formations can act in less than 15 seconds, whereas gel Sanitisers require up to 20 to 30 seconds to eliminate viral or bacterial content. Gel may also be slower to dry and moisturises the skin. Liquid Sanitisers may leave less residue and hence makes it a great formula to clean surfaces. Due to its consistency, liquid Sanitisers might be used more often. Further, the alcohol evaporates at a quicker rate leading to the solution to get over fast. Some users have found gel easier to dispense and handle than liquid Sanitisers. 

Based on their ingredients they can be found as:

1. Alcohol-based

Scientifically known as ABHRs, that is Alcohol-based hand Sanitisers. They generally contain 60 to 95 percent alcohol in the form of ethanol, isopropanol or n – propanol. Due to high concentration of alcohol, it is clinically proven to kill 99.9 percent of germs and is required in our current situation to combat the COVID - 19 virus. Thus, it is as recommended by regulatory authorities such as the FDA and WHO. 

2. Non – Alcohol-based

They normally contain disinfectants such as benzalkonium chloride or antimicrobial agents such as triclosan. 

Another important aspect to consider is the W/v and V/v content of alcohol used in the Sanitiser. Let us start by understanding these terms. W/v is the weight by volume measure used to identify the amount of solid chemical dissolved in the liquid mixture while V/v is the volume per volume measure of liquid chemicals dissolved in the liquid mixture. It is the proportion of a particular substance within a mixture, as measured by weight or mass. The concentration of alcohol in Sanitisers is usually described as a percentage. These percentages may be expressed by volume or by weight. The two different scales are necessary because the volume contracts if alcohols such as ethanol and water are mixed. It is recommended to use 60 percent W/v, equivalent to 75 percent V/v or above alcohol content for the Sanitiser to be effective. 

What are the ingredients approved by the FDA and WHO that can be used to formulate a Hand Sanitiser? 

The main ingredients and chemicals mixed in Hand Sanitisers are used for multiple reasons. The most common ingredients are as follows: 

1. Alcohol

It is recommended by the FDA for Hand Sanitisers to have at least 60 to 95 percent alcohol present in order to be effective. Generally, it consists of ethyl alcohol or isopropyl alcohol that are known to kill bacteria by using these denaturing alcohols that destroy the protein to disrupt its molecular conformation. 

2. Glycerol

Commonly known as glycerin, is a non – toxic, colourless and tasteless chemical used to moisturise and prevent dryness. It is used as an inactive element and has emollient properties to soften and smooth the skin and balance out the harsh effect of alcohol. For the Hand Sanitiser to be effective it should be rubbed on your hand for at least 20 seconds. However, some alcohols such as Ethanol evaporate very quickly. Using glycerine helps to solve this problem by forming hydrogen bonds that bring the glycerin molecules closer making it much slower to evaporate. This is the main reason that most Sanitisers contain glycerine. 

3. Carbomer

This is a synthetic thickening agent that is often found in gels and cosmetics to manage the viscosity and flow of the product. Its binding nature prevents the liquids from separating and retains water. 

4.Triethanolamine

This is an organic compound composed of three different alcohol groups. It is used in cosmetic and personal care products to balance the pH levels used in cleaning based detergent to remove the dirt and germs sitting on your skin surface. Its emulsifying properties attract both oil and water-based molecules. 
Aloe Vera: The medical properties of the Aloe Vera plant has made it an efficient ingredient in treating various skin concerns. It has a soothing effect on the skin reducing redness or itchiness. Adding aloe Vera to Hand Sanitisers provides moisture and nourishment to reduce the dryness caused by alcohol as well as thickening the consistency to increase the contact time needed for the sanitiser to work. 

How do Hand Sanitisers work? 

Hand Sanitisers contain alcohol as the key active ingredient mainly using components such as Ethyl alcohol, Isopropyl alcohol or Benzalkonium chloride. These components kill germs by dissolving their outer membrane by breaking down their cell walls by splitting the cell into pieces. It is a convenient alternative to washing your hands in the good old fashioned way if water and soap is out of reach. The effectiveness of the sanitiser increases depending on the measure of alcohol contents used. A higher concentration will work faster and better. On the other hand, using alcohol-free Hand Sanitiser with Benzalkonium chloride may not kill as many germs and may only reduce the growth. 

Alcohol is considered to last for a very long time if stored in a sealed container at room temperature. However, most Sanitisers will have an expiry date to indicate the time limit it should be used in once opened as the concentration of the alcohol might evaporate due to constant opening and closing considering its low boiling point. This may lead to reduced effectiveness of the Sanitiser. Alcohols are considered safe to use as antiseptics and generally do not show any toxic effect on the skin. However, excessive use may cause dryness.

What are some suggested precautions we must follow while using Hand Sanitisers and what are the warnings given by the FDA?

The FDA is the U.S. Food and Drug Administration responsible for protecting the health and safety of the public by regulating food, drugs, medical devices, cosmetics and other related products. It classifies hand Sanitisers as an over – the – counter, non – prescription drug and provides certain guidelines and warnings to its consumers, such as:

1. Keep the sanitiser out of the reach of pets and children who may be attracted to the bright colour and smell and may drink it causing damage as it is poisonous to consume even small portions.
2. Store the Sanitiser in cool and dry places to prolong the efficiency of the Sanitiser by preventing the alcohol contents from evaporating.
3. Avoid making your Sanitiser at home and use only those that are sold in stores and pharmacies. Packaged Sanitisers are tested, certified and regulated. They are designed by medical and chemical professionals. Sanitisers must follow certain prescribed formulas and guidelines to qualify as safe to use.
4. You cannot use a Sanitiser to get rid of greasy oils or visible dirt particles.
5. Look out for Sanitisers that are contaminated with Methanol in their ingredients. This is wood alcohol and can be toxic at life-threatening levels if absorbed through the skin.
6. The Sanitisers must contain prescribed levels of alcohol in order to be effective. Any amount of alcohol concentration between 60 to 95 percent is recommended. 

Before we buy our Hand Sanitiser, what certifications should we look for to ensure that it is safe to use? 

To be considered safe to use, a Hand Sanitiser must pass certain tests and benchmarks set by regulatory authorities.  Hand Sanitisers deactivate the harmful microorganisms on our skin surface and in order to avoid any adverse reaction we should invest in those products that are deemed safe.

Disinfectants are used to reduce the spread of germs while Sanitisers are considered biocides, killing the bacteria through breaking their outer membrane splitting them into pieces. In Europe, they are regulated by the Biocidal Products Regulation while in the U.S. it is regulated by the FDA Over - the – Counter Monographs for Consumers and Healthcare Personnel Handwashes and Handrubs.

Before you pick a Hand Sanitiser it is important to understand if its effectiveness has been clinically tested and claimed safe to use, if it has been produced by facilities approved by the FDA or are GMP Certified or both. The GMP is Good Manufacturing Practice, the practice that is required to conform to guidelines provided by regulatory bodies and agencies that control the authorisation and licensing of food, beverage and consumer-related article manufactures. 

Summary

There has been a drastic increase in the demand for Hand Sanitisers considering our current situation. The formulation helps to prevent bacteria and virus from spreading, keeping us and those around us safe. It can be used as an effective alternative to washing our hands the traditional way with soap and water when it is inaccessible to use. Using a hand Sanitiser is an extremely convenient, on – the - go solution. There are many benefits associated with the same, however, the guidelines and warnings must be followed to avoid unprecedented scenarios. Stay Safe, Stay Sanitised!

-By Howrah Lookmanji