• Elisabet Salmerón, science journalist

    Antibacterial gels: are they necessary?

    9 Mar

    With swine flu, hygiene and personal care became a priority. The fear of contagion meant that antibacterial gels – liquid solutions for hands that prevent germs from spreading – became popular and stocks ran out. But to have a healthy skin, isn’t it better to wash hands with soap and water in the traditional way, as a more inexpensive and safer way to stop bacteria spreading?


    The surface of the skin is one of the most important microbial habitats in the human body. More than 150 different species of bacteria may inhabit just a single hand. Many are harmless and beneficial, but opportunistic organisms responsible for infections and epidemics may also appear. Although it is impossible to keep the hands completely free of harmful germs, washing them frequently is one of the best ways to prevent disease from spreading.


    Antibacterial gels: before and after

    Hygiene acquired particular importance during the influenza A (H1N1) or swine flu pandemic in 2009. According to an international study by Svenska Cellulosa Aktiebolaget (SCA), a major personal care products company, seven in ten people consulted were concerned about the contagion risks. A collateral effect was that antibacterial gels, an alternative to soap and water, became so fashionable as to even exhaust supplies. In Spain, the pharmaceutical distributor Cofares sold over 45 000 single-dose bottles and boxes of antiseptics in just three months. Fewer than 50 boxes had been sold a year earlier over a similar period.

    Precautionary measures, in the form of gels or dispensers, extended to companies, pharmacies, educational centres and public bodies, increasing demand for this type of hygiene product exponentially. Social panic meant that the industry managed to supply these liquids – which until then had limited use in hospitals and surgeries – to places as unusual as cocktail lounges, bars and restaurants. Many Internet sites also tried to take advantage of the situation: you can still find many websites today that sell antibacterial products or that show you how to make make them at home.


    A practical and effective substitute

    The invention of antibacterial gels was a public health breakthrough. The name comes from the antibacterial agents they contain (typically alcohol), which prevent germs from growing and reproducing. Their effectiveness has been demonstrated by several scientific studies. For this reason, agencies such as the US Centers for Disease Control and Prevention (CDC) recommend their use when soap and water are unavailable.

    Hand hygiene is recommended after coughing or sneezing, after using the toilet and before and after meals. People who are ill or who have weakened immune systems particularly need to bear this in mind. For the gels to be effective, the entire surface of the hands should be rubbed for at least 20 seconds before the solution is allowed to dry.

    The different antibacterial agents have specific concentrations that ensure the desired outcome. Thus, alcohol-based gels should contain between 60% and 80% alcohol to be able to act against microbes and viruses. Some gels include moisturizing substances like aloe vera to offset the effects of the agents. Even so, it is important to apply a hand cream to prevent skin damage.

    It is also important to use gels in moderation and only at specific times. Overuse or uncontrolled use can cause reactions such as irritant dermatitis – associated with skin dryness, itching, irritation and even cracking and bleeding – and allergic contact dermatitis. In both kinds of dermatitis the affected area becomes inflamed. Initial treatment is to wash the skin with water to remove any residues. It is also advisable to obtain medical advice.


    Bacterial resistance?

    Antibacterial gels are practical and easy to carry. But are they more efficient than the traditional combination of water and soap? The answer is no: several studies conclude that antibacterial gels are no more effective than common soap in preventing disease and reducing the number of bacteria on the hands.

    Some studies have even warned that certain antibacterial agents may contribute to the creation of antibiotic-resistant germs. In one analysis, the bacterium Salmonella enterica mutated several times after contact with an antibacterial agent and developed resistance to an antibiotic called ampicillin.

    Given the doubts, the scientific community has launched a safety review of a number of antibacterial gels. No relevant conclusions have been reached as yet on the basis of which to recommend the withdrawal or disuse of specific products. Nor are results yet available that demonstrate that antibacterial gels may be harmful to the human body.


    Wash your hands!

    Antibacterial gels have proved a useful alternative to traditional hand washing: they act in seconds and can be conveniently carried around with us. However, they should not become a substitute for hand washing, as soap and water are the safest and least expensive protection against germs. Not to mention the best way to keep our skin healthy.



    World Health Organization