Hand antiseptics

A hand sanitizer, skin antiseptic, or sanitizer is a type of disinfectant used in the healthcare environment to prevent the transmission of pathogens and to follow basic hand hygiene practices in areas where a sink and soap are not available. Supplement or alternative to hand washing with soap and water as appropriate. Available in various forms: liquid solution, gel, foam. The active ingredient in handrub can be isopropanol, ethanol, n-propanol, or povidone iodine. Adjuvants typically include a thickener such as polyacrylic acid, humectants such as glycerin as well as propylene glycol, and plant essential oils. Alcohol-based antiseptics are considered to be more effective at killing microorganisms than soap, and they dry out the skin of the hands less. All hand sanitizers contain alcohol, tertiary or quaternary amines, low concentrations of the nitrogenous cationic surfactant benzalkonium chloride, chlorinated aromatics triclosan, or povidone iodine.

To effectively combat microbes, the alcohol concentration in hand cleaners must be above 80%. For healthcare facilities such as hospitals and clinics, the optimal concentration of alcohol to kill germs is 70% to 95%. Alcohol-based hand cleansers, which contain two different bacteria-fighting agents (i.e., alcohol and gluconate), are significantly more effective preoperative topical skin antiseptics in hospitals than alcohol itself. Most alcohol-based antiseptics contain a moisturizer to help protect your hands from drying out too much.

The same ingredients are used in both over-the-counter hand sanitizers and hospital antiseptics and include alcohols (ethanol, isopropanol, and others), sometimes combined with other compounds such as quaternary salts (benzalkonium chloride). The use of quaternary salts is mainly aimed at increasing the antimicrobial efficacy of the product, however, these compounds can cause allergic reactions in some people. However, allergic reactions to quaternary salts are extremely rare, and the benefits of using them (increased antimicrobial efficacy) far outweigh the risks. The concentration of quaternary salts in one known antiseptic was 200 parts per million. Such a concentration will never lead to "stickiness", even if the agent is applied dozens of times a day. Quaternary salts tend to build up on the skin, and since medical personnel use handrub frequently throughout the day, this build-up can lead to a "sticky" effect. Gel hand sanitizers, used many times a day, leave a "sticky" residue due to their gel structure. The gel does not evaporate and remains on the hands until removed with soap and water.

Known skin antiseptics based on Povidone-iodine. Povidone iodine is a complex compound of polyvinylpyrrolidone (PVP) and elemental iodine (I). PVP-I is readily soluble in water, alcohols, including ethylene glycol and glycerin. It first appeared on the market in 1955 and has since become a versatile, widely used skin antiseptic. Possesses low toxicity in comparison with other iodine-containing preparations. Iodine, which is in the form associated with polyvinylpyrrolidone, is very poorly absorbed through the skin. The main drawbacks of povidone iodine are the frequent incidence of skin redness, itching, and irritation of the tissues around the site of application.

All alcohol-based hand sanitizers eliminate the sticky effect and the risk of allergic reactions. The alcohol in the alcohol-containing gel evaporates, but the gel remains on the hands and can cause allergic reactions.