Cold and flu season is still ramping up, and moms all over KC are hoping for two things. First, no more snow days. Enough. Second, we want our kids to stay healthy! Even with our best intentions, it’s normal for every kid to get sick. There are some things we can do, however, to help keep those days to a minimum. 
Prioritizing sleep, proper nutrition, stress reduction, and the flu shot are all ways to keep the whole family healthy. Of course, dozens of research studies have also shown that one of the best ways to prevent illness is by washing our hands. There is a “right way” to wash your hands, and you and your kids need to know it. Think: running water, soap, scrubbing, and time.
Hot tip: Help your kids learn the proper hand washing technique for best illness prevention.
However, when soap and water are not available, many moms (and doctors!) reach for hand sanitizers. Hand sanitizers have been shown to be a quick and convenient way to decrease the transmission of illness in hospitals, daycare centers and within homes. There are lots of options on the shelf and not all products work the same.
Hand sanitizers are designed to decrease the number of germs on your hands. When applied correctly, the active ingredient breaks down the outer membrane of bacteria or the outer coat of viral particles. In other words, it kills them. Despite the word “sanitizer,” these products do not eliminate germs or make your hands sterile. They merely decrease the number of disease-carrying germs, thus decreasing the probability of getting infected or spreading disease.
There are two main types of commonly available hand sanitizers. One type uses alcohol as the active ingredient, the other uses non-alcohol-based agents. Overall, both types of these products work well when used on clean hands. If your hands are visibly dirty, go back to soap and water. Most studies suggest that hand sanitizers reduce the “disease burden,” or the number of infectious germs, by as much as 60-90%.
Hot tip: Choose alcohol-based hand sanitizers that include 2 or more varieties of alcohol (ethyl alcohol/isopropyl alcohol/propanol) at 60-70% concentration.
Alcohol-based sanitizers are available in gels, liquids, and foams. Look for products with at least 60% alcohol by volume, and with more than one type of alcohol in the ingredient list. (An Amazon Prime-able example would be Purell Advanced Gel.**) Alcohol-based sanitizers are cheap, readily available, and work fast. Many have emollients to help protect against the well-known skin dryness these products can cause. For some kids with sensitive skin or eczema, however, these options are simply too damaging to the skin to be helpful.
Besides dry skin, a criticism of alcohol-based sanitizers is the duration of action. Alcohol-based products keep their germ-busting properties for about 2 minutes after drying on the skin. This may not be a big deal for kids who need a quick “wash” right before eating. But for kids running around a playground or doctor’s office and touching everything in sight, a product with longer germ-fighting power seems like a better idea.
Hot tip: Hand sanitizers work best when rubbed on the entire surface of your hands until they are completely dry. This takes about 20 seconds.
Newer generations of hand sanitizers are trying to extend this duration of protection. These products are not alcohol-based. Instead, they use active ingredients, like benzalkonium chloride, that bind to skin cells and create a longer-acting “wall” of protection. (An Amazon Prime-able example would be Germ-X Alcohol-Free Hand Sanitizing wipes or foam.**) The anti-germ properties of these products last up to 6 hours, and are recommended for older children that can keep their hands out of their mouths. A big advantage is that these products don’t burn on application, making them better tolerated by those with sensitive skin.
Hot tip: For kids with sensitive skin or eczema, consider a non-alcohol based sanitizer.
Before you all jump to non-alcohol-based sanitizers, however, keep in mind the long-term safety data for these newer chemicals is not as complete. You could argue topical alcohols are the safer option based on what we know today, if they are not accidentally consumed. You shouldn’t drink the stuff. And, we know that there are important instances when hand sanitizers don’t work. If you contact a nasty virus that has a super-tough outer coat as part of its structure (read: norovirus, C. diff, MRSA), hand sanitizers do not work to eliminate that germ.
So, maybe that just brings us back to soap and water??
Bottom line: Soap and water is the best way to decrease germs that cause illness. When that is not available, proper use of a combination alcohol hand sanitizer is a quick and effective alternative. If your child is older and has sensitive skin or eczema, non-alcohol hand sanitizers might be a good option.
** NOT an ad or paid placement, just a practical recommendation to get you on the right track.
Dr. Natasha Burgert is a Kansas City mom, pediatrician, writer, educator, and National Spokesperson for the American Academy of Pediatrics. She is a routine contributor to NBC’s Parent Tool Kit, the US News and World Report parenting blog, and our local KCUR. She also represents Kansas City on the State of Missouri Advisory Committee on Childhood Immunizations. If you can’t catch her between patients at Pediatric Associates, find her on Instagram, Facebook, and Twitter.
