Since the onset of the COVID-19 pandemic, hand sanitizer has become a staple household item. However, many parents are wondering, is hand sanitizer safe for use in children? The short answer is yes, though it can be unsafe in certain circumstances.

Hand Hygiene

The Center for Disease Control and Prevention (CDC) recommends hand washing with warm soap and water for 20 seconds as the best way to practice good hand hygiene and prevent the spread of viruses. If you are out of the home and you don’t have access to the warm soap and water, only then is it recommended to use a hand sanitizer.

Studies have shown that hand sanitizers kill many types of bacteria and viruses very effectively.  But there are certain kinds of germs that hand sanitizer is not as effective against, especially if your hands are visibly dirty or soiled. The good news is that hand sanitizer with at least 60% alcohol content has been shown to kill the COVID-19 virus, as well as many other viruses and bacteria. (But remember, so does good old soap and water!!)

Is Hand Sanitizer Safe?

Like many household cleaning supplies, hand sanitizer is safe if used correctly.  But if hand sanitizer is ingested,it is dangerous and can have serious consequences. 

When hand sanitizer is used correctly – applied to your hands and fingers and kept away from eyes – hand sanitizer is not harmful. Some people wonder if using too much hand sanitizer can potentially absorb into your skin and cause alcohol to enter the bloodstream? Studies have shown this is not the case. Hand sanitizer is safe for children to use, even if children eat or lick their hands after using hand sanitizer, as long as their hands are dry. 

Hand sanitizer is a chemical and should be treated as such. If swallowed, even a small amount, hand sanitizer can cause alcohol poisoning and serious injuries. Especially in young children, alcohol poisoning can cause low blood sugar, seizures, coma and death. Unfortunately, in the last year with hand sanitizer so readily available in households, schools, retail stores, etc., there has been a rapid rise in the number of unintended poisonings from hand sanitizer. 

Hand Sanitizer Safety

The Canadian Paediatric Society and the CDC have outlined some tips for parents to follow in promoting safe hand sanitizer use by children: 

1. Keep hand sanitizers out of reach and sight of young children, the same way you would any other household chemical. Child-resistant caps could also be useful. 
2. Avoid hand sanitizers packaged in containers that resemble food or beverages as this increases the risk of ingestion by children and teens. 
3. Always supervise hand sanitizer use in young children.
4. When using hand sanitizer, apply a dime-sized amount of hand sanitizer to dry hands, and rub hands together until they are completely dry.
5. Never swallow hand sanitizer. Even small amounts can cause alcohol poisoning. If you are concerned that your child has ingested hand sanitizer, call a Poison Control Centre or 911 immediately.

Why am I seeing recalls of hand sanitizer in the news? 

Hand sanitizer with the proper alcohol content when used properly is safe to use. Safe and effective alcohol content in hand sanitizers will be listed as either ethanol, ethyl alcohol, isopropanol, or 2-propanol, and contains between 60-95% alcohol.  The FDA has found some sanitizers contaminated with potentially toxic types of alcohol, such as methanol or 1-propanol, thus leading to the recall of some hand sanitizers. 

If you are unsure if your hand sanitizer is safe to use, check the FDA’s and Sanitizer Do-Not-Use List at www.fda.gov/hadsanitizerlist or the Government of Canada’s list of hand sanitizers to learn more about which alcohol-based hand sanitizers are safe to use. 

Bottom Line

The best way to clean your hands is with warm water and soap for 20 seconds.  Hand sanitizer with at least 60% alcohol content is a safe and effective substitute to kill germs and prevent the spread of viruses such as COVID-19. Hand sanitizer is only dangerous if swallowed, so supervise its use and keep out of reach of young children. 

This post was co-authored by Nicole Brockman , a third year medical student at the University of Alberta and Dr. Yuliya Koledenko, a family physician with special interest in obstetrical care. 

The post was reviewed and edited by Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.

Resources: 

Jong, Geert ‘t., LE Saux, Nicole., and Rieder, Michael J. 2020. “Hand sanitizers: Promoting safe use by children.” Canadian Pediatric Society. Retrieved from https://www.cps.ca/blog-blogue/hand-sanitizers-promoting-safe-use-by-children

Miller, Michael A et al. 2006. “Does the clinical use of ethanol-based hand sanitizer elevate blood alcohol levels? A prospective study.” American Journal of Emergency Medicine 24(7):815-7. 

U.S. Food & Drug Administration. (2021). “FDA updates on hand sanitizers consumers should nto use”. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-updates-hand-sanitizers-consumers-should-not-use

Center for Disease Control and Prevention. 2020. “Show Me the Science- When & How to USe Hand Sanitizer in Community Settings”. Retrieved from https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html#twentyone

U.S. Food & Drug Administration. 2020. “Is your hand sanitizer on FDA’s list of products you should not use?”. Retrieved from https://www.fda.gov/consumers/consumer-updates/your-hand-sanitizer-fdas-list-products-you-should-not-use

Government of Canada. 2021. Hard-surface disinfectants and hand sanitizers (COVID-10). Retrieved from https://www.canada.ca/en/health-canada/services/drugs-health-products/disinfectants/covid-19.html

Sivilotti, Marco LA., et al. 2021. Isopropyl alcohol poisoning. UptoDate. Retrieved from https://www.uptodate.com/contents/isopropyl-alcohol-poisoning?source=history_widget