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CDC Recommends Alcohol-Based Sanitizer - But Is That Our Only Option?

By Sean Stewart, SONO Contributor

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No matter where you live, everyone wants this quarantine to end. And in spite of various cities and states throughout the country beginning to relax restrictions, we cannot all re-enter the public space care-free.

Wearing masks in public is one of the most critical restrictions in today’s climate, but we can’t neglect our hands either. The CDC recommends that everyone wash their hands frequently with soap and water, but that isn’t always possible, so it’s important to use a hand sanitizer in between hand-washing.

While alcohol-based hand sanitizer is what is recommended by the CDC at this time, some new research shows other types of hand sanitizer may be just as effective against coronaviruses.

The CDC simply hasn’t updated its guidelines yet.

There are a lot of options for hand sanitizer on the market. We’re going to help you choose the right one for you and your family by giving you the information you need to make that decision.

Hand Sanitizer Formula Options

There are two kinds of hand sanitizers currently on the market:

1. Alcohol-based
2. Non-alcohol based.

The alcohol-based formulations are made with either isopropyl alcohol or ethyl alcohol (ethanol).

We’re all familiar with isopropyl alcohol because many people keep a bottle in their homes to clean cuts and scrapes. Ethyl alcohol is commonly used for fuel, but it can also be used in hand sanitizers with the right precautions. To make it safe for your hands, it’s distilled using the same process as other consumable goods and monitored by the FDA.

Non-alcohol-based hand sanitizers are generally made using quaternary ammonium compounds, which are often referred to as Quats. Quats have been used in medical and household products since the 1940s, including serving as preservatives in eye drops and pre-surgery disinfection washes.

Different chemicals can be used to make Quats, but the most common formulation used in shampoos and disinfecting wipes is benzalkonium chloride (BZK). It’s also the key ingredient for most hand sanitizers that don’t use alcohol.

How Hand Sanitizer Is Regulated

During the Covid-19 crisis, the CDC is making recommendations for what hand sanitizer to use, but it doesn’t regulate its production or marketing activities. The FDA sets the standards for what ingredients are allowed in hand sanitizer, the concentration level of each ingredient, and how the product can be manufactured and marketed.

In 2019, the FDA issued a final rule designed to help ensure hand sanitizers available over-the-counter (OTC) are safe and effective for consumers. It’s currently only allowing benzalkonium chloride (BZK), ethyl alcohol, and isopropyl alcohol to be used until more studies are conducted.

Furthermore, the FDA is not currently allowing any manufacturers to claim their product kills or works in any way against Covid-19.

It has supported the CDC recommendation of using a hand sanitizer with at least 60% alcohol, but that’s not the same as allowing it to be a marketable claim. For that, the FDA needs studies that confirm alcohol and/or non-alcohol-based hand sanitizers are effective against Covid-19. So far, studies for this particular virus strain have either not been conducted, finished or reviewed by the FDA.

However, due to product shortages, the FDA has relaxed some of its rules to allow companies that don’t normally produce alcohol-based hand sanitizer to make it. Some high-profile beer and liquor manufacturers made headlines recently when they converted their factories to make it.

CDC Recommendations for Covid-19

The CDC is only recommending hand sanitizer with 60% alcohol or higher for Covid-19.

However, the only reason it seems to not be including BZK within its recommendation is due to one study conducted in 1998. It showed mixed results for BZK when it was tested to eliminate human coronavirus. Since then, independent lab tests conducted this year have shown BZK eliminates 99.9% of the virus in 30 seconds. Additional 60-second and 120-second exposure times had the same results.

Based on the new data, researchers, medical professionals and manufacturers have requested the CDC expand its current hand sanitizer recommendation to include BZK-based products. They say the new guidance is needed because there isn’t enough alcohol-based hand sanitizer supply to meet current demands (and with the FDA not closely regulating some of the new companies producing it, there is a lot of room for error and mislabeling).

At this time, the CDC has not made any statements about the new BZK research or the possibility of changing its guidelines.

New Covid-19 Hand Sanitizer Research

Aside from studies showing that BZK remains on your skin much longer than alcohol-based hand sanitizer, which means it protects against germs longer, the latest research shows it is effective against coronavirus.

BioScience Laboratories in Bozeman, Montana found BZK to be very effective against coronaviruses because it attacks the virus envelope and breaks it apart. Tests were conducted exposing BZK to the virus for 30 seconds, 60 seconds and 120 seconds. In every instance, BZK killed 99.9% of the coronavirus tested.

Pros and Cons of Alcohol-Based Hand Sanitizer

The biggest benefits for using alcohol-based hand sanitizers are that they eliminate germs and the CDC currently recommends them for Covid-19. However, due to product shortages, it can be extremely difficult to find. If you see any on sale, don’t wait to make a purchase because they move fast.

Other than being hard to find, some people experience mild skin irritation from alcohol-based hand sanitizer. It’s not very common, so if you’ve used it before, you’re not likely to have any problems.

Pros and Cons of BZK-Based Hand Sanitizer

BZK has a number of benefits that you won’t find in alcohol-based hand sanitizer. The biggest difference you’ll notice is that it doesn’t sting when applied to cuts or scrapes. There’s no alcohol, which is what normally causes a little pain.

It’s also more gentle on your skin. It doesn’t evaporate quickly, so you’ll not experience the dry or cracked hands that alcohol can sometimes leave you with. And as mentioned above, since it stays on your skin longer than alcohol, you’re protected from germs for a longer time.

BZK also isn’t flammable, so it’s possible schools would prefer it.

The primary con for the moment is the CDC doesn’t recommend BZK for Covid-19. And it’s not clear yet if the CDC is just slow to respond to the new data or intentionally ignoring it.

Here’s why: The CDC has a non-profit arm called the CDC Foundation, which is funded by corporate lobbying groups and big pharma. It has also been criticized in the past for not making decisions in the best interest of the public because of these ties.

In the end, the consumer should make the final decision as to what products they should use by researching independent studies published in scientific journals. Here’s one to get you started: It compared the effectiveness of BZK and alcohol-based hand sanitizer when used by healthcare workers.

Where To Store Hand Sanitizer

Alcohol-based hand sanitizer must be stored in a cool place away from direct sunlight. It also must have the cap securely tightened when not being used to ensure the alcohol doesn’t evaporate. Since it’s the primary germ-fighting ingredient, allowing evaporation will cause the product to be ineffective.

BZK-based hand sanitizers can be stored anywhere and evaporation isn’t a concern.

How Often To Apply Hand Sanitizer

Due to the Covid-19 crisis, it’s best to carry hand sanitizer with you when you’re away from home. Be sure to use it every time before eating and before touching your face. It’s also a good idea to use it immediately after leaving a building, specifically before you touch your vehicle.

Beyond hand hygiene, you should also remember to use disinfecting wipes on items you bring home and inside your vehicle after being out. A good way to find which brand of disinfecting wipes to buy is to look at what hospitals use. More often than not, you’ll see them using SONO Disinfecting Wipes.

Where To Buy SONO Healthcare Hand Sanitizer

SONO Healthcare makes a moisturizing, BZK-based foaming hand sanitizer with bergamot oil. You can order it online through sonohealthcare.com. They also just released an 80% alcohol-based hand sanitizer that is compounded according to World Health Organization (WHO) guidelines for the Covid-19 crisis.

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Sean Stewart is a freelance writer based in North Carolina. He has an interdisciplinary PhD and served as a college professor for 12 years.

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