I have recently received several unsolicited e-mails from manufacturers about products claiming to be ideal for hand decontamination that make claims that alcohol sanitisers:

Cause skin damage

Are ineffective against COVID-19

They generally promote their alcohol-free skin sanitiser as being safer and more effective. Requests for the supporting evidence have generally gone unanswered. As far as I can establish none of the claims for the effectiveness of their products have been validated by properly conducted, peer-reviewed studies that are available to consider.

This prompted me to review the facts once again. You will find a great deal of information on the following two websites:

https://www.nice.org.uk/guidance/qs61/chapter/quality-statement-3-hand-decontamination

https://www.nice.org.uk/guidance/cg139/chapter/1-Guidance#standard-principles

In addition, the WHO website is quite clear that properly formulated alcohol based sanitisers are effective against COVID-19. The HICPAC (Healthcare Infection Control Practices Advisory Committee, a USA federal agency) guidelines issued in 2002 defined alcohol-based handrubbing, where available, as the standard of care for hand hygiene, with two specific exceptions.

As regards the claim that alcohol sanitisers damage the skin, I have numerous studies on my database all of which point to one simple conclusion. Alcohol sanitisers do not cause skin damage and, properly formulated, can actually help maintain a safe and infection resistant skin condition.

So I would advise you treat any claims to the contrary with considerable caution.

In my mind, if you have an over zealous hand geller in your office space who insists on gelling their hands what feels like vry 10 mins. It's probably more but everytime I see them in the office they are rubbing gel in. Surely the gel removes a bit of the skins natural oils and can cause dryness.

I have no scientific basis for this thought process but it seems logical for those that overgel

Firstly, if we are speaking of the alcohol sanitising gel, if this is formulated to WHO standard then it will contain a moisturising element. The evidence is that alcohol sanitisers do not defat the skin. Indeed I have several studies demonstrating how their use actually has helped the skin recover from the damage done by excessive hand washing. The alcohol sanitiser works as it evaporates and since it does not remove anything from the skin (unless of course you wipe it off whilst still wet) how can it remove the skin's own hydro-lipidic surface film (unlike hand washing which emulsifies the skin's film and takes it away when the hands are rinsed)?

When considering skin moisturisers the key is that unless the skin is visibly damage the best moisturiser is a lotion. What we are trying to do with the moisturiser is to replicate the skin's own surface hydrolipidic film. The concept that a thicker cream, e.g. vaseline, is better than a thinner lotion is not born out by the evidence. Indeed studies have shown that thick cream applied to normal skin can result in occlusion leading to hyperhydration with the consequent increase in skin vulnerability to irritant chemicals. The secret with moisturisers is 'little and often'. Thick creams should be restricted to those situations where the skin is visibly damaged when their effect is really needed to help restore the skin's normal condition.