Due to the excessive use of hand-sanitizers throughout the pandemic, my skin developed a severe reaction causing dryness, itching, and cracking of my skin, leading to occasional bleeding. The situation came to my attention not only because of my experience but also thanks to health experts, the media, our governments, and other health sectors. My case led me to consider the risk of the excessive use of hand-sanitization and how unaware many of us are of the hazards that its use may cause. This paper aims to highlight the effectiveness of hand-sanitizers, the risks of their constant use, and the importance of hand-washing as opposed to hand-sanitizations. Moreover, this paper will argue for a shift in regulations concerning the manufacturing and use of hand-sanitization during the pandemic.

Hand-washing, or sanitation, is a vital part of a person’s hygiene, as he or she is prone to easy and fast contamination from direct contact with microorganisms. Proper hand sanitization, for instance, is required to interrupt the transmission of the coronavirus (Jing et al., 2020). This behavior was endorsed by medical experts, health organizations such as the World Health Organization (WHO), the media, and our governments alike in order to control and inactivate the virus through contact isolation as well as other strict infection control tools such as hand-sanitation (Jing et al., 2020). This explains the sudden shift in people’s behavior globally in using hygienic products for instant sanitation as a response to fear concerning health safety due to the COVID-19 pandemic—an alternative in the absence of access to clean water and soap (Brundu, 2020). As such, manufacturers from different industries began producing hand-sanitizers as a response to the high global demand, which led the WHO and other certified health organizations to ease the regulations on the production of hand-sanitizers. However, concerns grew as people began replacing hand-sanitizers completely with hand-washing as a result of many people experiencing skin irritations among other things. Lebanon was no exception to the rule of production and consumption of the product.

Nonetheless, it fell short in many aspects, including the protection of consumers from its hazardous effects.

The Effectivity and Risks of Hand-Sanitizers as Opposed to Soap: 

As has been established, hand-sanitization is vital to avoid contamination, especially in times of a pandemic, such as the novel COVID-19 virus. International response to the contamination was through hand-sanitation, which not only included the use of soap, but also the use of alcohol-based hand-rub or ABHR, such as alcohol-based sanitizers (CDC, 2020). It has been proven that hand-washing with soap is the most effective way to prevent the spread of pathogens and to inactivate the virus upon contact. However, for the process to be highly effective, one must wash his/her hands for at least 20 seconds, as recommended by all health professionals and organizations (Kingsland, 2020). While hand-washing with soap removes the pathogens completely, hand-rubs require a certain range of at least 60%-70% of alcohol concentrations to inactivate the virus (Kingsland, 2020). Therefore, hand-sanitizers are considered effective alternatives in the absence of water and soap, but* unlike soap, it does not eliminate all types of germs (Jing et al., 2020). For the product to be effective, it must be rubbed for about 25-30 seconds on the hands. However, the excessive use of these products has proved to be harmful in many ways due to the products’ alcohol base, which as stated before, causes dryness, irritation due to allergic reactions, cracking, and peeling of the skin. This, may in fact, have a reverse effect allowing the colonization of the bacteria (Jing et al., 2020). Though, the most recommended type of hand-sanitizer is that including Ethanol, which causes the least reactions to the product. 

International Standard Procedure:

Typically, hand-sanitizers are commercially available in many forms including water-based, alcohol-based, foam, rubs, or even wipes. Still, the WHO recommended the use of alcohol-based hand-sanitizer in the case of pandemics (Jing et al., 2020). According to the FDA and the WHO organizations, manufacturers should maintain certain regulations in producing hand-sanitizers as to minimize the risks of their commercial use as follows (Richeson & Darden, 2020): 

1. Manufacturers should be registered with the FDA. 
2. The product is manufactured using no less than 94.9% ethanol, or Isopropyl, food-grade glycerin, hydrogen peroxide, and finally sterile water. 
3. The manufacturers should follow the formula provided by the guidance provided by the FDA. 
4. The content used should be previously verified before product distribution.
5. Proper labeling in compliance with WHO standards.

However, with the pandemic, the WHO, along with the FDA, has eased its restrictions on the manufacturing of the product to accelerate its release in the market. In other words, no action will be enforced against firms preparing alcohol-based hand-rubs for both consumers and public health sectors (SGS, 2020).

Case Study on an Incident: 

With the lower restrictions on the manufacturing of the product, many incidents have risen. For example, the use of methanol in hand-sanitizers is considered harmful, as the FDA and WHO organizations discourage the purchase and use of hand-rubs with an alcohol base of methanol. 

Early in 2020, the FDA had warned consumers of hand-sanitizer products that contain ethanol, but have tested positive for the methanol contamination. Methanol, in this case, could be toxic when absorbed by the skin or ingested differently, and even life-threatening. It could also result in nausea, vomiting, headache, blurred vision, permanent blindness, seizures, coma, and other life-threatening issues (Center for Drug Evaluation and Research, 2020). The picture provided on the right is of my own hand and shows evidence of the dryness and irritation the skin suffers due to hand-sanitizers. These symptoms lasted for 2-3 months.