Washing hands off tricky situations, might not yield definitive solutions to problems in life; but washing hands regularly (literally, without any other ulterior meanings) with appropriate cleansing and sanitizing agents definitely, helps prevent several diseases that are transmitted through fecal-oral routes and direct physical contacts. Hand-washing or hand-hygiene particularly holds important in hospitals and medical treatment scenario, in order to prevent or minimize the disease and its communication. Nevertheless, everyone can benefit from its routine use.

Several hand-washing agents are available in the markets: detergent- based, water –based, non-water-based or alcohol-based, to name a few. Water alone is ineffective for cleaning skin as the fats, oils, and proteins (which are components of organic soil) present on the skin cannot be removed with its application. Addition of detergents in appropriate amounts helps removal of microorganisms, dirt and soil particles; whichever present on the skin. However, there must be a considerable flow of water to rinse them off.  These detergent based products are marketed as “soaps”. Hard or “solid’ soaps, can be reused; and therefore, it may be believed that they hold bacteria acquired from previous uses. Studies say that it is quite unlikely to incur or transfer infections from multiple uses, as the bacteria get washed away with the foam. However, most of these anti-bacterial soaps contain Triclosan; to which many organisms have become resistant over a period of time. Consequently, they may not be as effective as they are marketed to be!

Another class of hand-washing agents that hit popularity in the early twenty first century is the “hand-sanitizers”. They are alcohol rub, non-water based means to maintain hand hygiene. Majority of these, contain an isopropyl alcohol or ethanol base, formulated together with a thickening agent such as Carbomer to form gel, or a humectant like glycerin into a liquid, or foam for ease of use and lessen the drying effect induced by alcohol. Highly effective hand-sanitizers contain alcohol in the range of 60-95%. This helps kill bacteria, multi-drug resistant bacteria, tuberculosis, and some viruses like HIV, herpes, rhinovirus, influenza, hepatitis etc. However, they are ineffective against Norovirus (or Norwalk type viruses), the most common pathogen of contagious gastroenteritis.

Nevertheless, the efficiency of alcohol rub sanitizers in avoiding the communication of pathogens is more than that observed with soap and water. Despite this fact, whether they could serve as a replacement over soap and water is still a question. As frequent use of alcohol-based hand sanitizers can cause dry skin unless emollients and/or skin moisturizers are added to the formula. And further, they do not clean the hands of organic material; rather simple disinfection is their course of action.

Typically, the use of soap and warm running water and washing hand surfaces and fingernails thoroughly, is seen as necessary. One should apply a hand cleansing agent and rub wet, soapy hands together outside the stream of running water for at least 20 seconds, before rinsing thoroughly and then drying with a clean towel, disposable or otherwise. Studies have shown that using clean towels aid in effective contaminant removal, by absorbing and removing excess water containing suspended contaminants if any.  Should there be a need for frequent hand-washing; application of moisturizers could help prevent unwanted skin dryness.

While on travel, in the absence of soap and water; hand-sanitizing wipes offer a convenient alternative to conventional hand-washing.

Overall, following a good hand-hygiene regime helps check the number of child mortalities due to diarrhea (which is the second leading cause of deaths in children) by almost half and also due to pneumonia (the leading cause of deaths in children) by one-quarter. It may help to remember here that there are five critical times in washing hands with soap and/or using of a hand antiseptic related to fecal-oral transmission: after using a bathroom (private or public), after changing a diaper, before feeding a child, before eating and before preparing food or handling raw meat, fish, or poultry, or any other situation leading to potential contamination .To lessen the chances of spreading of the germs, it is also better to wash the hands and/or use a hand antiseptic before and after tending to a sick person.

As they say: “A stitch in time saves nine”; we all can prevent some unwanted harm, just by washing our hands regularly!