Hand Sanitizers

One major route of transmission of the SARS-CoV-2 coronavirus is via touching your mouth, nose or eyes after your hands have been in contact with a virally-contaminated surface.

Thus washing your hands when you get home is important, and in addition, when you are out and about, applying an alcohol hand sanitizer every hour or two is a good idea. But during an average day, an individual comes into contact with 300 surfaces every 30 minutes. Ref: 1 And one study found that on average, people touch their face every 3 minutes.

So even if you regularly use a hand sanitizer every hour, there are still many opportunities for viral contamination on a surface to be transferred to your face via your hands.



So I started thinking in terms of a persistent hand sanitizer, which would destroy any coronavirus contamination picked up on the hands even hours after the sanitizer is applied.

I came across povidone-iodine, which may work for this purpose: this paper surveys disinfectants for coronavirus, and says that povidone-iodine solution at just 0.23% is sufficient to destroy SARS and MERS coronaviruses within 15 seconds to 1 minute (see table 2), when coronavirus particles are placed in suspension in that solution.

Furthermore, unlike alcohol which only disinfects the hands there and then, applying povidone-iodine to the hands appears to have a persistent antimicrobial action, which can last for 6 hours (at least with respect to bacteria, but I could not find data for viruses). Ref: 1

10% povidone-iodine solution is available online (about £5 for 125 ml). So my idea was if you apply say a 1% or 2% povidone-iodine solution to your hands before you go out, your hands in theory may be self-decontaminating for the next few hours.

Obviously this approach has not been tested, but it may work. Any thoughts on its viability?



Another potentially useful persistent hand sanitizer for coronavirus is benzalkonium chloride. The above study found a 0.2% solution was less effective for coronavirus compared to povidone-iodine and alcohol, but nevertheless benzalkonium chloride has a persistent action on hands, lasting for 4 hours. Ref: 1

A similar disinfectant compound called benzethonium chloride is found in grape seed extract liquid supplements such as Citricidal® at around 8%. Ref: 1

 

Had an email from my aunt- lugol' s iodine and coconut oil 1: 10 parts suggested.

 

Although I expect regular iodine solutions or tinctures will deactivate coronavirus at time you apply it, I am not sure if they will have a persistent effect.

Iodine is slowly released from povidone-iodine, which I think may underlie its long-lasting action.

 

No idea if it would work but my hands are in bits.

My skin doesn't like soap at the best of times and if I don't do something soon I'm going to have cracks and splits in the skin.

What I'd be like if I was having to apply an alcohol based solution to them them if I had to be out and about I don't know. I'm sure there are plenty of folk who have to go out and about with sore, stinging hands. So if you found something that worked I daresay it would be popular.

@Kitty mentioned a Dermol product she uses instead of soap at home so I'm going to give that a try.

 

I commented on this elsewhere, but I wonder how many people would be happy with bright purple hands? Better than the alternative of course, but it might make the idea hard to catch on. The other problem is iodine is in short supply globally, or at least it was the last time I looked into this.

 

Ah.

 

Because coincidently I already happened to have a bottle of 10% povidone-iodine solution that I bought a few years ago, I was able to make up a 2% solution and test it:

There is almost no noticeable change in the appearance of your hands when you apply a 1% or 2% solution.

Even if you use a 10% solution, it only makes your hands look very mildly suntanned brown, but not something that anyone would particularly notice.


With 10% though, there would be quite a bit of systemic iodine absorption: according to a rough calculation I did: if you applied 1 ml of 10% povidone-iodine solution to the skin, then over the hours you would slowly absorb about 5000 mcg of iodine. Though there are high-dose iodine supplements which are 15,000 mcg per tablet, so that's within an acceptable range.

But note that a high dose of iodine can exacerbate Hashimoto's.

I am not sure about global supplies, but there does not seem to be any coronavirus pandemic price hike on povidone-iodine when I looked recently. Unlike isopropyl alcohol, which has recently gone up from around £15 for 5 liters to about £80, because everyone wants this for hand and surface disinfection.

 

While researching hand sanitizers and disinfectants, I came across something interesting about hand washing which may be relevant to avoiding skin dryness:

Source: The WHO guidelines on hand hygiene in health care. Chapter 13

 

I have to be very, very careful which soap brands I use or I get very severe allergic reactions. I usually use different (tolerable) brands during the day to keep changing the chemicals going on my skin. I've just worked out which brands I can use through trial and error over the years. However, I'm lucky that I currently live alone, so don't have to wash my hands much more than normal (which unfortunately is a lot, even in 'normal' circumstances).

 

I discovered last year that I could tolerate the Tesco own brand hand sanitiser antibacterial gel, but now there's none available. Extremely annoying as this was helping me cope with my toileting needs by using it regularly after washing my hands for the extra hygiene and protection it afforded, in case I hadn't managed to clean my hands as well as needed (my difficulties are extreme due to a rare bowel disorder that affects me and means I have to wash my hands a lot and several times in the space of a couple of minutes).

 

The hospital job I had at the time of getting ME required quite strict decontamination and cross-infection control, and the first rule about it is that it is very hard to implement strictly 100% for long periods, even among professionals who do it every day. We all get complacent, lazy, tired, stressed, etc. It is very easy to make just one tiny but critical lapse in procedures. Microbes are very unforgiving.

Which is why society has to go for hard social distancing, alongside basic hygiene control. Those two, if done right, should be enough to keep the worst at bay.

 

I haven't seen much written recently about the importance of hand drying, as well as washing. When my elderly mum was in hospital, they were very keen to stress the importance of this – damp hands can apparently spread many times the number of residual bacteria, viruses and spores than well-dried hands. It also helps avoid getting chapped hands.

As well as using this to wash your hands, it can be used as an emollient cream afterwards. If it works for you, I've found that Weldrick's Pharmacy's online shop often has the best price, and if you can afford to buy several bottles at once, the postage is free.

My hands do still get sore sometimes, especially after I've been cleaning, and the most effective treatment for me is supermarket own-brand petroleum jelly (it seems a bit lighter and easier to spread than branded Vaseline). I rub it in to the backs of my hands and then clean it off my palms and fingers with a dry tissue. I know some people prefer to avoid petroleum products, but for me it's one of the few things that doesn't make the dermatitis worse; I can use olive or coconut oil, but it's not as effective as a barrier.

 

I wear washing up gloves (non rubber/latex which I am allergic to) whenever I handle anything coming into the house. Then I can wash the item and my hands with the gloves on as normal with whatever (eg washing up liquid).
I've always worn them for any cleaning in the house.
I've also started wearing them for doing things outside generally as my gardening gloves are fabric ones, get dirty easily and then have to be soaked in a bucket before washing.

 

I managed to get some disposable gloves about 10 days ago. I use them for pumping gas and at the grocery store, when I absolutely have to go. I've also seen people invert a produce bag over their hands at the grocery store for a make-shift glove, which is better than nothing.

I have a little 91% alcohol and some aloe vera gel from before the pandemic, but it will make only about 1/2 a cup.

 

As of a few days ago, there seemed to be plenty of surgical spirit available in the UK – I bought half a litre from Boots for about £4. I wouldn't use it as hand sanitiser, as it's safer for me to just wash them, but as I was in there anyway and my current bottle only has a bit left in it, I thought I'd get some in case I need it for anything.

 

I couldn’t get anything when my ex went for me last week. So I’m making my own with Isopropanol, aloe Vera gel, tea tree oil and glycerine.

I have one watery version for sprays and another thicker version with added xantham gum which over a few hours blends the aloe Vera gel with the rest of the mixture for use with squeeze bottles.

 

My bottle of Dermol 500 arrived today. Oh bliss! The comfort of washing & drying your hands without them stinging!

Now lets just hope I don't develop an allergy to it, which would be par for the course!

Thanks @Kitty!

 

Fingers crossed! It does have an antimicrobial in it, but it's one that doesn't cause allergies in many people.

ETA: when I get down to the bottom of the bottle and the pump isn't working well any more, I just take it off. I add a bit of water to the cream, swish it around, and then just tip a bit into my hand each time I need to wash them. It's too expensive to waste!

 

This is my backup hand sanitizer, in case I run out of isopropyl.