Saturday, March 7, 2020

Hand-washing 101

Key Points


  • Frequent and proper hand-washing has always been the best protection against the spread of flu viruses and other germs.
  • Avoid touching the T-Zone of your face.
  • Wash all surfaces of your hands frequently with soap and water for 20 seconds.
  • Use alcohol-based hand sanitizer if you cannot wash your hands.
  • Hand-washing has been shown to reduce the risk of acquiring a respiratory infections such as a cold or the flu by between 16 and 21%.

Why is frequent and proper hand-washing so important to overall health?

Washing your hands removes bacteria and viruses from the skin surface. The skin surface of dead cells is a barrier to germs entering the body, so removing them aids the effectiveness in keeping them from entering and causing an infection.

But removing germs from your hands not only lowers your risk of an infection, it protects the health of others around you. Germs from your hands can transfer to commonly touched objects such as handrails, table tops, and shared office equipment. The next person touching these items can pick up the germs onto their hands without knowing it.

Why should you not touch your face?

While dead skin cells serve as a barrier to the entry of germs, there are places in the body where live cells are exposed. These are the mucous membranes that line the eyes, nose and mouth on the face. This region of the face is known as the T zone. The surfaces of mucous membranes are places that germs can easily enter the body.

Most people touch their eyes, nose, and mouth many times an hour, without realizing they are doing so. People have been shown to unconsciously touch their face as often as 23 times per hour, and almost half of those touches included contact with a mucus membrane. Germs can easily enter the body through the mucus membranes of the eyes, nose, and mouth, and cause infections. This process is called self-inoculation.

Researchers have developed a model for infection risk due to face touching, taking into account the “rate of pathogen transfer to the hands via contact with contaminated environmental surfaces, and the rate of pathogen loss from the hands due to pathogen die-off and transfer from the hands to environmental surfaces and to target facial membranes during touching.”

Learn why not to touch your T zone from this video with Henry the Hand: https://www.henrythehand.com/healthful-tips/t-zone/.

When should you wash your hands?

It is impossible to keep your hands totally germ free. But proper hand washing does significantly lower the number of viruses, bacteria, and other microbes on your skin.

Your own germs are all over your body, including on your hands. This is especially true if you are ill or have been blowing your nose for any reason. Therefore, to avoid spreading your germs to others, you should wash your hands before:

  • Handling your contact lenses
  • Preparing food 
  • Eating
  • Caring for anyone who is ill or injured

Certain daily activities expose your hands to additional germs. Always wash your hands after you:

  • Blow your nose, sneeze or cough
  • Use the toilet
  • Prepare food
  • Handle garbage
  • Touch an animal, animal food or treats, or animal waste

Since germs get on your hands from things you touch that have been touched by other people, you should wash your hands after doing the following:

  • Caring for anyone who is ill or injured
  • Changing a diaper or cleaning a child who has used the toilet
  • Touching items in common usage, such as door handles, grocery carts, gasoline pumps, ATMs or other public keypads, public bathroom fixtures, shared office equipment

To avoid other sources of germs:

  • Avoid shaking hands (or cheek kissing)  
  • Do not share snacks from packages or bowls that other people are dipping their fingers into

And of course, if your hands are dirty, wash them right away.

Unfortunately, observational studies have shown that only two thirds of persons wash their hands at all after using a public restroom and about three-quarters wash after using their home bathroom. (There is a significant gender difference here: while 35% of women don’t wash their hands in public bathrooms, 69% of men do not do so.) It is frightening to realize that over 93% of people observed to cough or sneeze did not wash their hands.

What is the reason for this unhealthy lack of hand-washing? While three-quarters of those surveyed were aware that hand-washing prevents communicable diseases, a third of them said they were “not accustomed” to washing their hands, and a third said hand-washing was “annoying.”

It seems that the American public does not pay adequate attention to evidence-based preventive health behaviors. Instead, they tend to focus on billable professional healthcare treatments, while the healthcare system itself focuses on marketable newly developed products rather than less expensive options.

How should you wash your hands?


  • Wet your hands with clean, running water at a comfortable temperature  either warm or cold, it does not matter. Turn the water off.
  • Apply soap and lather well.
  • Rub your hands vigorously for at least 20 seconds. Generally this is the time it takes to sing Happy Birthday or the alphabet song twice through.
  • Scrub all surfaces of your hands, including the backs, your wrists, between your fingers and under your fingernails.
  • Turn the water on again. Rinse well to remove soap. Turn the water off.
  • Dry with a clean towel or air-dry your hands.

Unfortunately, the average person washes his or her hands for only six seconds. Only about 5% of the population washes hands properly.

Here are a couple of comedic videos on proper hand-washing technique that just might inspire you to scrub for the full 20 seconds:


Do you need to use antimicrobial soap?

Probably not. Research has shown “Antimicrobial hand soaps provide a greater bacterial reduction than non-antimicrobial soaps. However, the link between greater bacterial reduction and a reduction of disease has not been definitively demonstrated.” In another study “The most beneficial intervention was hand-hygiene education with use of non-antibacterial soap.”

Why is the Food and Drug Administration recommending against the use of antibacterial soap? The ingredients have not been shown to be either safe for long term use nor as effective as plain soap and water.

What if you can’t wash your hands?

You will need to clean your hands sometimes when you do not have access to soap and water. An acceptable alternative is to use an alcohol-based gel hand sanitizer that contains at least 60% alcohol.

  • The proper way to use hand sanitizers is to:
  • Carry hand sanitizer with you so you can frequently clean your hands when you are away from home.
  • Read the label to find out how much to use each time.
  • Apply that amount into one palm.
  • Rub your hands together, then rub the gel over all palm and back surfaces of your hands and fingers.
  • Continue to rub in the gel until your hands are dry. Do not wipe it off.

According to research using a hand sanitizer is not as effective as regular soap and water hand-washing, but it is far better than not cleaning your hands at all.

Please remember!

Properly washing your hands (and avoiding touching your face) is the most effective way to avoid catching flu viruses and other respiratory infections. It is also the best way to avoid spreading your germs to others.

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