Dear Doctor Column, February 18, 2008

Good Handwashing Habits Can Cut Down Infections

Question:

What's the proper way to wash your hands?  What about antibacterial soaps? Are they worth the money?

Answer:

The purpose of hand washing is to remove possible harmful bacteria from the skin. Soap and water act on the surface of the skin to loosen and remove soil and grime, body secretions, dead skin cells, and germs. Studies have shown that washing with water alone removes no bacteria whatsoever.

If you don't wash your hands regularly, you pick up germs from other sources and then infect yourself when you touch your eyes, nose, or mouth. One of the most common ways people "catch" colds is by rubbing their nose or eyes after their hands have been contaminated with the cold virus. You also can spread germs to others or onto surfaces other people touch, and before you know it, everyone around you is sick. Remember, too, that colds, and serious diseases, such as hepatitis A, meningitis, and infectious diarrhea, can be prevented if people make a habit of washing their hands.

According to the National Consumer League one of every four visits to the doctor's office is a result of an infectious disease, such as a cold, the flu, or food poisoning, usually caused by germs common hand washing eliminates.

The Centers for Disease Control and Prevention (CDC) cite studies showing only 20% to 50% of health care workers comply with hand hygiene procedures, and an estimated 90,000 Americans die every year from hospital-acquired infections: CDC studies show that when adherence to hand hygiene practices improves, hospital infection rates drop. With the number of drug-resistant infections on the rise, hand hygiene has taken on a new urgency, and hospitals across the nation are urging their patients to ask nurses and doctors "Have you cleaned your hands?"

It's especially important to wash your hands before, during, and after preparing food; before eating and after using the bathroom; after handling animals or animal waste; and when you're around someone sick. Rings and artificial nails impede the removal of bacteria and serve as breeding grounds for micro-organisms; long natural nails can harbor stubborn colonies of bacteria, too.

Here's the correct way to wash your hands:

• First, wet your hands and apply liquid or clean bar soap.
• Next, rub your hands vigorously together and scrub all surfaces, including all fingers, in between fingers, and the back of your hands.
• Continuing rubbing for about 20 to 30 seconds — about the time it takes to sing "Happy Birthday." It's the soap combined with the scrubbing action that helps dislodge and remove germs.
• Rinse well and dry your hands with a clean cloth.

Health experts say it makes little difference, as far as killing germs, whether you use cold or hot water. For ordinary cleansing purposes, warm water wins hands down over cold water for removing grease and grime by increasing soap's ability to penetrate oils and dirt. Plus, it just feels better to wash in warm rather than cold water.

Don't bother with antibacterial soaps unless you don't have easy access to soap and water. Researchers have found that antibacterial soap removes 97% of bacteria on the hands. Washing with ordinary soap removes 95% of the bacteria on the hands — not a big difference, except maybe in price.

Here are some additional tips for washing your skin, including your hands:

• Avoid using hot water and scrubbing with strong soap, which can strip the skin of too much oil causing it to become dry, chapped, and itchy. Be sure to rinse away all traces of soap.
• Do not use a medicated soap unless prescribed by your doctor. Allergic reactions and increased sensitivity to light some people experience after using these products outweigh possible benefits.
• Use a hand cream or lotion to soothe skin and seal in moisture after washing.

Alcohol-based hand sanitizers have become a popular way of washing up where soap and water are not available. Experts caution, however, that alcohol-based hand sanitizers are not a substitute for soap and water.