Is It Possible to Have an Allergic Reaction to Hand Sanitizer?

Hand sanitizer use is becoming increasingly common throughout the country, and with good reason. The trouble is, some people may find that they have an adverse reaction to the stuff. Sometimes this reaction is immediate, that is, on the first use, while other times it doesn't show up for several uses. So what's going on? Is this an allergic reaction, or something else, and can it be solved?

What Causes Allergic Reactions?

Allergic reactions are your body identifying a generally harmless substance as an invader and stimulating an immune response to fight it off. When the invader is a disease, like a virus or infection, this is a good reaction. You feel sick, but you don't die, and your system beats back the invader.

When the invader is something otherwise harmless, like mold, dust, dander, or pollen, your immune system struggles to fight off something that's not attacking. You end up with symptoms of being sick, like a stuffy or runny nose, or a rash or hives on the skin, but without the effects of an infection as well. This is why allergies are generally less terrible than an actual illness.

Extreme allergies can cause correspondingly extreme reactions. If you've heard about people whose airways swell up if they eat peanuts or are stung by a bee, that's an extreme form of an allergic reaction. This extreme reaction is called anaphylaxis.

Anaphylaxis requires medical treatment immediately, or it can kill. This is why those with known extreme allergies tend to carry an EpiPen, to administer epinephrine, an antihistamine. This, coupled with a trip to an emergency room, is usually enough to save the person, albeit with some level of suffering until their immune system calms down.

Most people have low-level allergies. If you find your eyes watering and your nose clogging in the presence of pollen in the spring, or whenever your sibling's cat sits near you, that's an allergic response. It may be extremely mild, or it may be akin to catching a cold that lasts for a day or two. Extreme, life-threatening allergies are relatively rare.

There is a huge variety of different allergies. We've all heard of the common ones, like mold, dust, dander and pets, insect stings, peanuts, shellfish, and so on. However, there are less common allergies, like penicillin, latex, and lanolin, which is common in wool. Nickel, a metal used in everything from jewelry to cell phones, can also cause a low-grade allergic reaction. Allergies can manifest to a wide range of different environmental contaminants, though.

Ingredients in Hand Sanitizer

So where does hand sanitizer come into play? Well, hand sanitizer has a few typical ingredients and a few less typical ingredients, and you can technically be allergic to any one of them.

The primary ingredients in hand sanitizer are water and alcohol. You're not going to be allergic to water. You can, however, be allergic to alcohol.

Alcohol allergies are generally quite rare. A real alcohol allergy tends to be severe and is most often caused by drinking alcohol, not simply coming into contact with it. However, an alcohol allergy can show as a rash or hives on contact, if you have it. Many people who feel like they're allergic to alcohol are actually just intolerant of it. 

Alcohol intolerance shows symptoms like headache, nausea, vomiting, and a rapid heartbeat, and is only going to occur if you're drinking alcohol. Since you aren't drinking hand sanitizer, you won't experience negative effects if you use it.

Alcohol allergies, meanwhile, can occur both with contact and with the consumption of alcohol. Symptoms include itching skin, hives, swelling, congestion, abdominal pain, dizziness, and more severe versions of all of those symptoms. 

Hand sanitizers also often include additional ingredients. You may be allergic to some of these ingredients.

• Antiseptics. Chemicals such as chlorhexidine serve as additional antiseptics. It's possible to have an allergy to this chemical, but it's quite rare.
• Sporicides. Meant to kill spores from molds and bacteria, the most common sporicide is hydrogen peroxide. It is, again, possible to be allergic to this ingredient, but it's very rare.
• Gelling agents and emollients, meant to keep the sanitizer in a thick gel rather than a thin liquid. The most common are petrolatum and cetyl alcohol. You can, again, be allergic to these, but it's exceedingly rare.
• Foaming agents. These help a hand sanitizer lather up like a soap to better encourage rubbing it in. Same story as above.
• Perfumes. A wide range of substances can be included in hand sanitizer to dull the alcohol scent and cover it up with more pleasant fragrances. These can range from artificial chemicals to natural herbs like lavender, and you can be allergic to them the same way you can be allergic to plants. Allergies to these ingredients are far more common but much less severe.

As you can see, it's possible to be allergic to hand sanitizer, but the chances are very low. The thing is, you can experience an adverse reaction to hand sanitizer that has nothing to do with allergic reactions.

Contact Dermatitis

There are generally two kinds of reactions that you might experience that are minor and not as severe as an allergic reaction. Allergies traditionally have respiratory symptoms and, for obvious reasons, you want to avoid suffering an attack during the current medical crisis.

Thankfully, the kinds of reactions you're likely to experience from hand sanitizer are minimal. They will generally not affect your respiratory system unless you're inhaling hand sanitizer, in which case you have bigger problems to worry about, such as why you're inhaling hand sanitizer.

The first of the two kinds of issues you can experience is contact dermatitis. Contact dermatitis is a fancy phrase literally meaning "inflammation of the skin on contact with a substance." In other words, a red, itchy rash.

You can think of it sort of like the kind of rash you would get from touching poison ivy. It can last for a few days, and it can range from a mild red itch to a more intense itch to rashes that blister or cause hives. Extreme cases of contact dermatitis can last for as much as a month.

Contact dermatitis is very rarely threatening, just unpleasant. You can treat it with anti-itch creams, cool compresses, and other soothing lotions.

Technically, contact dermatitis is an allergic reaction, but it's a very minor one. It's annoying, but it's not contagious, it's not life-threatening, and it's nothing more than unpleasant. It's very rare that it becomes anything more severe, and that's typically when you have prolonged exposure to whatever is causing you the issue, and it's widespread, such as being allergic to a new brand of laundry detergent and wearing a full outfit recently washed in it.

The Drying Effects of Hand Sanitizer

The other kind of reaction you can get from hand sanitizer is dry skin. Hand sanitizer works by using alcohol to sanitize and strip oils, greases, and grime from your hands, which you wipe off and eventually rinse off later when you get the chance.

The trouble here is that the alcohol in hand sanitizer doesn't distinguish between bad oils and good oils. This means in addition to stripping grease you may have picked up in contact with substances and surfaces, it also strips the natural oils your skin produces.

These natural oils are part of the protective system that keeps your skin supple, healthy, and impermeable to most intruders. When you strip away these oils, they can't protect your skin. This means the outer layers of your skin dry out, and can crack and flake. 

For most people, this won't happen if you use hand sanitizer a couple of times per day. If you're using much more regularly, however, you're far more likely to experience these symptoms.

What symptoms? Specifically, your skin will dry and you may feel cracks forming, particularly around your fingertips. The more you use hand sanitizer, the more likely this is to happen.

This isn't isolated to hand sanitizer, however. Millions of people are currently experiencing what healthcare workers have to fight with on a daily basis; the cleansing effects of soap. Soap and water do an even better job of stripping oils from the skin.

This is why healthcare workers often carry lotions with them, and it's why we're recommending a lotion as well. Any moisturizing lotion, used after hand sanitizer, can help restore that barrier to your skin and minimize the amount of dryness and cracking that can happen.

You definitely want to minimize this dryness. Cracked skin is an additional vector for infection, and even if you don't fall victim to the current pandemic, the irritation and potential for skin infection is bad enough.

How to Handle Hand Sanitizer Problems

If you're considering using hand sanitizer more often – and you probably should, if you have to leave your house for anything during these days of social isolation – you'll want to make sure that you're not going to experience negative effects from using the stuff. Here are our tips.

First, know what you're allergic to if anything. We're not saying you have to go out and get a full allergy test, but if you know you're allergic to plant pollen, you might want to make sure the hand sanitizer you're using doesn't use plant ingredients in it. Most of them won't, but some of the more organic-focused or scented sanitizers will.

Second, try to avoid hand sanitizers that have a ton of extra ingredients. The more ingredients in the sanitizer, the more chances you have that something will irritate your skin. Pure, simple hand sanitizer that's little more than alcohol, a gelling agent, and some water should be fine. Slightly more complex formulas with a scent can be fine as well if you don't like the alcohol smell, though that dissipates soon enough.

Additionally, test your hand sanitizer in a small spot on the back of your hand or your wrist. Testing a small dab of hand sanitizer on exposed skin is a good idea to see whether or not you're likely to experience a reaction. If you are, it will probably happen soon, though it's worth mentioning that some people don't experience allergic reactions right away. Keep an eye on it, and don't assume that your hand sanitizer is safe just because you've been using it for a week already.

You can also try to use soap and water more than you use hand sanitizer. Both have the effect of drying out your skin, and both should be followed up with a moisturizer, but soap is typically one ingredient, rather than several that you'll find in a common hand sanitizer.

We recommend always carrying a moisturizing lotion with you when you carry a hand sanitizer. The generally-recommended go-to lotion for healthcare workers is Aquaphor, but you can use pretty much any moisturizing lotion or skin cream that you have on hand. The key is the moisturizer more than anything.

Finally, consider carrying an antihistamine with you just in case. Something like cetirizine is a good choice. The typical Benedryl can make you drowsy and shouldn't be used if you're out and about, and you shouldn't need something like an EpiPen for a low-level allergic rash. Something like cetirizine can help dull the itching while you look for an alternative to your current hand sanitizer.