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Antibacterial Soaps and Cleansers:
Are They Safe and Effective?

Take the Quiz

In the midst of the cold and flu season, we all want our immune systems functioning at their best. So we eat well, drink plenty of water and wash our hands frequently, often with the ubiquitous "antibacterial soap." But do these heavily marketed antibacterial cleansers offer any extra advantage over plain soap and water? And are they safe? Take this true or false quiz and test your knowledge against the research.

TRUE or FALSE: Families who use antibacterial soap get sick less often than families who use plain soap.
(show answer) (hide answer)   FALSE. In studies of households randomized to use antibacterial soaps versus plain soap over the course of a year, there was no significant difference in rate of infections. Antibacterials are NOT effective on viruses--which are the cause of illnesses such as colds and flu. Failure of the antibacterial cleansers to prevent the spread of illness may also be due to the fact that in order for most of the antibacterial products to work, they must remain on the surface for more than 2 minutes. Most consumers are simply not patient enough to use the products effectively. Regular soap and water do a fine job of lifting dirt and germs and rinsing them away especially if we accompany the use of soap and hot water with a reasonable amount of friction from rubbing the hands. The American Medical Association has opposed routine, household use of anti-bacterial soaps since 2002. The Canadian Pediatric Society has also recommended that parents to stop buying anti-bacterial products and instead use plain soap and water to wash toys, hands and household items.

TRUE or FALSE: Antimicrobial cleansers contribute to the mutations of superbugs - drug resistant bacteria.
(show answer) (hide answer)   Probably TRUE. Scientists believe the reason resistant strains develop is that when bacteria are faced with the stressor of being attacked by the active chemicals in the antibacterial products, they begin to mutate to resist against being wiped out. Researchers consistently find resistant strains of bacteria when they expose germs to antibacterial chemicals using in vitro tests in the lab, but they have been unable to show this same result in household tests. Dr. Stuart Levy, a leading researcher at Tufts University School of Medicine points out that we need further real world investigation and we may not be able to recreate this in a household situation because we simply are not giving a long enough exposure for the mutations to occur. After review of available research in 2002, Dr. Tan and colleagues concluded "the use of common antimicrobials for which acquired bacterial resistance has been demonstrated should be discontinued in consumer products unless data emerge to conclusively show that such resistance has no effect on public health and that such products are effective at preventing infection." While most researchers conclude that the use of antibacterial cleansers should be used very conservatively and judiciously, the causes for the mutations of superbugs is likely multifactorial.

TRUE or FALSE: Antibacterial cleansers biodegrade quickly and are safe for the environment.
(show answer) (hide answer)   FALSE. Nothing could be further from the truth. Triclosan and triclocarbon, the main chemicals used in antibacterial cleansers, are bioaccumulative. This means that they do not breakdown in wastewater and are not removed in water treatment. According to scientists at the Center for Water and Health at Johns Hopkins Bloomberg School of Public Health these chemicals are found in 60% of our fresh water lakes and streams. While the amounts may be minute, they may be enough to disrupt thyroid function. These chemicals are also found in most wastewater, fish and even breastmilk. Ick!

TRUE or FALSE: Antibacterial soaps & cleansers are associated with an increased incidence in allergies.
(show answer) (hide answer)   TRUE. Our immune systems need to be stimulated and challenged--by exposure to germs--to function properly. Regular use of cleansers such as antibacterials and antiseptics wipes out the healthy, helpful microbes that exist to help our bodies to fight the harmful bugs. There is evidence that too much hygiene, especially via the overuse of antibacterials, is a predisposing factor for the development of allergies and asthma.

What To Do

Good hand washing habits can prevent most disease according to the Mayo Clinic. Get in the habit of washing hands anytime they are visibly soiled, before and after eating, and after toileting. Making hand washing the first thing you do when getting home each day will significantly stop the spread of germs in your house. When someone in the house is sick, be sure everyone is washes hands and avoid sleeping in the same room with the infected person. Use plain soap and water to wash off commonly touched surfaces such as doorknobs, faucets, refrigerator handles and light switches.

Good hand washing technique: Wet your hands with warm, running water Lather up with a plain (preferably biodegradable) soap such as Mountain Girl Botanics. Rub your hands vigorously together for at least 15 to 20 seconds. Scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails. Rinse well. Dry your hands with a clean or disposable towel. Use a towel to turn off the faucet.

Conclusion

The use of antibacterial products in the typical household is unnecessary. Not only are they harmful to the environment and may possibly contribute to the mutation of resistant bacteria, they provide no demonstrable health benefit over plain soap and water.

Citations

Adolfsson-Erici, M., M. Peersson, J. Parkkonen, and J. Sturve. 2002. Triclosan, a commonly used bactericide found in human milk and in the aquatic environment in Sweden. Chemosphere 46:1485-1489

Aiello AE, Larson E. Antibacterial cleaning and hygiene products as an emerging risk factor for antibiotic resistance in the community. Lancet Infect Dis. 2003 Aug;3(8):501-6

Aiello AE, Marshall B, Levy SB, Della-Latta P, Larson E. Relationship between triclosan and susceptibilities of bacteria isolated from hands in the community. Antimicrob Agents Chemother. 2004 Aug;48(8):2973-9.

Aiello AE, Marshall B, Levy SB, Della-Latta P, Lin SX, Larson E. Antibacterial cleaning products and drug resistance. Emerg Infect Dis. 2005 Oct;11(10):1565-70.

Alliance for the Prudent Use of Antibiotics. http://www.tufts.edu/med/apua/.

Aviva Glaser. The Ubiquitous Triclosan, A common antibacterial agent exposed. Pesticides and You, Beyond Pesticides/National Coalition Against the Misuse of PesticidesVol. 24, No. 3, 2004.

Ballentyne, Coco. Strange but True: Antibacterial Products May Do More Harm Than Good: Antibacterial soaps and other cleaners may actually be aiding in the development of superbacteria. Scientific American, June 2007.

Braun-Fahrländer CH, Gassner M, Grize L, Neu U, Sennhauser FH, Varonier HS, et al. Prevalence of hay fever and allergic sensitization in farmer's children and their peers living in the same rural community. Clin Exp Allergy 1999;29:28-34.

Brown, J.M., 2005. Effectiveness of antibacterial hand soap and alcohol gel sanitizer to disinfect hands in the home. M.S. professional paper. Dept. Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.

Geraldo IM, Gilman A, Shintre MS, Modak SM. Rapid antibacterial activity of 2 novel hand soaps: evaluation of the risk of development of bacterial resistance to the antibacterial agents. Infect Control Hosp Epidemiol. 2008 Aug;29(8):736-41.

Levy, S. B. 2001. Antibacterial Household Products: Cause for Concern. Emerging Infectious Diseases 7(3, Supplement): 512-515

Matricardi PM, Rosmini F, Riondino S, Fortini M, Ferrigno L, Rapicetta M, et al. Exposure to foodborne and orofecal microbes versus airbone viruses in relation to atopy and allergic asthma: epidemiological study. BMJ 2000;320:412-7

Mayo Clinic Staff. Hand washing: An easy way to prevent infection. October 16, 2007.

Perencevich EN, Wong MT, Harris AD. National and regional assessment of the antibacterial soap market: a step toward determining the impact of prevalent antibacterial soaps. Am J Infect Control. 2001 Oct;29(5):281-3.

Rook GAW, Stanford JL. Give us this day our daily germs. Immunol Today 1998;19:113-6.

Strachan DP. Hay fever, hygiene, and household size. BMJ 1989;299:1259-60.

Sutton,Rebecca PhD, EWG Scientist; Naidenko, Olga PhD, EWG Scientist; Chwialkowski, Natalia EWG Intern; Houlihan, Jane Vice President for Research. Pesticide in Soap, Toothpaste and Breast Milk - Is It Kid-Safe? Summary & Recommendations. July 2008.

Tan LL, Nielsen NH, Young DC, Trizna Z; Council on Scientific Affairs, American Medical Association. Use of antimicrobial agents in consumer products. Arch Dermatol. 2002 Aug;138(8):1082-6.

U.S. Environmental Protection Agency. Reregistration Eligibility Decision and Risk Assessment for the Pesticidal Uses of Triclosan. October 2008.