Is Washing Hands with Water Alone Worse Than Not Washing?

Q: Is Washing Hands with Water Alone Worse Than Not Washing?

Dear Mr. <br>Paul：<br>1. <br>The surface of our skin naturally harbors a variety of bacteria; the air and environment are also filled with various microorganisms and spores. <br>When these settle on our skin, they can germinate or proliferate in suitable conditions (including tem

Regarding handwashing and bacteria/viruses?

Hello, doctor.
I would like to ask you about something I've seen in the news and read in various sources.
They say that washing hands with just water is equivalent to not washing them at all, and that if hands are not dried properly, there could be even more bacteria and viruses than before washing.
So, after using the restroom or engaging in any activity that dirties the hands, wouldn't washing with just water be worse than not washing them at all? This seems illogical to me, or is the actual situation really like this? This issue has been quite troubling for me.
Thank you for your help.

Paul, 30~39 year old female. Ask Date: 2022/08/20

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Paul:
1.
The surface of our skin naturally harbors a variety of bacteria; the air and environment are also filled with various microorganisms and spores.
When these settle on our skin, they can germinate or proliferate in suitable conditions (including temperature, humidity, nutrients, sebum, etc.).
In fact, our skin surface should not be "too clean." If we frequently use hot water and cleansers on our skin, leading to the loss of sebum and a significant reduction in normal bacterial flora, it can sometimes trigger conditions such as atopic dermatitis, xerotic eczema, winter itch, or dishydrotic eczema.
Additionally, if women excessively wash the vagina or perineum, altering the vaginal pH or normal flora, it can lead to vaginitis.
2.
Washing hands with plain water and rubbing them is a physical cleaning method that can effectively remove some bacteria and dirt.
Using alcohol-based hand sanitizers (around 70%) can also eliminate a portion of bacteria or viruses.
When using household soap, the added chemical ingredients and alkaline properties not only remove the skin's oils but also clean some microorganisms that plain water or alcohol cannot eliminate.
Healthcare professionals must use disinfectants, water, and soft brushes to scrub their hands before surgeries, which is a more stringent requirement.
Therefore, due to varying environmental or occupational needs, hand hygiene requirements differ.
It is generally recommended for the average person to wash their hands with soap before meals or when there is a potential exposure to pathogens; there is no need to adhere to the high standards of surgical handwashing (in fact, many surgeons and nurses in operating rooms have rough skin on their hands).
3.
Regarding the statement, "I read in the news or researched that washing hands with plain water is equivalent to not washing them at all, and that if hands are not dried, there may be more bacteria and viruses than before washing," I would like to explain that the number of bacteria on the skin surface of the hands may be relatively low due to dryness.
However, when exposed to water, these bacteria can become activated and proliferate significantly, especially if the hands are not dried afterward.

Reply Date: 2022/08/20

More Info

Washing hands is a critical practice for maintaining hygiene and preventing the spread of infections. However, the effectiveness of washing hands with just water is a topic of debate. To address your question, it is essential to understand the mechanics of handwashing and the role of various cleaning agents.

When you wash your hands with water alone, you may remove some dirt and debris, but you are unlikely to eliminate a significant number of pathogens, such as bacteria and viruses. Water can help dislodge some particles from the skin, but it does not have the surfactant properties that soaps possess. Soaps contain molecules that can bind to both water and oil, allowing them to lift and wash away oils, dirt, and microbes more effectively than water alone.

Research has shown that washing hands with soap and water is significantly more effective at reducing the number of pathogens on the skin compared to washing with water alone. In fact, studies indicate that washing with soap can reduce the presence of harmful microorganisms by up to 90%. On the other hand, washing with just water may not only fail to remove pathogens effectively but could potentially lead to a false sense of security. If hands are not dried properly after washing, moisture can create an environment conducive to bacterial growth, which may lead to an increase in microbial load.

In situations where soap and water are not available, using an alcohol-based hand sanitizer (with at least 60% alcohol) is a recommended alternative. Hand sanitizers can effectively kill many types of germs, although they may not eliminate all types of germs, especially if hands are visibly dirty or greasy.

Regarding your concern about washing hands after using the restroom or engaging in activities that may expose your hands to pathogens, it is crucial to use soap and water whenever possible. If you find yourself in a situation where only water is available, it is still better to wash your hands with water than not to wash them at all. However, it is essential to follow up with proper hand hygiene practices, such as using soap as soon as it is available.

In summary, while washing hands with water alone is better than not washing at all, it is not as effective as using soap. The best practice is to wash your hands with soap and water, scrub for at least 20 seconds, and dry them thoroughly. This method significantly reduces the risk of infection and helps maintain overall health. If you have concerns about hand hygiene or specific situations that may pose a risk for infection, consulting with a healthcare professional can provide personalized guidance and recommendations.

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