Similar to the hygienic ritual required of surgeons, massage therapists find themselves washing their hands repeatedly throughout the day. With the rising popularity of hand sanitizers, some therapists are opting to rub an alcohol-based gel between their hands in lieu of scrubbing with soap and water. While hand sanitizers have revolutionized how we practice infection control, it may not always be the best choice for massage therapists.

Bodyworkers’ hands function as their primary tools. Because their tools are reused on each and every client, keeping their hands free of pathogens is a prerequisite to being a responsible therapist. Bodyworkers must wash their hands:

  • Before and after eating
  • Before and after using the restroom
  • Before and after each interaction with a client

That adds up to a significant amount of time at the sink as well as consumption of a lot of soap and water. In an attempt to minimize the cost and time of frequent hand washing, some therapists are choosing a quick spritz of hand sanitizer instead. Before choosing one method of hand cleansing over the other, make sure you know why washing with soap and water remains the standard procedure.

Hand Sanitizer Pros and Cons

Alcohol kills most pathogens. Thus, hand sanitizer’s high alcohol content will eliminate many types of bacteria and viruses. Alcohol has even proven effective against some dangerous forms of bacteria, like methicillin-resistant staphylococcus aureus (MRSA), which can cause the deadly and frightening flesh-eating bacteria.
Hand sanitizer is especially convenient due to its ease-of-use, portability and non-reliance on water. However, many are not aware of its limitations:

  • Hand sanitizer must have a minimum of 60 percent alcohol concentration to be effective. Some discount sanitizers and do-it-yourself preparations contain a lower concentration of alcohol. According to Scott Reynolds, a specialist in infection control at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, TN, hand sanitizer with an insufficient concentration of alcohol appears to mobilize bacteria, spreading them around the hand instead of killing them.
  • At least a dime-sized dollop should be scrubbed all over the hands for 30 seconds. If the sanitizer dries in less time, one likely did not use enough and should repeat the process.
  • Any breaks in the skin (including hangnails) can be aggravated by alcohol-based hand sanitizer with burning, itching or rash development.
  • While non-alcohol sanitizers are available, claims of their effectiveness are not as reliable as the alcohol-based gels.
  • Hand sanitizers do not effectively clean the hands when they are exposed to bodily fluids, especially blood or fecal matter.
  • Some individuals are sensitive to alcohol and will develop contact dermatitis from hand sanitizers.

Soap and Water

An integral element to any massage therapist’s routine, washing with soap and water remains the best way to cleanse hands of dirt, germs and other harmful substances. Just like hand sanitizers, hand washing also has demonstrated the ability to prevent the spread of MRSA. However, the following steps must be adhered to for optimal hand washing effectiveness:

  • Use warm water – not cold.
  • Use soap and work it into a thick lather. Research shows that both regular and anti-bacterial soaps are equally effective.
  • Rub hands with lather for at least 30 seconds covering every surface, including fingertips, beneath the nails and the base of the wrists.
  • Rinse hands thoroughly.
  • Dry hands with a towel.

Soap is an emulsifying agent, which means it is capable of dispersing oil in water. When people wash their hands, dirt and germs trapped in the natural oils of the skin are lifted and suspended in water. Body fluids or a massage lubricant could easily trap pathogens on a therapist’s hands. Thus, the old fashioned approach of hand washing is preferred by most health professionals because it physically removes such substances.

When it comes to efficiency, there is actually very little time difference between properly cleansing the hands with hand sanitizers vs. soap and water washing. Since half a minute is required for either cleansing method, only hand washing’s requirement of water (for lathering and rinsing) and a towel (for drying) make hand sanitizers more “convenient.” On the other hand, soap and water is better at removing bodily fluids from the hands than hand sanitizer.

At first thought, bodyworkers may think that hand sanitizers save them time during their requisite hand cleansing. However, further investigation shows that this assumption is not accurate. In addition, hand sanitizers may kill most types of bacteria and viruses but they are not sufficient for removing body fluids from the hands. Thus, the old-fashioned approach using water, soap and a towel remains the preferred way for massage therapists to achieve clean, hygienic hands.