Reconsidering the Seemingly Simple Act of Washing Our Hands

The tidal wave of handwashing that has occurred since the arrival of the novel coronavirus has constituted a pretty significant change in our lives. We’re all spending more time at the sink and becoming increasingly weary of singing the "Happy Birthday" song. (In fact, when you sing the "Happy Birthday" song at a kid’s party, watch to see if you are unconsciously rubbing your hands together, à la Lady Macbeth).  

However this raised consciousness around handwashing is actually a very good thing, as frequent handwashing with soap is essential for removing germs, avoiding illness and preventing the spread of germs to others. The CDC was recommending handwashing as the “do-it-yourself vaccine” way before Covid. In fact, studies done by the U.S. military have demonstrated that “handwashing with soap prevents disease in a more straightforward and cost-effective way than any single vaccine or medical treatment.” 

All that lathering leads to other questions: what is the impact of frequent washing on our skin — might we be compromising its ability to protect us by stripping it of the natural oils that act as a protective barrier? If the skin becomes very dry, or even cracked, might tiny fissures provide an entryway for pathogens? 

There are methods to prevent that which we will discuss, but before we proceed we should emphasize that our recommendations are based on hand washing only. We still recommend that you limit face washing to no more than 1-2 times daily. You don’t even have to use a cleanser — yoghurt with a water rinse or just rinsing with water only are fine for the most part. If you are exposed to a lot of grime, you may want to use an oil or gel cleanser at the end of the day.

The routine is different for washing your hands because of the way soap, and only soap, works to break down and carry away dirt, grime, grease and microorganisms. It really was a marvelous invention.

Soap and How It Works

Humans invented this novel cleaning agent thousands of years ago (the first evidence was found in ancient Babylon in 2800 BCE).  Combining fat or oil with an alkaline such as lye, a caustic salt whose chemical name is sodium hydroxide (NaOH), produces soap. The process is called saponification.  

Under ordinary circumstances oil and water don’t mix. Emulsifiers change all that — they can hold oil-loving (lipophilic) and water-loving (hydrophilic) substances together. Soap acts as an emulsifier; and when you mix soap with water it creates an emulsion by forming micelles. These micelles form an aggregate, with their water-loving tails pointing outwards into the solvent (in this case water), while the oil-loving tails point inwards, sequestering the oils.

This means that while washing your hands with water won’t clean them very well, adding soap makes all the difference. By mixing soap and water, you’ve created an emulsion that carries away not just grease and grime, but the microorganisms that stick to it. As an added bonus, research has shown that viruses (including the coronavirus) are self assembled nanoparticles in which the weakest link is the lipid bilayer. Soap dissolves the fat membrane and the virus falls apart.  

So when you wash your hands with soap, the main thing you’re doing is collecting the germs present on your hands and removing them — from your body, your household and your community. 

Washing Your Hands Do's and Don'ts

With the ‘why’ of handwashing resolved, let’s move on to the ‘how.’  

1. Washing hands properly requires soap and a small amount of water. You do not need running water — just enough clean water to rinse your hands is fine. (We’ll go into why carrying hand washing supplies is superior to hand sanitizers in a minute.)
   
2. Cover wet hands with soap — bar soap is preferable because it is more alkaline than liquid soap, but either will do — then scrub all surfaces, including palms, back, between the fingers and under the fingernails for twenty seconds, and finally, use a cloth or wave your hands in the air to dry them. You can carry your hand washing materials with you anywhere you go — a small bar of soap and a bottle, can or thermos of water for rinsing is sufficient.
3. Avoid detergent — detergents are similar to soap in their cleaning action, but they are mixtures of surfactants that can irritate skin. Liquid soaps can also contain surfactants that increase the sudsiness, so stick to the mild surfactants like caprylic/capric triglycerides and cocamidopropyl betaine, and best to stay away from detergents and soaps containing surfactants like SLS (sodium lauryl sulfate) and SLES (sodium laureth sulfate).

Best Practices

Do:

• Use bar soap — it is more alkaline than liquid soap, but liquid soap is your next best alternative. (But again, don’t use bar soap on your face.) Bar soap is also a better choice from an environmental standpoint; you can purchase it without the pretty-but-wasteful packaging liquid soap comes in.
  
• Keep it simple — all soaps are equally effective at removing bacteria and viruses that cause disease, but the reason soap is effective is because it is an emulsifier that carries off dirt and germs — it’s NOT ABOUT the chemicals, natural herbs or essential oils used, or any antibacterial claims. Stay away from fragranced soap as well. Just the plainest bar soap you can find is the one you want — and one that contains glycerin to keep your hands from drying out.
  
• Wash your hands after using the toilet, after sneezing or coughing and before handling food. If you go out for short trips, like to the store, wash your hands as soon as you get home. For longer outings where you feel like you need to wash before returning home, use the soap and water you have had the foresight to carry with you.
  
• Try not to touch your face when you are away from home and in between washings — it’s the transference of germs to nasal/mucous membrane passages that spreads infection.   

Don’t:

• Don’t use hand sanitizers. Unlike soap and water, they are simply not effective at removing all germs. They contain alcohol and are required to be at least a 60% alcohol solution, so overuse will dry your hands out and may cause cracking. Dry, cracked skin creates passages for pathogens to enter, so too much “washing” with alcohol can actually do more harm than good.
  
  
• Don’t use antibacterial soap. The FDA says there’s no evidence that antibacterial soaps are better at cleaning and there are chemicals in them that pose environmental and health risks. Triclosan, which used to be in anti-acne soaps and all the soap dispensers in hospitals, is a carcinogen, and while it has been banned for a while, watch out for its reappearance.
  
  
• Don’t use scented soaps. So many pitfalls to watch out for, but essential oils and fragrances are the number one cause of contact dermatitis. Too much handwashing with unsafe chemicals and fragrances will damage your skin and perhaps set up a pathway for microbial ingress, which is exactly what you don’t want. 

Post-Washing Care

Even though you have seen the light and aren’t destroying your hands with the above don’ts, you may still find that they are rather dry. Here are a few tips to alleviate dryness and improve hand skin health:

• Make a face and hand mask for yourself with yoghurt! For your face you can add a little bit of honey or a few squeezes of lemon for brightening. For your hands, try with just plain yogurt — you can add some oil to thicken such as Vitamin E or a few spoonfuls of dehydrated goat’s milk powder for extra nourishing. This is also fantastic for your gut lining (another type of skin) so make sure you save a little yogurt to eat!
  
  
• Rebalance pH. Ideal skin pH is around 4.5-5. Make a hand tonic with green tea, a splash of apple cider vinegar and a spoonful of honey, and use it each time you cleanse with soap. This will keep the pH in range and help soften the skin. After the tonic you can apply a lipid blend of sunflower seed oil and borage oil to replenish the lipid layer. If you need something to seal in moisture, you could finish with an occlusive such as shea butter, cocoa butter or coconut oil.