How effective are antibacterial products like soaps, hand cleaners and bleach?

Although the FTC doesn’t regulate the production or labeling of over the counter drugs, it does have a say in the way they are advertised.

And they can be just as fussy as the FDA when it comes to making claims about antibacterial products. A complaint the FTC filed against Unilever in 1999 is illustrative.

Unilever manufactures Vaseline Brand Intensive Care Antibacterial Hand Lotion. They advertised it as “antibacterial hand lotion” that “stops germs longer than washing alone” and “stops germs for hours.” The FTC cited several different print and TV ads that made these claims and maintained that Unilever had expressly or by implication said that:

A. Vaseline Brand Intensive Care Antibacterial Hand Lotion stops germs on hands longer than washing alone.
B. Vaseline Brand Intensive Care Antibacterial Hand Lotion provides continuous protection from germs for hours.
C. Vaseline Brand Intensive Care Antibacterial Hand Lotion is effective against disease-causing germs, such as cold and flu viruses.

The FTC begged to differ on all three claims. There is no scientific evidence that the lotion stops germs on hands longer than washing alone. Triclosan, the active ingredient in the hand lotion, can reduce the number of germs on a user’s hands, but the degree and duration of its effectiveness have not been established scientifically. And finally, triclosan has no effect whatsoever on viruses, which cause colds and flu, even though Unilever was implying that it does. The FTC viewed all this as false advertising and unfair or deceptive acts or practices in violation of various sections of the Federal Trade Commission Act.

After some discussion among Unilever lawyers and the FTC, Unilever, however reluctantly, began to see things the FTC way. Without admitting that they had ever done anything wrong in the past, they agreed in the future to stop doing those things they never admitted having done. They agreed to stop saying that:

A. Such product is as effective as, or more effective than, washing alone in protecting users against germs;
B. such product has a continuous effect against germs; C. such product has any effect on any specific germ;
D. such product treats, cures, alleviates the symptoms of, prevents, or reduces the risk of developing colds, allergies, influenza, food-borne illnesses, or any other disease or disorder.

Jodie Bernstein, director of the FTC’s Bureau of Consumer Protection, said in announcing the Unilever settlement, “No marketing claims will wash without adequate substantiation. That’s the law. And right now, there’s simply no evidence that using antibacterial lotion reduces the incidence of any disease. We want consumers to know that washing well with soap and water is as good as it gets when it comes to warding off disease-causing germs and protecting themselves from colds and flu.”

The label on Vaseline Brand Intensive Care Antibacterial Hand Lotion lotion still says “antibacterial,” since triclosan is still in there, but with the FTC having enforced all of the above, it would seem difficult for any company to make any claims at all about the beneficial effect in battling infection of any soap or hand lotion containing antibacterials.

Difficult, but not impossible. Ad copywriters have devised many ways of obeying the law while at the same time promoting good personal hygiene and implying that if you don’t use their product you will be proving yourself at best somewhat cavalier and irresponsible, and at worst a smelly, germ-infested social outcast.

The company that makes Suave Antibacterial Hand Sanitizer, for example, has a helpful “Frequently Asked Questions” section on their web page. “Do hand sanitizers work?” they ask. And they answer their own question, “Yes, using a hand sanitizer can help kill germs you come in contact with every day. To help reduce the number of germs on skin, carry a small tube in your purse or backpack to use when soap and water are not available.”

Notice that they say that it will reduce the number of germs on skin, but they don’t claim that this will improve your health any more than ordinary hand washing, because it won’t. Then they say it’s good to use it when you don’t have any soap and water. In other words, it’s better than nothing, but no better than ordinary soap. So, yes, antibacterial hand soaps “work,” but it is up to you to decide exactly how well. The active ingredient in Suave Antibacterial Hand Sanitizer is ethyl alcohol, a substance that will unquestionably kill certain bacteria on contact.

In addition to its antibacterial hand sanitizer, Suave also makes an antibacterial cake soap. It’s called Suave Antibacterial Deodorant Soap, and its antibacterial ingredient is triclosan. It also contains the following “inactive ingredients”: sodium tallowate, sodium cocoate or palm kernelate, water, fragrance, propylene glycol, sodium chloride, glycerin, disodium phosphate, trisodium EDTA, trisodium etidronate, BHT, FD&C red #4, D&C yellow #8, and D&C yellow #5.

Suave also makes a bar soap called Suave Refreshing Deodorant Soap. This one has every single inactive ingredient contained in the Antibacterial Deodorant Soap (except that it has green dye instead of yellow and red). The only thing it lacks is the triclosan. Suave sells the two different kinds of soap over the Internet for the same price: $2.50 for six bars. You get the triclosan for nothing, and it’s probably worth it.

There are several peer-reviewed studies of hand sanitizers, most of them carried out by employees of companies that manufacture the stuff. At least two studies show that using antibacterial hand sanitizers works better than not washing at all, but none I have been able to find that shows that antibacterial hand sanitizers are any more effective than ordinary hand washing.

One study shows that washing for 20 seconds with ordinary soap and water is more effective than a 70 percent ethyl alcohol hand sanitizer. Dial makes a hand sanitizer that is 62 percent ethyl alcohol, and GOJO Industries makes a hand sanitizer called Purell that is also 62 percent ethyl alcohol. Like triclosan, alcohol has no persistent germ-killing effect. Once it evaporates, its effect stops. Unlike triclosan, alcohol does not encourage the development of resistant strains of bacteria.

Ethyl alcohol sometimes presents a problem: it irritates the skin. In fact, that’s one of the warnings printed on the labels of alcohol-based hand sanitizers, if redness or sores appear on your skin, the label says, you should discontinue use and consult a physician.

The warning also says that the product will irritate your eyes, so you should keep it away from your face, and if you do get it in your eyes, you should wash them out immediately with clean water and get medical attention if the irritation persists. It also says that you should keep it away from flames, since alcohol is quite flammable. The label ends with a warning to prevent children from getting near it, something you might have already concluded after having read about its other qualities. One would think that most people would hesitate to use a hand-sanitizing product if told that it might irritate their skin and eyes to a point where they would have to call a physician, and that in addition it might under certain circumstances burst into flame.

There are many antibacterial products designed for cleaning kitchens, bathrooms, and other parts of the house. The Clorox Company is a large producer of such products. Their cleaning products contain a Clean-Up is recommended for kitchens and bathrooms.

Clorox Automatic Toilet Bowl Cleaner is designed for toilet bowls (“Just drop the tablet in your toilet tank, and with every flush, it will clean, deodorize and kill 99.9% of germs in the bowl water”). It also comes in a gel form that “sticks to the sides of the bowl while it cleans tough stains to leave the bowl sparkling clean and sanitary.”

For laundry use, the makers recommend Clorox Liquid Bleach, whose active ingredient, like all of the Clorox products, is sodium hypochlorite. Notice the strategic placement of the ® in the name of their liquid bleach, only the “Clorox” is registered. Sodium hypochlorite, or liquid bleach, can be sold by anyone and registered by no one, the sodium hypochlorite sold under the supermarket house brand name is no different from the chemical Clorox puts in its antibacterial cleaning products.

Chlorine bleach is, without doubt, an effective germ killer. It will even kill viruses, which is why it is used for cleaning up blood and body fluids that are potentially infected with HIV. The Clorox Company recommends it for cleaning your clothes; cleaning up a toilet backup; purifying drinking water; cleaning combs, brushes, coffeemakers, flowerpots and planters; sanitizing the kitchen sink, sponges, countertops, cutting boards, and dishcloths; cleaning the kitchen floor, stovetop, and trash cans; spraying on surfaces inside the refrigerator; and cleaning the tub, sink, toilet bowl, and floor in the bathroom.

They suggest sprinkling it in the kids’ sandbox and wading pool; using it to remove mold from steps, siding, tile, bricks, stucco, and stone; and applying it to any number of things that little kids touch in order to protect them from germs. If you did everything Clorox tells you to do with chlorine bleach, it seems, you’d have little time to do anything else and everything in and outside your house would smell like a swimming pool.

Of course, Clorox doesn’t specify exactly what good all of this will do for your health, since it probably will do little or nothing that routinely conscientious housecleaning wouldn’t do just as well.