Are Antibacterial Gels and Their Ingredients Safe with Frequent Use?

What's in antibacterial gels?

Antibacterial gels and hand sanitisers are one of the most widely used categories of hygiene products. Antibacterial gels typically contain one or more active ingredients with a biocidal action, supplemented by conditioning agents and substances that create the gel-like texture. The most common active ingredients include:

• Ethyl alcohol (Ethanol) — at a concentration of 60-80%, it mechanically denatures the proteins of bacteria and viruses
• Isopropyl alcohol (Isopropanol / Propan-2-ol) — a similar mechanism, often used interchangeably or in combination
• Octenidine (Octenidine Dihydrochloride) — a cationic antibacterial agent that is also active against fungi and certain viruses
• Benzalkonium chloride — a quaternary ammonium salt that acts as both a preservative and an antibacterial agent
• Triclosan — historically popular, but now restricted under EU regulations

Alcohol — damage to the skin with frequent use

The main active ingredient in most gels is alcohol, usually ethanol at a concentration of at least 60%. Alcohol effectively eliminates bacteria and viruses, including SARS-CoV-2, as confirmed by the WHO. However, with intensive daily use it can lead to:

• Skin dryness and damage to the epidermal lipid barrier
• Irritation, redness and a burning sensation
• Flare-ups of existing inflammatory skin conditions (atopic dermatitis, psoriasis)
• Chronic contact dermatitis in people working in the healthcare sector

This is why good-quality antibacterial gels contain moisturising and conditioning substances — glycerine, aloe vera, panthenol — which partly offset the drying effect of alcohol. It's worth looking out for these ingredients when choosing a product.

Octenidine — safety profile

Octenidine dihydrochloride (INCI: Octenidine Dihydrochloride) is an ingredient used primarily in medical preparations (Octenisept) and some antibacterial cosmetics. Unlike alcohol, it works at lower concentrations (0.1-1%) and has a broad spectrum of activity.

The safety profile of octenidine is well documented:

• The SCCS and regulatory authorities consider it safe for use on the skin at approved concentrations
• It is not classified as a carcinogen, mutagen or reproductive toxicant
• It carries a low risk of contact sensitisation — significantly lower than, for example, some preservatives used in conventional cosmetics
• Key limitation: octenidine is toxic if swallowed and if injected into tissue (this primarily concerns its medical use). Applied externally to the skin, it is safe

If you are prone to allergic reactions to cosmetic ingredients, check the available information in the PurScore ingredient encyclopaedia.

Triclosan — its regulatory history

For years, triclosan was one of the most popular antibacterial ingredients in soaps, toothpastes and gels. However, EU Regulation 1223/2009 restricted its use in cosmetics to a concentration of 0.3% and only in selected product categories (toothpaste, hand soap, body soap, deodorant, mouthwash, powder and corrective foundation). The reasons are concerns about its potential endocrine-disrupting properties and its contribution to bacterial resistance.

As a result, triclosan in hand sanitiser gels is now rare in European products, and many manufacturers have voluntarily phased it out.

Antibiotic resistance — myth or real threat?

A common concern is that using antibacterial gels promotes the emergence of resistant bacterial strains. The WHO and the ECDC (European Centre for Disease Prevention and Control) emphasise that:

• Alcohol, as a biocidal ingredient, works physico-chemically — it denatures proteins. This mechanism does not generate resistance in the way antibiotics do
• The risk of resistance is higher with regular use of products containing triclosan and other ingredients that activate specific genetic pathways in bacteria
• For healthy people using alcohol-based gels daily, the risk of cultivating resistant strains is marginal

It's worth remembering, though, that soap and water are equally effective in many situations and gentler on the skin. Antibacterial gels are essential when there is no access to a sink — they don't have to replace traditional handwashing in every situation.

For whom might antibacterial gels be problematic?

People who are prone to contact allergies or have atopic dermatitis may react to the ingredients in gels — both to alcohol and to soaps and other hand products containing similar irritating substances. In such cases, it's worth choosing products with a minimal ingredient list or consulting a dermatologist before long-term use. You'll find a comparison of different cleansing agents in our rankings of the best-rated products.

Note: this article is for informational purposes only and does not constitute medical advice. In the event of allergic reactions or irritation, consult a dermatologist.

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