Should I buy antibacterial soap?

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It's such a funny construct to imagine a soap that is friendly to bacteria and viruses. I love that so much. Hey there, I'm John Glynhill. This is Explain It To Me, your go-to hotline for all your unanswered questions. The new year's just begun, but some things never change. Like germs and all that they bring. Norovirus, colds, COVID, flu. And yeah, there's always lots of talk about new ways of fighting these diseases.

mRNA vaccines, virus-killing UV lights, fancy masks, HEPA filters. But today, we're going old school. We're answering this question a Vox.com reader wrote in, as read by our immensely talented producer, Sophie Lalonde. Why is some soap labeled antibiotic? Is there a soap that's friendly to germs and viruses? I thought the whole idea was to get rid of germs and viruses. To answer, we called up Karen Landman. She's a senior reporter here at Vox and covers health. Hello! Hello!

Before she entered the lucrative world of journalism, she was a doctor and epidemiologist. Karen, tell me about the kinds of stories you cover. Oh boy, I cover a huge range of things, but a lot of what I've been covering lately are... issues in health that are important to normal everyday people. So people who are on the internet and see recommendations from people on social media on what to buy or how to live, how to interact with the healthcare system.

do a lot of other stuff too but that's does that make sense is that the answer we're going for how many times do you think you've washed your hands today like five or six times Yeah. I fed the dog. So after feeding the dog, I washed my hands because who knows what's in her food. And then before I made lunch and then after I made lunch and then probably a couple of times after I used the bathroom.

Okay, so you are a doctor turned journalist, and I feel like that makes you an expert about the question we're going to be answering today. You'd be surprised. You know, I think a lot of doctors have a concept of soap that came up when they were either early in training or...

You know, just as sort of whatever their hospital asks them to do. And they may not, you know, they may still have a kind of antiquated sense of what the best cleaning material is to use at any given moment. I know I actually was surprised by what I found when I started looking into.

this so I wouldn't guarantee that uh that all doctors necessarily understand this uh as well as the real experts do on this but I'm I I appreciate your faith in our profession okay so What jumped out to you about this question?

It's such a funny construct just to imagine a soap that is friendly to bacteria and viruses. I loves it. I love that so much. But also, yeah, I distinctly remember looking at bottles of soap in a... store and being like antibacterial like like i have the same question myself like isn't also antibacterial isn't that kind of the whole point of soap is to get bacteria off your hands um

And I didn't, at that point, realize that so much of what soap does is actually mechanical. It's not murdering bacteria. It just kind of moves them to a different place. And it probably weakens them a little bit because of... the chemical makeup of the soap and how that interacts with the protective wall of a lot of bacteria and viruses. But it's not as murderous a material to those creatures as you might imagine.

How did you go about finding the answer? So I went back and looked at what the CDC's guidelines are on how healthcare workers...

should clean their hands because that's kind of the gold standard, right? Like people in a healthcare environment, they're the highest stakes for those people and the patients that they take care of if their hands are dirty because they're seeing people who are more likely to be infected with stuff and then they're going to see people who are... are more likely to develop a...

bad infection if they get infected with that stuff. So I looked at their guidelines, and then I looked back at old sets of guidelines to understand how this has changed over time. And it has changed over time. There was a time when we We felt like killing germs was worth any damage we had to do to our own hands. What time period are you talking about when you talk about that? I'd say probably like the 80s and maybe early 90s.

Okay. Yeah. And, you know, our understanding of good germs and how they're actually protective for us and our skin and the understanding that if it hurts to wash your hands or if it causes damage to your skin to wash your hands. hands, people aren't going to do it as much. So we need to make it comfortable and easy to wash our hands frequently in healthcare. But then we also need to make it comfortable and easy and safe to wash our hands.

This may seem very elementary, but first, what is soap and how exactly does it work? That is not as simple a question as you might think. Soap is originally plain soap. The soap that our ancestors used is traditionally made by combining ash with animal fat. Oh. Yeah. So if you want to, you can find directions online for making your own soap.

And it usually involves creating a bunch of ash by burning a bunch of something combustible, usually wood or something like that. And then purifying that ash by mixing it with water and then drying that out. And then mixing that with animal fat or another kind of fat. People make their own tallow soap and people can make their own olive oil soap. But what this basically does is it creates something that on the acid-base spectrum is pretty basic. And its chemical composition...

has basically a yin and yang kind of quality. Each molecule of the soap has one half that will bind easily to water and another half that binds easily to greasy stuff. So that makes it... good at binding to the grime that is on your hands or on your clothes or on anything. And then when you mix water into it, pulling that grime off and absorbing it into the water.

So it's kind of an emulsifier in a way, sort of like if you've ever made an olive oil and vinegar dressing and then whisked in something like an egg yolk or mustard and suddenly it all binds together. That's kind of what soap does for dirt and water. It kind of mixes the dirt up with the water so that the water can wash it away.

Oh, I feel like now I understand how oil cleansing also works. Thank you for explaining my skincare routine to me. I appreciate that. Happy to help. What's our goal when we wash our hands then? You know, like, what are we trying to do? You're trying to basically surround the bacteria with enough soap molecules that it gets slippery and slides easily off your hands when you rub them together under the water. So like the reader asked, why is some hand soap labeled antibiotic and others aren't?

first started coming up with antibacterial or antimicrobial or antibiotic soaps. They're usually called antimicrobial or antibacterial soaps. They included not just these ingredients of plain soap, but extra ingredients. that actually do break up the outer walls of bacteria and viruses and spill out all their guts, basically resulting in the death of that organism. They would use things like triclosan and...

triclocarbon and benzodiazepine chloride and all kinds of other, you know, alphabet soup type chemicals that you'd never heard of, but that had been found, proven to kill germs, right? Not just whisk them off your hands, which the plain soap part of the...

soap did, but murder them. And that seemed like a good idea, especially in healthcare, right? Yeah. Well, sometime around like 2010-ish, the... FDA started to get concerned about whether these added chemicals, these germ homicidal chemicals, were possibly actually bad for us. Oh. And part of the mechanism for that was they caused more irritation to the skin. And so people, after washing their hands a whole lot with these chemicals, would end up with tiny little...

breaks in their skin. And that created more opportunities for stuff that was in their hand wash to actually enter their capillaries and enter their bloodstreams in small amounts. And so the FDA looked at the data around whether having any amount of these chemicals in the bloodstream could result in a bad health problem. There's not a ton of human data on that, so they really had to look at a lot of animal data. But it did suggest that specifically with these chemicals triclosan and triclocarban,

they could be absorbed from the skin into the blood. And in animal studies, those chemicals had hormone-like effects on the thyroid and on sex hormones. Oh my gosh. Okay. Of like mice and rats, but still. Yeah, yeah, yeah, yeah, yeah, yeah.

I want to pause here for a second and talk about quantity. You know, when people do these studies with animals, they're usually not mimicking real world settings. A lot of times the amount that these animals are exposed to and the way they're exposed to them is... Nothing like the way you and I are exposed to soap when we wash our hands. But you know, the FDA doesn't always...

They're making rules that apply to the entire public, including people who do wacky stuff like fill an entire tub with soap and sit in it for a couple of days. And because the FDA can't be sure that's not. happening with any consumer product. They really have to make the most cautious law that keeps everybody, even people who do wild stuff, as safe as possible.

Why is some hand soap still labeled as antibiotic if the FDA's banned the use of a lot of antimicrobials? Right. So in 2016, the FDA banned... most germ-killing ingredients from these soaps, including triclosan and triclocarban. But they did find that there were a few of them that had been proven safe enough to use at home that they could stay in antimicrobial soap.

So even though I think they got rid of something like 19 or 20 of them, they allowed three of them to stay on the market. And those are benzalkonium chloride, benzothonium chloride, and chloroxy. And chloroxylinol. Chloroxylinol? Chloroxylinol. Chloroxylinol. I don't know how you say that word. So...

Now we know how these different types of soap work. Some make the germs go away, others straight up destroy them. Both are good strategies for ridding yourself of the dirt in your life. But which should we be using? and when. That's after the break. Go ahead and wash your hands a couple of times and we'll be right back. It's been reported that one in four people experience sensory sensitivities, making everyday experiences like a trip to the dentist especially difficult.

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Okay, Karen, give us the dirt on these different kinds of soaps. Like, should we even have antibacterial soap, especially since regular soap gets the job done and doesn't have any of these adverse effects? So, arguably, people do not need antimicrobial soap at home. When you see antimicrobial soaps used and when you see them... recommended to be used it's in a super super narrow range of settings that usually involve cutting into the human body

Just zooming out for a minute, day-to-day life, we actually need good bacteria around to outcompete the bad stuff. So we don't typically want to eliminate bacteria from our skin completely or from our insides completely. We need good bacteria. Surgery is a different animal because even a good bacteria in the wrong place inside the body, which you could only access through surgery, can cause a problem. So...

Surgeons before they go into surgery have to wash their hands and even under their fingernails and just really, really carefully with antimicrobial soap. People before they get surgery are often asked to wash their skin at home with antimicrobial soap. soap to reduce the load of any bacteria that they have and then you know when you are getting surgery one of the first things that the surgeon and everybody else in the room does before you have your surgery is they

clean your skin, they sterilize your skin as best they can with strong antimicrobial products. So we do still use those products on skin, but it's not in an everyday context. It's really just in a context where somebody is... is going to cut into your body. And if there is even a good bacteria hanging out on the skin anywhere near where that incision is, there's a high risk that it could cause a problem if it gets inside you. So they really want to limit that risk as much as possible.

There are not really many settings where you and I in our day-to-day life would necessarily need antimicrobial soap. Now, the thing that I have not said yet, but that I will say now, is that hand sanitizer is actually better than plain soap in almost all situations. The exceptions are important. I'll talk about them in a minute.

So it reliably kills stuff that is on your hands in a way that plain soap doesn't. So actually, for most applications, as long as your skin can tolerate it, we recommend using alcohol sanitizer rather than plain soap. Oh, wow. I know. Because it seems, I'm like, I like those hands washed, you know? I get it. It feels cleaner. Especially if you're like...

If you're about to make a meal, I'm like, I need you to get a little, let's get a little sudsy. I guess suds don't do anything either, but you know. Well, I mean, suds indicate that you are agitating. Your hands, right? You don't get suds if you're not rubbing them together. I'm sorry. I hope you can't hear me rubbing my hands together. No, we love ASMR. ASMR episode. Gross. My hair just stood on edit in a bad way. You were like, ugh. I'm the opposite of ASMR. Eddie Hoodle.

The question that I always have about hand sanitizer is like, where does the dirt go? This is a great segue into talking about the exceptions for like when you should not use hand sanitizer and instead use soap and water or maybe even, you know, double up and use soap and water and then.

hand sanitizer, although I think that's probably a little overkill. So if your hands have visible dirt, visible grime on them, wash them with soap and water. Because you're right, hand sanitizer, it might break them up. Break the bits of grime up, but it's not going to get it off of your hands the way soaping them up and washing them with water will. So, yeah, if you've just finished gardening, you know, without gloves and you've got hands covered with dirt, you can put a...

bunch of sanitizer on there and you know the dirt on your hands will probably have a lower bacterial load in it but there's still going to be dirt on there and then if you eat afterwards you will taste the grit and grime right so yeah so wash your hands after you do something

really nasty like that or if your hands are visibly soiled and actually before eating also it's recommended to wash your hands again for the same reason like it's not just that there is grit on your hands if you only sanitize a visibly dirty hand. So before eating, after using the bathroom, kind of similar reason. Yeah. And then when you're worried about contact with specific types of germs, so like norovirus, which is the germ that causes the most gastroenteritis.

Whenever you hear of somebody having a 24-hour stomach bug, it's almost always norovirus. There's a lot of it going around right now. That virus is not... killed by alcohol sanitizer, not reliably. So you need to use soap and water to wash your hands before and after contact with yourself or anybody else who might have norovirus. And C. diff, which is a common...

cause of diarrhea, often in people who've taken antibiotics or been hospitalized. That's another germ where we're not confident that an alcohol sanitizer is going to kill that. So if you ever have concerns, you've had contact with that, you want to be a situation. us about cleaning with soap and water. Okay. A question that I also wonder is how all this...

antimicrobial soap hasn't caused resistance. How do we not have super germs or at least like more super germs than we already have? Well, so that is another concern that the FDA had in mind when they decided to take a lot. of these antimicrobial soaps off the market. There were starting to see signs in several studies of people who use these products over the course of months to a year at home that they were evolving.

microbes with resistance to certain antibiotics not just the ones that were in the soaps but ones that were merely related to those antimicrobial products do we have to worry about germs developing resistance to regular soap? No. So because regular soap doesn't actually kill germs, you're not kind of putting the pressure on any one particular group of germs to evolve a better way to survive your onslaught with soap, right? So no, you don't have the same.

kind of what we call in science evolutionary pressure to adapt in new ways that will make those bacteria resistant to other antimicrobial chemicals. What should I look for when I go to the store for soap? Does it matter at all? I would just say buy the soap that to you feels best on your skin.

I don't think you need to be particularly fussy about which soap you buy for routine everyday use. Pretty much any plain soap is fine. You do not need to be particularly fussy about whether your soap or body wash, you know, it has certain ingredients. or doesn't. You know, you definitely do not need to reach for anything labeled antibacterial or antimicrobial. In fact, the CDC recently released guidance that says, you know, consumers really shouldn't be buying antibacterial soap.

to wash their hands during routine use. There's just not a great... situation that I can come up with where a consumer would need to use antibacterial soap at home. So I wouldn't really bother with that. I would make sure that the alcohol-based hand sanitizer that you're using is... has a high enough percentage that it will kill germs. And usually it'll say that on the bottle.

Where I would be maybe a little bit more careful with how you clean surfaces in particular is in the kitchen. So in the kitchen, and I mean, surfaces are kind of a different animal, right? You're willing to use harsher chemicals on a surface than you are on your...

skin. But even in the kitchen, you know, I talked to a food safety expert around Thanksgiving. And he said that even in the kitchen, you can and should use alcohol based sanitizer after handling Even poultry, unless your hands are super grimy and covered with fat, it's just going to do a better job at killing the salmonella that is in so much of our poultry.

The soap and water stuff will. So he recommends that, you know, if you've got hands covered in, sorry, chicken juice or turkey juice, that you use alcohol-based sanitizers to clean them rather than getting your faucets. dirty by touching them with a grimy hand. All right, Karen Landman, thank you so much for explaining this to us. Oh my God, thank you for having me on. It's always a treat to talk to you.

You can read Karen's stories about soap, about medication expiration dates, and about a whole bunch of other things regarding health on our website, Vox.com. We'll also include some links in our show notes. After the break, we have a sneak preview of some of your questions that we're tackling this year on Explain It To Me. Hey guys, it's Andy Roddick, former world number one tennis player, and now a podcaster. It's clay season in pro tennis, and that means the French Open.

On our show served with me, Andy Roddick, we have wall-to-wall coverage for the entire two weeks. We kick things off with a draw special presented by Amazon Prime, breaking down both the men's and women's brackets, making picks, and yeah, probably getting most of them wrong. Plus...

On June 3rd, my idol Andre Agassi is joining Served. Be sure to tune in. After that, we wrap all things French Open with a full recap show, also presented by Amazon Prime. That's June 10th. So be sure to find the show Served with me, Andy Roddick. on YouTube, or wherever you get your podcasts.

on the recent tariff turmoil and what he's watching as we head into second quarter earnings. This is going to be a contest between market resilience and economic resilience as to whether in fact the markets are overestimating the resilience of the economy. And that's what the actual numbers are going to deliver is maybe the economy and markets are a lot more resilient than we gave them credit for.

In which case, we'll come out of this year just like we came out of 2020 and 2022 with much less damage than we thought would be created. You can find that conversation exclusively on the Prof G Markets feed. Hey, it's Jonathan. I wanted to give you a little taste of what's coming up this year on Explain It To Me. As you know, we can't make the show without you. When you call 1-800-618-8545, we really do listen. Like...

to every single voicemail. Why do dads make dad jokes? What makes us want to make dad jokes? I never wanted to make dad jokes and then one day I just did. Hey guys, my question actually came from a conversation I had in traffic with my teenage daughter. We saw something happen, modestly criminal, and I said to her, you should make a citizen's arrest. Jokingly. But she had never really heard of that.

My question is, was that ever really a thing? Or is that just a TV writer trope? Or has anyone ever successfully made a citizen's arrest? I am also curious about women's reproductive rights. This was a huge issue for me when I went into the polls this year. So I'm curious how much this is really going to impact things from where they are today.

What on earth is going on with the implementation and enforcement of the real ID law? What on earth is happening in the last 20 years that this law keeps getting delayed? So keep calling with the questions that are most important to you. But from what I've read, the success rate is really low and the cost is super high, not to mention the physical and the mental toll it can take. That's the reality of it.

And our team of journalists here at Vox will keep reporting out the answers. There's just a lot of complexities out there when it comes to your reproductive life cycle and how that intersects with like your career and your social life cycle. And these things are.

like really hard right now and they're especially hard for a lot of women a lot of people that have uteruses and ovaries like it's difficult and I think for some people, egg freezing can be a tool, but I do think sometimes it's framed as this thing that's going to just magically take... all of your anxieties around balancing these complicated areas of your life away and like it's not going to do that.

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I had a conversation with writer and educator Eve Ewing on the show, and I wanted to share a little excerpt of it with you. I'm really excited to talk to you because I've admired your work for a really long time. Thank you. But I'm not going to lie, it was kind of hard to pin down what exactly to talk about. Because, like, girl, you do poetry, children's books, nonfiction, comic books, teaching, education policy and research, art. Is there a through line?

Oh, yeah. Like, how do you how do you think of all of your work kind of in conversation with one another? I think that part of why it feels overwhelming or confusing to people is that I work across a lot of different genres. And I think that a lot of people kind of define their work by the genre in which they write. And for me, I'm more interested in kind of like a...

connected set of questions. So I describe my work by saying some of my work is about the world as it is and how it got to be this way. And some of it is about the world as it could be and how we speculate to create something different. Most of what I do is in some way about...

thinking about Black liberation, dreaming about Black liberation through this kind of critical examination of the past, but then, you know, the dreamy, imaginative work of the future. And I also write a lot about Black girlhood and womanhood. But to keep it kind of... of a buck with you. The real thing is that I just like telling stories and I am kind of like too foolish to be too silly to be bound in by the idea that like, well, I've never written this type of thing in this way before.

Usually if it occurs to me, I'm just willing to give it a shot. Want to hear more? Join our membership program today at Vox.com slash members.

That's it for this episode of Explain It To Me. It was fact-checked by Caitlin Pincey Moog and edited by Jorge Just with mixing, sound design, and engineering by Andrea Kristen's daughter. Special thanks to Rob Byers. Our producer is Sophie Lalonde. Our supervising producer is Carla Javier. And I'm your host, John Gwynhill. Thanks again for listening. Thanks for calling. And thanks for supporting our show. Talk to you soon. Bye.