The Pros and Cons of Alcohol-Free Hand Sanitisers

Most alcohol-free products available today come in a water-based foam. The products contain the active ingredient Benzalkonium Chloride, a quaternary ammonium. Unlike alcohol-based products, alcohol-free hand sanitisers often contain less than a 0.1% concentration of Benzalkonium. They still provide the same level of protection. The rest of the solution is mainly water and will often be enhanced with skin conditioners such as vitamin E and green tea extract. It’s non-flammable, and the low concentrations of Benzalkonium make it relatively non-toxic. However, these products are all recommended for external use only.

Alcohol-free hand sanitisers entered the market to address the concerns and complaints of gels. In many ways, they have succeeded. Typically, these solutions are much easier on the hands. They also pose much less of a threat in cases of accidental ingestion. Alcohol-free hand sanitisers are a low fire hazard and are non-damaging to surfaces. One other clear benefit is the extended protection that occurs. Alcohol-based product’s ability to kill bacteria ends once the product has dried on the skin, but benzalkonium-based products continue to provide protection well after the solution has dried.

Despite some clear benefits, alcohol-free based products have yet to gain real traction in the health market. Alcohol-based gels continue to be favored by health organizations, and therefore seen as a more credible solution by many in the field. It's not that these organizations don't recognize the effectiveness of benzalkonium based solutions. The term "alcohol-free" could apply to any number of products on the market. It's a broad term that makes it impossible for agencies like the CDC and WHO to endorse.

Table 1. Active Ingredients and Their Working Concentrations Effective Against Coronaviruses

S/N	Active Ingredient (A.I.)	Contact Time (min)
1	Accelerated hydrogen peroxide (0.5%)^a	1
2	Benzalkonium chloride* (0.05%)^b	10
3	Chloroxylenol (0.12%)^c	10
4	Ethyl alcohol (70%)^d	10
5	Iodine in iodophor (50 ppm)^b	10
6	Isopropanol (50%)^b	10
7	Povidone-iodine (1% iodine)^d	1
8	Sodium hypochlorite (0.05 – 0.5%)^{d, e}	5
9	Sodium chlorite (0.23%)^b	10

*Alternative name: alkyl dimethyl benzyl ammonium chloride

Source (https://www.nea.gov.sg/our-services/public-cleanliness/environmental-cleaning-guidelines/guidelines/interim-list-of-household-products-and-active-ingredients-for-disinfection-of-covid-19)