Various other products have also been examined, some of which utilize active ingredients such as quaternary ammonia salts and phenolic compounds, and are effective after 1 to 10 minutes of contact, depending on preparation (Table 1).5 While potent, these agents are relegated to surface decontamination of inanimate objects as they can instigate an inflammatory reaction in the mucous membranes as well as the skin.14 At this time, the more common agents used for handwashing are alcohol-derived products and classic soap and water. Alcohol-based disinfectants with a concentration between 50–90% function by disrupting requisite microbial cell membrane proteins and are highly efficacious in eliminating unwanted microbes.5 However, overexposure to alcohol-based disinfectants from repetitive applications can deplete the skin of necessary fatty acids, disrupting normal barrier function leading to irritant contact dermatitis.5 Soap and water are highly effective in decreasing microbial load, however their virucidal properties are highly dependent on the chemical composition of their fatty-acid components.5 While soap and water do not have the same risk profile for irritant contact dermatitis (unless used in excess) their usage is typically limited by access to running water.2,5
