Antibacterial Soaps Do More Harm Than Good: Australian Medical Experts

A person washes their hands with soap. Gang Liu/Shutterstock

The widespread use of antibacterial hand wash and hand sanitisers, promoted as a prevention measure against COVID-19, will lead to a rise in superbugs that cause untreatable diseases, Australian biomedical experts warn.

Researchers from Monash University are urging the public to stop using soaps labelled as “antibacterial” when washing hands because they could lead to antibacterial or anti-microbial resistant (AMR) bacteria.

“If I wash my hands constantly with antibacterial or antimicrobial soaps, the microbes that live on my hands will be constantly barraged by antimicrobials, and they’ll become superbugs,” said Professor Trevor Lithgow, director of Monash’s Centre to Impact AMR. “So I end up carrying superbugs with me wherever I go.”

“Then, if I cut my hand in the garden, the thing that goes into my bloodstream is whatever was on my hands at the time, and if those are drug-resistant bacteria, it doesn’t matter how fast I get to hospital, I have an untreatable infection,” Lithgow said.

A review on AMR commissioned by the UK government in 2014 reported that superbugs could lead to 10 million deaths by 2050, which was echoed by the United Nations (UN) and World Health Organisation (WHO) 2019.

A PhD student at Melbourne's Doherty Institute inspects the superbug Staphylococcus epidermidis on an agar plate in Melbourne on September 4, 2018. WILLIAM WEST/AFP via Getty Images

In 2016, the U.S. Food and Drug Administration (FDA) banned 19 active ingredients found in antibacterial hand wash after ascertaining no evidence that the added ingredients were more effective than regular soap.

“Consumers may think antibacterial washes are more effective at preventing the spread of germs, but we have no scientific evidence that they’re any better than plain soap or water,” said Janet Woodcock, the director of the FDA’s Center for Drug Evaluation and Research. “In fact, some data suggests that antibacterial ingredients may do more harm than good over the long-term.”

Monash’s AMR research team agrees with Woodcock, saying the science “unequivocally” supports the statement.

Lithgow believes the only purpose the “antibacterial” label serves is for marketing purposes that exploit current consumer concerns around COVID-19.

“[The label] makes people think it’s a better product,” he said. “The thought is, ‘I want my hands to be sterile, so I use antibacterial soaps. But it’s a false logic, and a misunderstanding people have.”

Bottles of antibacterial soap are seen on a grocery store shelf on December 17, 2013, in Miami, Florida. Joe Raedle/Getty Images

Lithgow wants a new public health campaign on handwashing that centres on what products to use in the face of these issues.

“The message is not how to wash your hands,” he said. “It’s what to wash your hands with.”

“The message is: soaps are good. Keep using them. Keep washing your hands,” Lithgow said. “But antibacterial additives in soap are not good. You don’t need them, so don’t buy the soaps that include them.

Antibacterial Ingredient Concerns

The most prominent ingredients in antibacterial soaps are triclosan and triclocarban. These are two of the 19 ingredients banned by the American FDA.

Triclosan is also added to toothpaste, cosmetics, dishwater detergent, furniture, and more, with researchers finding around 75 percent of all Americans would likely be exposed to this chemical through consumer goods alone.

Originally thought to be a general antimicrobial chemical, many studies, including one by the American Society for Microbiology (pdf), have found that bacteria exposed to triclosan can become resistant to triclosan and show cross-resistance to antibiotics.

Most concerns around chemicals like triclosan are not around its immediate effects but rather the long-term effects.

A bottle of antibacterial soap contains the active ingredient triclosan on December 17, 2013, in Miami, Florida. Joe Raedle/Getty Images

After using products with triclosan, it is washed down the sink and goes into the environment or back into waste-treatment plants, and because of its antibacterial nature, it is resistant to the waste-treatment process, which is rich in bacteria and can lead to cross-resistance to relevant medication.