Hand Sanitizer Is a Newly Recognized COVID-19 Danger for Kids and Teens

By: Scott R. Schoem, MD, MBA, FAAP, and Kevin Borrup, DrPH, JD, MPA

With hand hygiene front and center during COVID-19, almost every family now has many individual small bottles or several bulk-size bottles of hand sanitizer sitting on counters, and easily accessible to toddlers and teens.

The danger? Hand sanitizer is meant to be applied topically, not swallowed. But there are growing reports from the National Poison Control Center of unintentional ingestion by toddlers – and intentional ingestion by teens.

Pediatric otolaryngologist Scott R. Schoem, MD, MBA, FAAP, associate director of surgical clinical services, and Kevin Borrup, DrPH, JD, MPA, the interim director of Connecticut Children’s Injury Prevention Center, join the blog to help families use this household item safely.

Why is hand sanitizer dangerous to ingest?

It’s dangerous to ingest any household products not intended for human consumption. For hand sanitizer, the biggest reason is a high alcohol content.

Hand sanitizers typically contain ethyl alcohol, isopropyl alcohol or benzalkonium alcohol (Purell and Germ-X). Ethyl alcohol hand sanitizers contain 60–65% ethanol.

This is a very high alcohol content, which can lead to alcohol poisoning. To put it into perspective, consuming an 8-ounce (240 ml) bottle of hand sanitizer is the equivalent of five shots of hard liquor.

What’s the danger for toddlers?

If a toddler licks and ingests some hand sanitizer, it will taste bad but not be toxic. Even if a toddler ingests one tiny squirt, it will not cause any serious injuries.

However, ingesting several squirts of hand sanitizer will make a toddler intoxicated. Too much can lead to vomiting, liver damage, low blood sugar, seizures, coma and death.

So keep hand sanitizer out of your child’s reach when it’s not in use. And be sure that adults are always supervising when toddlers and younger kids clean their hands with hand sanitizer (including at camp or day care).

What’s the danger for teenagers?

Since hand sanitizer has a high alcohol content, and is cheap, easy to purchase and has no age limit for purchase, it has become a popular choice for teens experimenting with substance abuse. Teens may intentionally ingest large quantities of hand sanitizer to get drunk – which can lead to serious medical outcomes including alcohol poisoning and death.

Hide and lock up large quantities of hand sanitizer in your house, and make sure your teen doesn’t have access to other potentially harmful household items like cleaning supplies and medications. If you’re concerned about your teen’s mental health, here’s what to look for, ask and do.

Which hand sanitizers should my family avoid? Which have been recalled by the FDA?

The Food and Drug Administration (FDA) has noticed an increase in the number of hand sanitizers that contain methanol, or wood alcohol, but which have been mislabeled as ethanol. 

It’s very important to avoid these products: Wood alcohol is toxic when absorbed through the skin, and life threatening if ingested.

Check FDA.gov for the list of hand sanitizers to avoid.

What should I do if I’m concerned for my child’s health?

If you have serious concerns, contact the National Poison Control Center at 1.800.222.1222 or check their website at poison.org.

If you or your child experience nausea, vomiting, headaches, blurred vision, or worse symptoms after using hand sanitizer, or a suspected ingestion, seek immediate medical treatment.

What’s a safer alternative to hand sanitizers?

Whenever possible, parents should remember that washing with soap and water for at least 20 seconds is your first line of defense before the use of hand sanitizers.

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