The Food and Drug Administration (FDA) has recently identified problems related to hand sanitizer products. One is that some products are ineffective because of insufficient active ingredients. Hand sanitizers must contain at least 60% ethanol (ethyl alcohol) or isopropyl alcohol. Another is that many imported hand sanitizer products contain methanol, sometimes referred to as wood grain alcohol (the FDA has issued an alert to stop these products from coming into the country). Methanol can be toxic if absorbed through the skin or ingested. Adverse effects include nausea, vomiting, headache, blurred vision, permanent blindness, seizures, coma, permanent damage to the nervous system, and death. Emergency care should be sought immediately if methanol exposure and poisoning are suspected.

Nurses should teach parents of young children to keep hand sanitizers away from a child's reach. All patients should be taught to read the label carefully to confirm that the alcohol is isopropyl or ethanol, not methanol; however, some methanol-containing hand sanitizers do not list methanol on the label. Other ways to tell if a particular brand of hand sanitizer might be fraudulent include claims that the product prevents the spread of COVID-19 for prolonged periods (for example, 24 hours); claims that the product is "FDA approved" (there are no FDA-approved hand sanitizers); products packaged to appear like drinks, candy, or liquor bottles or marketed as drinks or cocktails. The full list of products to avoid can be found at http://www.fda.gov/drugs/drug-safety-and-availability/fda-updates-hand-sanitizer. Patients should be encouraged to wash their hands frequently for 20 seconds with soap and water whenever possible, especially if they are not sure about the safety of their hand sanitizer product.

Report adverse effects or quality problems with hand sanitizers to the FDA MedWatch program: http://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-repo.