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Antibacterial Soap

The FDA’s ruling on antibacterial soaps

Kid washing hands with mom in the bathroom.On September 1, 2016, the FDA issued a ruling that bans the use of 19 chemicals in antibacterial soaps, including the popular chemicals: triclosan and triclocarban. “There’s no data demonstrating that over-the-counter antibacterial soaps are better at preventing illness than washing with plain soap and water, “ the FDA said in a press release after the ruling was announced. Companies using these agents have a year to take these chemicals out of their antibacterial soaps or take these products off the market.

The 19 chemicals that are banned are the following: Cloflucarban, Fluorosalan, Hexachlorophene, Hexylresorcinol, Iodine complex (ammonium ether sulfate and polyoxyethylene sorbitan monolaurate), Iodine complex (phosphate ester of alkylaryloxy polyethylene glycol), Nonylphenoxypoly (ethyleneoxy) ethanoliodine, Poloxamer-iodine complex, Povidone-iodine 5 to 10 percent, Undecoylium chloride iodine complex, Methylbenzethonium chloride, Phenol (greater than 1.5 percent), Phenol (less than 1.5 percent) 16, Secondary amyltricresols, Sodium oxychlorosene, Tribromsalan, Triclocarban, Triclosan, and Triple dye.

What is the reasoning for this FDA ban?

In December 2013, the FDA proposed a rule that would require manufacturers of antibacterial soaps and washes to provide substantial data demonstrating the safety and effectiveness of antibacterials containing agents such as triclosan or triclocarban. Why? The latest data suggests that the risks associated with long-term, daily use of antibacterial soaps may outweigh the benefits. Since the FDA made that announcement in 2013, many companies began to phase out these banned chemicals. Of note, the popular antibacterial Dial soap is still using triclosan as its active agent. Companies began replacing the banned chemicals with benzalkonium chloride, benzethonium chloride or chloroxylenol (PCMX). The FDA is demanding proof for better efficacy with these chemicals as well- demanding for companies to show that washing for 20 to 30 seconds with products with these chemicals is better than using simple soap and water.

Having antibacterial agents, which should further rid of bacteria, in soaps and washes sounds like a great idea, but is it really? Historically, antibacterials were commonly found in healthcare environments and hospitals as hand sanitizers to slow the spread of germs. However, starting in the 1990s, the general population became exposed to the wide availability of antibacterials commonly found in soap, body washes, detergents, and household cleaning agents. About 75% of antibacterial hand washes contain antibacterial-agents containing triclosan. It seemed like a good idea, but again, is it really?

Here are the 2 prominent concerns with antibacterial soaps:

  • Killing off good bacteria and creating worse bacteria: Let’s first understand the technicalities of antibacterials. There are 2 types of antibacterials- non-residue producing (antibacterial agents that evaporate such as chlorine, alcohol, peroxide) and residue producing (substances that leave residue to have prolonged action such as triclosan, benzalkonium chloride). Non-residue producing agents such as alcohol kill bacteria quickly since they globally kill bacteria immediately and effectively. On the other hand, residue-producing agents such as triclosan tend to target specific parts of the bacteria and thus could lead to more resistant bacteria or triclosan mutant bacteria. With this understanding in mind, the concern is that we are killing off potentially good bacteria and possibly increasing the production of worse, resistant bacteria.
  • Triclosan is bad for both the body and the environment. A good percentage of antibacterial hand washes contain triclosan, an ingredient of concern to many environmental groups. Triclosan gets washed away and ends up in our sewage plants and water sources. Bottlenose dolphins off the coast of Florida and Carolinas were found to contain traces of triclosan, and it was found in the bile of other fish. Animal studies have shown that triclosan may alter the way hormones work in the body. Even though animal studies are dissimilar to human studies, the FDA notes the hormone concern and considers it a potential In addition, laboratory studies demonstrate the possibility that triclosan contributes to making bacteria resistant to antibiotics. Resistant bacteria are a huge concern because that means certain antibiotics may not kill off bacteria as they should.

Final recommendations are these:

  • 70% alcohol, bleach or peroxide is the best at killing bacteria because each attacks the entire component of bacteria and not a specific part of bacteria. If you choose to continue using hand sanitizer, look for these as the active ingredients.
  • Outside of hospitals and healthcare environments, the CDC recommends the old-fashioned hand washing: wash your hands with conventional soap and water. Remember that alcohol from hand sanitizer kills bacteria, but it doesn’t physically remove dirt or anything else you may have touched. A 20 to 30 second hand wash with soap is best at removing both the dirt and bacteria.