Toxicity of chemical-based hand sanitizers on children and the development of natural alternatives: a computational approach

Crit Rev Toxicol. 2023 Dec;53(9):572-599. doi: 10.1080/10408444.2023.2270496. Epub 2023 Dec 5.


The unintended exposure of children to hand sanitizers poses a high risk of potentially fatal complications. Skin irritation, dryness, cracking, peeling, hypoglycemia, apnea, and acidosis are examples of unintended consequences of hand sanitizer. The sanitizer reportedly kills normal microbial flora on hands, which usually promotes innate immunity among children under 12. Children are more susceptible to the toxicity associated with the chemical constituents of marketed chemical-based hand sanitizers; however, the studies to develop sanitizer formulations for children are rudimentary. The adverse events limit the use of hand sanitizers specifically in children because of their sensitive and delicate skin. Additionally, it is reported that many chemical-based hand sanitizer formulations, especially alcohol-based ones may also contain contaminants like methanol, acetaldehyde, benzene, isopropanol, and ethyl-acetate. These contaminants are found to be hazardous to human health exhibiting toxicity on ingestion, inhalation, or dermal exposure, especially in children. Therefore, it is important to design novel, innovative, safer sanitizer formulations for children. The study aims to discuss the toxic contaminants in chemical-based sanitizer formulations and propose a design for novel herbal formulations with minimal toxicity and adverse effects, especially for children. The review focuses on ADMET analysis of the common contaminants in hand sanitizers, molecular docking, Lipinski's rule of five analysis, and molecular simulation studies to analyze the efficacy of interaction with the receptor leading to anti-microbial activity and drug-likeness of the compound. The in silico methods can effectively validate the potential efficacy of novel formulations of hand sanitizers designed for children as an efficient alternative to chemical-based sanitizers with greater efficacy and the absence of toxic contaminants.

Keywords: Hand hygiene; adverse effects; children; contaminants; docking; molecular simulation; novel formulation; sanitizers; toxicity.

Publication types

  • Review

MeSH terms

  • Acetaldehyde
  • Child
  • Ethanol
  • Hand Sanitizers* / chemistry
  • Humans
  • Methanol
  • Molecular Docking Simulation


  • Hand Sanitizers
  • Ethanol
  • Methanol
  • Acetaldehyde