We’re not against cleanliness — we’re for smarter hygiene.
At Fishtown Medicine, we believe soap and water is still the safest, most effective way to clean your hands — especially when it comes to protecting your long-term health, immune system, and microbiome.
Hand sanitizers have their place. But overusing them — especially instead of washing — can carry risks we don’t always see right away.
🧼 Why we recommend soap and water first:
Physically removes dirt, microbes, and toxins
Doesn’t disrupt your skin microbiome
Leaves no residue or chemical film
Reduces risk of skin irritation and inflammation
Supports immune system development (especially in kids)
Soap + water = clean and biologically wise.
⚠️ Why we limit hand sanitizer:
1. It doesn’t remove everything
Sanitizers don’t remove:
Norovirus
Cryptosporidium
C. diff
Pesticides or heavy metals
Mucus, grease, or dirt
They kill some germs — but not all. And they can’t clean off physical contaminants.
2. It can damage your skin barrier
Alcohol-based sanitizers can cause:
Dryness
Cracks
Micro-injuries
Increased skin sensitivity
This makes it easier for irritants and allergens to enter the body.
3. It disrupts the skin microbiome
Over-sanitizing reduces microbial diversity — the “training ground” for your immune system.
This has been linked to:
Increased eczema and skin disorders
Greater risk of autoimmune conditions
Higher rates of allergies, especially when early-life exposure to dirt is limited
4. Some products are still unsafe
Even after the FDA removed toxic ingredients like triclosan in 2017, many products remain on shelves that:
Contain methanol or 1-propanol
Use harsh preservatives or synthetic fragrance
Are on the FDA’s “Do Not Use” list
📦 Callout: Safe Alternatives When Soap Isn’t Available
If you don’t have access to soap and water, we recommend non-antibacterial wet wipes that are gentle, effective, and free of harsh chemicals.
✅ Recommended non-antibacterial wipes:
Huggies Natural Care Sensitive Baby Wipes
WaterWipes Original (99.9% water + drop of fruit extract)
Surviveware Biodegradable Wet Wipes (great for outdoor use)
Sea to Summit Wilderness Wipes
Natracare Organic Cotton Intimate Wipes (gentle, no harsh chemicals)
These wipes clean without disrupting your microbiome — and don’t leave behind alcohol residue or strip your skin barrier.
Pro tip: Always check for fragrance-free, alcohol-free, and non-antibacterial on the label.
✅ When sanitizer is actually helpful:
No access to running water
Public or healthcare settings
After touching high-traffic surfaces
Before meals outdoors or while traveling
In those cases, choose:
60–70% alcohol
Fragrance-free and dye-free
From trusted brands (e.g. Purell Advanced, EO/Everyone, Dr. Bronner’s, Touchland, Honest Company)
🌿 Clean ≠ Sterile
Your immune system doesn’t develop from living in a sterile world.
It develops by learning to tolerate — and interact with — the natural world.
That means:
Playing in dirt
Being around animals
Touching tree bark, grass, soil
Avoiding the overuse of synthetic antibacterials
This early-life exposure builds resilience — and lowers the risk of asthma, allergies, and autoimmune issues later in life.
💡 Bottom line:
Wash with soap and water when you can.
Use sanitizer only when you must.
And if you’re out in the world, baby wipes or wilderness wipes are often the smarter backup.
Your skin is a living ecosystem. Let’s treat it like one.