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Comment by acabal | Hacker News Reader

I never used antibacterial hand soap precisely because I assumed it would somehow contribute to bacterial resistance, and because humanity survived just fine with regular hand soap in the bathroom for centuries. Having said that I've recently been given a bottle of it. Maybe I'm overthinking things, but is there any way to dispose of this stuff in a responsible way?

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> humanity survived just fine with regular hand soap in the bathroom for centuries.

What? No! No, we didn't do well at all! Child mortality in the US was 20% just a hundred years ago. What killed everyone? Infectious disease. Yeah, the entire human population didn't die out. Obviously your great grandparents both survived long enough to reproduce. Go check how many of their aunts, uncles, siblings, and children didn't.

The past sucked. Wealth and technology has made it much, much better. There are some drawbacks, but let's not pretend we were doing just fine without.

That's true in a general sense, but has technologically improved household soap in particular contributed measurably to the reduction in mortality rates? There are large contributions from antibiotics, vaccines, the general improvement in living quarters, improved workplace-safety regulations... I could even believe things like more frequent laundering play a role. But I'd be surprised if changes in the composition of household soap have improved health.

Clean water,public sanitation (my Dad used an outhouse until he reached his mid-twenties), Doctors washing their hands before operations/births, vaccines, all these were much more helpful in the past 100 years in reducing child mortality and adult mortality rates due to infectious diseases than anti-bacterial soap has in it's (what, 20 years?) period of commercial success.

> The past sucked. Wealth and technology has made it much, much better.

Yes, but "antibacterial hand soap in home bathrooms" isn't one of the ways that technology has made the world better than the past, except, perhaps, for people selling antibacterial hand soap.

Technology has made many positive changes to the world, but that doesn't mean that every use of technology is positive.

It won't contribute to resistance. There is a possibility it could become resistant to the chemical itself at best, but it's not like it would become resistant to antibiotics or anything from that. If anything the resistance would make it weaker, since adaptions that make organisms resistant usually make them reproduce slower and less fit.

Only a small percent of bacteria would be exposed to the soap so it wouldn't have a huge selection pressure. Chemicals used to kill bacteria outside the body are generally much harsher and harder to build resistance to than antibiotics which have to avoid killing human cells. So I don't think resistance is very likely.

I don't know if there is an advantage of antibacterial soap, but humanity hasn't "survived just fine" with regular hand soap. Washing hands to prevent infection wasn't even common until the past century or so.

If all antibacterials were harsh chemicals like hydrogen peroxide that might be true. But check out multidrug efflux pumps, and things like triclosan.

Why speculate? There is plenty of research that verifies that triclosan resistance occurs.

http://www.ncbi.nlm.nih.gov/m/pubmed/16922622/

http://ec.europa.eu/health/scientific_committees/opinions_la...

http://m.jac.oxfordjournals.org/content/46/1/11.long

I think his point (which is correct) is it doesn't matter if bacteria develop resistance to triclosan. Triclosan is not used to control bacteria in the medical setting and there is no cross-resistance to antibiotics.

> Triclosan is not used to control bacteria in the medical setting

Well, it actually is. The debate about whether using Triclosan-containing soap while caring for patients is appropriate is occurring in the medical field. I saw at least one paper out there discussing it in that context (sorry, no url) but I assumed the soap they're using has a higher concentration of triclosan than what you'd pickup in the grocery store. In retrospect I'm not certain that's true.

When my mother had a bone marrow transplant, the hospital used triclosan to disinfect anyone entering her room. A quick Google search shows this to still be a common approach.

I don't disagree with your conclusion, but do want to point out that the "humanity has survived just fine without this" argument could be used to argue against anything that might improve survival rates. Back when people didn't wash their hands, it could be used to argue against washing hands.

True, but we have to look at the risk. Is cleaning your hands thoroughly with sopa after going to the bathroom makes you healthier or cleaning your desk often with chemical makes you healthier?

If a desk is infected with some deadly virus or bacteria, then cleaning the desk with chemical is apparently the right thing to do.

But if not, because that odd is low than compare to not washing your hand after taking a poop, then sure cleaning your desk with chemical is not a top priority. I don't clean my desk with chemical. I apply water and I wipe it, unless the stain can only be removed with chemical. Because I know that my desk will just be as dangerous as the rest if I continue to let it expose to the open air. But what is immediate threat to me? Sleeping late, exposing myself in a crowd coughing, not washing my hands after restroom, no shower for a week, and eating junk food every day makes me weaker.

I've had a hard time finding liquid hand-soap without triclosan in it.

Just buy cheap dish soap at a dollar store.

"Method" hand soap has no triclosan in it.

I just reuse a foam soap pump bottle and fill with about 3 or 4 parts water to 1 part plain dish washing liquid (non-antibacterial, of course).

I consider foam soap to be one of the great advances of the past few decades.

A friend told me they did this recently, and I argued to her that it was a bad idea. It's going to sit around for however long with all the baddies in it multiplying, and then you're going to smear it all over your hands to "clean" them. This was my feeling mostly because she had made it with just tap water and dish soap, but I imagine even boiling the water first wouldn't stop this happening as it's going to sit around as still water for weeks/months or even longer.

Maybe I was over reacting a bit, I'm admittedly not sure how store-bought foam soap is produced. I just search around quickly and see that the prime ingredient in most foam soaps is (unsurprisingly) water, but they're also pumped full of other stuff.

Costco now only sells triclosan-free bulk soap now.

Humanity survived just fine ... ? Do you have any idea what mortality rates used to be?

Hey, maybe the GP doesn't use medication, automobiles, electricity, or computers either. Humanity survived just fine without those too. ;)

EDIT: You might find "Bacteria Living on Antibiotics" blog post interesting though: http://www.bunniestudios.com/blog/?p=239

If you ever have a dirty cut, it's useful. I'd just put it under the sink or in a closet.

This is my recommendation as well. I don't use it to wash my hands, but I have found that when I get a small cut or scratch, a drop or two of triclosan soap placed full strength on the cut, and left there for a minute or so before rinsing, seems to reduce infection and speed healing. At the rate I'm using it -- a few drops a month -- one bottle will last many years.

If you do just want to give it away, I'm not sure what to suggest. I wouldn't pour it down the drain or put it in the trash, but taking it to a household toxics center seems overly fussy, considering the amount people are using. Maybe just ask your neighbors to find one who already uses it and give it to them.

There are much better alternatives for that, I'd recommend an antiseptic wash (there's a good one put out under the bandaid brand). Besides which you'll need to use an antibacterial cream for the wound regardless.

hydrogen peroxide would be better

Presumably you could throw it in the garbage. Way worse chemicals are thrown in the garbage every day, and waste sites are required to be protected from leeching into the groundwater to the extent possible. Or you could use an incinerator, but then you have to weigh the significant economic and environmental costs against the almost trivial risk of having it in a dump somewhere.

Currently the advice is to throw it to the garbage, until a better plan is found.

You could just use it occasionally, or put it out for guests. After all, if used only occasionally the generations of bacteria would not develop resistance?

That could easily be worse.

Immunity to antibiotic drugs arises faster when people don't take their full course of medications. Intermittent exposure means that bacteria with any resistance can survive, and this resistance can be built on to full immunity. "Always take the full, prescribed course of antibiotics" and all that.

Is it an alcohol handgel? Or a soap with triclosan or similar in it?

It's a triclosan one. I imagine flushing it all at once would be worse than using it.

Just put it in the garbage. As is, bottle closed.

Or save it for special occasions (which is what it was designed for). For example people are sick in the house, or you just cleaned out something really disgusting.

That was first question:

Have there been any studies on the bacterial resistance impact of EtOH gels? Natural selection will find a way to prevent cell membranes from being dissolved. Nature is a great hacker.

There have been extensive studies on the efficacy of EtOH hand gels - for a wide number of pathogens, they are just as, if not less effective than soap and water, especially when you add in mechanical action.

They're an excellent substitute, but not a stop-gap, especially not in the concentrations available through retail in the U.S.

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