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Antibacterial Soap: Safe Suds or Snake Oil?

image of Laura Fraser
About 75 percent of U.S. adults have traces of triclosan, an ingredient in antibacterial soaps, in their urine.
The main ingredient in many antibacterial soaps is not only useless, it’s bad for you

It seems like every time you go to wash your hands these days, the soap is “antibacterial.” And it’s not just soap: There’s antibacterial dishwashing liquid, hand lotion, shaving cream, trash bags, toothpaste, deodorants, cutting boards, bedding, sandals, toys, socks, sports clothing … almost everything we put on or near our skin.

I’m suspicious of antibacterial soaps, because it seems that nuking all the bacteria around you might lower your resistance to the really bad bugs. But that’s just my hunch. So I decided to find out whether the antibacterial stuff works any better than regular, chemical-free soap -- or whether it’s just a marketing scam.

What I discovered is even more disturbing. It turns out that most antibacterial soaps are actually worse than useless: they’re an outright threat to our health and environment.

The active ingredient in most antibacterial soaps, listed on the label, is triclosan, which is indeed ubiquitous. Triclosan appears in more than half of all hand soaps sold in the United States, and over $1 billion worth of products per year. Because we absorb it into our skin (or via our mouths, with toothpaste and mouthwash), and it accumulates in our bodies, the Centers for Disease Control and Prevention has reported that it shows up in the urine of three-quarters of the population over the age of five; it also appears in breast milk and umbilical cord blood. More than a million pounds of triclosan are produced annually in the U.S.

Can all that triclosan be good for you? The FDA, which regulates the chemical in personal products, says it is “not currently known to be hazardous to humans.” But it hedges that statement: “several scientific studies have come out since the last time FDA reviewed this ingredient that merit further review.” That’s not surprising, since the last time the agency reviewed triclosan in antibacterial products was 38 years ago, and it has yet to make a decision about whether the chemical should stay on the market. The FDA has declined to act despite scores of studies, the vast majority of which raise concerns about triclosan’s potential ill health effects.

Meanwhile, as the FDA continues its glacial review process, several elected officials, consumer and environmental groups (including the Natural Resources Defense Council, which publishes OnEarth), and even the American Medical Association -- all of whom have reviewed the studies -- are insisting that the FDA finally regulate triclosan, because those studies show it to be not only useless, but risky.

Special Report: The FDA Is Out to Lunch

Take even a casual look at some of the studies the FDA is supposedly reviewing, and it’s clear that triclosan is hazardous. Animal studies have shown that triclosan alters hormone levels -- lowering levels of thyroid and testosterone in lab rats, as BPA in plastics does. Although scientists still don’t know exactly how triclosan affects human hormones, endocrine disruptors in general can cause early-onset puberty, reduced fertility, obesity, and cancer. Another recent study on mice shows that triclosan impairs the functioning of their muscles.

Triclosan behaves like a very potent drug, says UC Davis molecular biologist Isaac Pessah, who did those mice and fish studies. The structure of the triclosan molecule is similar to other compounds not found in the environment that can affect muscle contraction, so his research team decided to see whether triclosan had the same effect. After they found that triclosan slowed down human heart muscle cells and fibers, they tried it on mice, giving them doses comparable to the levels people get in consumer products. The result: Mice given a single dose of triclosan experienced a 25 percent reduction in heart function, and an 18 percent reduction in grip strength for an hour. The researchers also exposed fathead minnows (which are frequently used in pollution studies because of their high sensitivity) to triclosan and found a marked reduction in their swimming activity after they had been exposed to the chemical for a week.

Pessah believes the chemical could cause muscle problems in people, too, and would be particularly dangerous to those with heart conditions or other muscle disorders. “If you already had muscle impairment, a small decline in cardiac output would be devastating,” Pessah says. He hopes his findings will spur epidemiological studies to see if people who have been exposed to triclosan during their daily lives suffer more muscle impairment than people who have less exposure.

Where You'll Find Triclosan

All personal care products that contain triclosan must list it as an active ingredient on the label. It’s likely to be found in products advertised as “antibacterial,” but not always. The U.S Department of Health and Human Services provides a complete list, but here are some of the most popular products containing the chemical:

Dial Liquid Soap, Body Wash, and Antibacterial Bar Soap

Palmolive Ultra Antibacterial Hand Soap

Ultra Dawn Dishwashing Liquid and Antibacerial Hand Soap

Lever 2000 Antibacterial Soap Bar

Clearasil Daily Face Wash

Ajax Antibacterial Dish Liquid

Palmolive Aromatherapy Liquid Hand Soap

Colgate Total Toothpaste

Vaseline Intensive Care Antibacterial Hand Lotion

Suave Liquid Hand Soap, Antibacterial

Noxzema Triple Clean Antibacterial Lathering Cleanswer

Revlon ColorStay LipSHINE Lipcolor Plus Gloss

So given all that, should triclosan be banned? Pessah said the chemical might have some useful niches as a prescription drug, targeting some bacteria as an antibiotic, but he doesn’t think it should be sold over-the-counter. “You don’t put Prozac in virtually every product you use, including your cosmetics and underarm deodorant,” he says. “Here’s a compound that’s very biologically active, and could be useful in some prescription situations, yet it’s being manufactured in millions of pounds, ending up everywhere.”

Other researchers have shown that exposure to triclosan is indeed taking its toll on people. In 2011, epidemiologists at the University of Michigan School of Public Health found that the more triclosan researchers detected in children’s urine, the more likely they were to have allergies. In 2012, Johns Hopkins immunologist Jessica Savage found that triclosan levels were also correlated with food allergies -- to peanuts, shrimp and dairy -- particularly among boys. The researchers speculated that it was the antimicrobial qualities of the chemical that altered people’s immune responses -- if you don’t get exposed to bacteria because you’re killing off all the good and bad ones, your system doesn’t know which ones to fight off and so goes into overdrive against any invaders.

Triclosan was initially developed as a surgical scrub in the 1960s by Ciba, which is now part of the German chemical giant BASF. Ironically, it has proven to be most deadly in hospitals. Triclosan is a biocide and kills certain bacteria, including healthy flora, but it lets other harmful bacteria flourish. One of the bugs triclosan doesn’t kill is pseudomonas, a major cause of hospital-acquired infections. In some cases, fatal outbreaks of the disease have been traced back to the hospital triclosan soap dispenser. Kaiser Permanente was the first large hospital chain to stop using triclosan.

The American Medical Association has also raised a red flag about triclosan, concerned that it causes antibiotic resistance: the germs that survive triclosan become stronger, making it harder to treat common infections with our current arsenal of antibiotics. When bugs like e. coli, staph, and salmonella are exposed to triclosan, they develop a cross-resistance to other antibiotics that work by a similar mechanism. In 2000, the AMA issued a statement recommending that triclosan and other antimicrobials “should be discontinued” in consumer products. It also urged the FDA to finish the process of banning triclosan in consumer products. That was a dozen years ago.

The risks associated with antibacterial soaps are certainly enough to give one pause. But are there benefits that outweigh the fact that most of us are carrying a load of triclosan in our bodies?

The American Cleaning Institute, which represents the $30 billion U.S. cleaning products industry, makes the case that antibacterial soaps are important to public health, stating on its website that antibacterial personal care products provide “an extra measure of protection for both consumers at home and doctors and nurses in hospitals seeking to prevent the spread of germs.” The implication is that soap and water aren’t enough to get rid of disease-causing germs and to protect public health, so responsible consumers should use triclosan. Many consumers have indeed bought this notion that if clean is good, cleaner is better -- a claim that producers of triclosan products can continue to make as long as they are unregulated by the FDA.

But scientists say that’s just a marketing ploy. “The whole concept is bunk,” says Allison Aiello, a University of Michigan epidemiologist who analyzed 27 studies of triclosan and its impact on preventing illness that have been conducted while the FDA has been making up its mind about the chemical. First off, “germs” is a catch-all term for bacteria and viruses, and triclosan doesn’t touch viruses. Second, it doesn’t fight bacteria any better than when you wash your hands -- no matter what the cleaning institute claims. “Triclosan doesn’t provide any benefit above and beyond soap,” Aiello says. “This is a case where the risk outweighs the benefit.” The only people who disagree with her are the ones making or marketing the stuff.

To explain why triclosan doesn’t work any better than soap, Aiello described what happens when we wash our hands. First, just the friction of rubbing your hands under water makes most of the bacteria on them slide into the sink (that’s why it’s better, in a pinch, to rinse your hands with water when there’s no soap). More important than what soap you use is how long you spend washing your hands -- at least 15 seconds. Soap, innocent of toxic chemicals, works very elegantly: It doesn’t kill germs, but attaches to them and carries them away. Soap molecules have a head and tail, like sperm, but even smaller. The tail attaches to organic materials -- oil, viruses, bacteria, fungi, dead skin -- while the head keeps it afloat in the water. Together, soap molecules surround the materials they’ve attached to, making an impenetrable barrier while escorting the dirty stuff down the drain. Triclosan may kill some of those bacteria (again, not the viruses), but Aiello says, there’s no point, since the bacteria is already on its way down the sink.

Brian Sansoni, spokesman for the American Cleaning Institute, disagrees. He calls concerns about triclosan “overblown accusations,” and was quoted in ICIS.com, a trade news service for the chemical industry, saying that the notion that triclosan increases bacteria resistance was a “suburban myth” (the AMA, apparently, has offices in the suburbs). He points to a handful of studies that show that triclosan is more effective than plain soap and water in killing germs; most of these studies, however, were sponsored by the institute or Dial soap, makers of the best-selling triclosan product.

I called Rutgers University microbiologist Don Schaffner, who published analyses of many of the studies on triclosan that were funded by the institute and appear on its website. He said that while triclosan does kill more of some bacteria than soap, that difference was “small,” and appeared in studies where there were “artificially high” levels of microorganisms on the skin. In one study he looked at, for instance, participants dipped their hands in Shigell and E. coli and then handled melon balls right afterward. These were not real-world situations, but scenarios where participants slathered themselves with the exact same bacteria that triclosan kills, so it’s no wonder the triclosan came out ahead.

“No one is dunking their hands in an E. coli broth before handling food,” says Sarah Janssen, a physician and senior scientist with NRDC, which joined other environmental groups last year in suing the FDA to rule on restricting the use of triclosan. Many studies, as well as meta-studies that have looked at the results of other research papers, have examined infection rates in populations of people who used a triclosan soap and plain soap and have shown no difference. “In the real world,” she says, “plain soap was just as effective as triclosan soap at preventing infection.” Using triclosan soap, she says is “an unnecessary exposure to an unsafe chemical.”

Which brings us to the obvious question: Why, with so many people urging that triclosan be regulated, hasn’t the FDA banned triclosan? “The FDA has sat on its decision on triclosan forever,” says Janssen. The FDA first proposed a regulation that would remove triclosan from over-the-counter use in 1974, but declared that the data were insufficient to make a final classification. “There’s a loophole in the FDA regulations that allows anyone to manufacture and distribute these products,” says Janssen. If the FDA finalized its decision, $1 billion worth of antibacterial products -- 76 percent of liquid soaps by one measure -- would have to come off the market. “There’s a big financial incentive not to finalize the decision,” Janssen says. (OnEarth exposes other laxes in FDA oversight in the Winter 2013 cover story, "The FDA is Out to Lunch.")

The FDA’s decision-making process on over-the-counter drugs is the opposite of the precautionary principle, which holds that if something is suspected of causing harm to individuals or the environment, the burden of proof is on the manufacturer to show that it is safe. “They want very specific, complete evidence of harm,” says Alison Aiello, who has conducted metastudies on triclosan and who sat on the advisory panel in 2005 FDA hearings which concluded that there was no evidence that antibacterial soaps work better than regular soap and water, “yet it doesn’t seem anyone is weighing the fact that there’s no benefit whatsoever.”

When I called the FDA to ask what was going on, spokesperson Stephanie Yao commented, “Rulemaking takes time.” When I mentioned that 38 years seemed like a lot of time, she replied in an email, “We are committed to completing our review and communicating our findings as soon as possible,” but was not specific about when.

There may be some movement toward getting rid of triclosan, though. Nichelle Harriott, a staff scientist with Beyond Pesticides, a Washington, D.C.-based science and policy non-profit group that focuses on reducing toxic pesticide use, says the FDA may be waiting for the EPA, which regulates the chemical in the environment, to weigh in on triclosan before finalizing its decision. Harriott predicts that given the new health and environmental studies on triclosan, “we’re going to see triclosan phased out.”

Every few years, the EPA has to review chemicals that are used as pesticides; triclosan was first registered as a pesticide in 1969. Aside from consumer products, triclosan is used in agriculture to stop the growth of bacteria, fungi, and mildew. It also has industrial uses, preventing bacterial growth in such products as fire hoses, conveyor belts, and ice-making equipment, and as a preservative in many fabrics, plastics (toys, toothbrushes), floor waxes, carpeting, and a wide variety of products. The EPA last assessed triclosan in 2008, but is updating its assessment, it says, based on recent data on the thyroid and estrogen effects of the chemical.

Aside from the potential health risks of triclosan, there are plenty of other environmental hazards. Because consumers wash so much triclosan down the drain, it gets diffused throughout the environment. It’s one of the most frequently detected chemicals in streams and has even shown up in wild bottlenose dolphins. Triclosan is found in high concentrations in treated sewage sludge, called biosolids, which are often used as fertilizer in agricultural fields. Sarah Janssen says that once in the soil, the triclosan gets absorbed into the roots of the plants we eat. “Consumer product use is resulting in contamination of the food chain, which gives us a double dose of exposure.”

While the EPA and FDA have done nothing to restrict triclosan, there has been enough pressure by environmental and medical groups that some manufacturers have voluntarily stopped using the chemical.

Johnson & Johnson has removed triclosan from all its personal care products. Spokesperson Peggy Ballman says that even though the ingredients are “safe by scientific standards,” questions about its environmental impact have been raised, so the company decided to phase triclosan out to give consumers “peace of mind.” No more tears. Colgate-Palmolive has removed it from some of its dish and hand soaps, but kept the chemical in its toothpaste, which is FDA-approved for treating gingivitis (the only use of triclosan that is fully approved by the FDA, even though the triclosan is in toothpaste that everyone uses, whether or not they have gum disease).

Kaiser Permanente, a Bay Area-based nonprofit hospital system with hospitals in nine states and over 9 million health plan subscribers, has also banned triclosan. Kathy Gerwig, Vice President for Workplace Safety and Environmental Stewardship, says the organization was convinced that triclosan was no more effective than soap and water, and they were concerned about the bigger health care picture. “When we look at how we prevent disease, it’s not just preventing colds and flu, but longer-term diseases that might be a result of health hazards that are caused by chemicals found in products and the environment,” she says, pointing to the studies on the chemical’s effect on immune functioning, allergies, and hormones. “Where credible evidence exists for us to think there is a problem with a chemical or product, we consider it our obligation to use a safer alternative.”

The credible evidence that there’s a problem with triclosan clearly does exist -- so much so that large corporations and hospital chains are moving away from its use. But that’s no thanks to the agency charged with taking care of our health. Perhaps an even bigger problem is that the FDA has taken nearly four decades to review ample evidence that triclosan is harmful; it may only finally regulate it after all the companies in the $750 million hand soap market have a chance to substitute it -- perhaps with something equally ineffective, or hazardous, which will take another lifetime to regulate.

Fortunately, for consumers, it’s a simple matter to avoid the chemical by checking labels, since triclosan is always listed, and buy soap instead (or alcohol-based hand sanitizers). Eating organic foods that haven’t been slathered with triclosan-infused fertilizer is also a good move. The FDA clearly isn’t going to protect us from triclosan; the only thing concerned consumers can do is wash their hands of the stuff.

image of Laura Fraser
Laura Fraser is the author of "Losing It: America’s Obsession with Weight and the Industry that Feeds On It" and the recent travel memoir "All Over the Map". The San Francisco-based journalist has written for the New York Times, Tricycle, Gourmet, ... READ MORE >
Good article & great info. So now, how do I safely dispose of the remaining supply of the "nasty" soap??
I'm afraid I find this article to be quite fundamentally flawed. The author is clearly ignorant of some key concepts needed to meaningfully understand this debate. Firstly, she refers early on to "chemical-free soaps." There is no such thing as a chemical-free soap. There is, in fact, no such thing as a chemical-free anything (unless that thing does not have actual matter!). Chemicals are everywhere. We ourselves, are simply chemicals. Secondly, chemicals are neither inherently bad or good. It is not scientific to divide chemicals into 'toxic' and 'non-toxic' categories like the author does. Essentially ALL chemicals are toxic in that a certain dose WILL kill you. Heck, drink too much water too quickly and it will kill you. Medicines (natural or synthetic) can treat illness in small doses, yet too much of them will kill you. It's not a question of a chemical being 'toxic' or 'non-toxic'. It's the dose that determines when toxic (or beneficial!) effects will be experienced. To repeat the classic line, it's the dose that makes the poison. The author's failure to appreciate this basic toxicological principle is the reason for so much of the other problematic issues with this article. Yes, some tests have shown toxic effects in animals. But such tests with chemicals typically involve very high doses, often via intravenous injection of the pure chemical into a mouse. This is simply not the same thing as a human being being exposed to TINY quantities of a chemical in their everyday products. Yes, if such chemicals are in everything around us then we can as society experience a build-us in our collective blood, urine, etc. But this is ONLY a problem if the quantities are approaching the levels that lead to toxic effects. In the vast majority of chemical 'scare stories' like this one, the actual amounts of the chemical - in our products, in ourselves, etc. - are tiny. Really, really tiny, and far below the levels at which adverse effects are observed in the lab. Don't be fooled. If Colgate-Palmolive or whoever decides to (publicly) remove certain chemicals from their products, chances are it's got nothing to do with an actual safety concern. It's far more likely that such companies can no longer continue defending their safe use of certain ingredients, because that defence requires people to actually bother learning the above principles. Certainly, it's a major challenge to explain all this to people, when on the other hand they have the simplistic and easy-to-grasp logic of articles like this, which simply say: "Chemical X is bad, Chemical X is in this product, Chemical X must go..." And so, what we have is a proliferation of products with 'natural' ingredients that are supposedly 'chemical-free.' Except these ingredients ARE chemicals, and often we know far, far less about their safety than synthetics that have been studied for decades and used in products all over the world without causing problems. Now wash your hands. It's one of the best ways to avoid getting sick. And whether you use an 'antibacterial' or 'natural' soap, don't be fooled. The benefits are all from chemicals, enough of which WILL kill you.
This is ridiculous stating that synthetics have been studied for decades "natural" ingredients have not??? How about natural ingredients eg: tea tree, Rose Mary, Oregano Oil, Clove Oil have been "studied" for thousands of years for their use in antibacterial qualities and effectiveness. There is little to be gained financially when using such "chemicals" that we can grow in our own yards. There are significant properties with in many plants and herbs that do not destroy the environment or our health. Do we think synthetics are more powerful than what the earth has naturally created for us? This limited grandiose thinking is why we are in the mess we are in environmentally. Please please open your eyes and see the solutions right in your own back yard. Not in a lab.
While in general the concept of the dose equals the poison is reasonably accurate, in the context of hormonal drugs it does not hold. Hormone disruptors are more likely to demonstrate hormesis, or a U shaped toxicity curve where both very low and very (relatively) high doses are toxic, but may demonstrate that toxicity in different ways, and where there is a dose between low and very low where there is no effect. As well, one must consider that many hormone-disruptors affect organisms at very early stages of development, where cells are exceptionally susceptible to hormonal effects. In short, your argument, while generally correct, is wrong in this instance.
While there has not been developed an absolute testing procedure for computing chronic toxicity of irritants/inducers via alteration of systematic physical states in vivo in real time , large amount of data and observations have suggested that the risk of a wide spread exposure and uncontrollable streams of factors do affect human health over time. - http://www.ec.gc.ca/ese-ees/default.asp?lang=En&n=6EF68BEC-1
I liked your article and feel equally frustrated by the lack of responsibility of some of the manufacturers. The average consumer is not aware that there is a difference between antibacterials and antimicrobials. Even within antimicrobials there are hundreds of kinds. They aren't equal. So what's a Mom to do? I too was concerned about the long term health risks of what we track into our homes on the soles of our shoes. When I began to research the issue I wanted to solve the problem without creating a bigger problem. I reached out to experts in the field and found an antimicrobial formula that works and does not poison the microbes. It doesn't leach into the environment and can't penetrate the skin. No Triclosan, instead the microbes are disabled through a physical mode of action, very much like popping a balloon with a pin. You don't want to kill or destroy good bacteria in our body However, I did discover that none of the nasty germs on our shoes or doormats were worthy of rescuing.
Dear Laura, Thank you so much for eloquently putting forward the problems with triclosan and the failures of the pHarMedgeddon industries in addressing them, including the FDA's failure to do its job. We have been warning people about Triclosan since the last millenia, while our founder was being sued all the way to the US supreme court to fraudulently steal and suppress his work; and guess who laid him off when he was producing 90 to 100% response rates in melanoma and myeloma with unoptimized regimens of a non-toxic, natural immune stimulant.....that's rigtht, Jane Henney, former deputy director of the FDA who went on to become director of the FDA and then tried to shut down every compounding pharmacist in the nation. This appeared to be a blatant "Henneyous" suppression of scientific health research and practices for the obscene profits of the pHarMedgeddon industries, the very industries that probably kill more healthy, prebiotic and probiotic organisms, with antibiotics and other carcinogenic chemicals, than they do harmful ones, a position not far from the concerns you expressed in your article: http://www.vitaletherapeutics.org/vtltclxn.htm (They've known about problems with triclosan since 1983) Also, in 1983, the Merck Index started bad-mouthing the gluconic acid and dimethylglycine building blocks of pangamic acid (vitamin B15) that had been shown in 1981 to increase antibody-mediated immune responses to a Merck vaccine 4 to 5 times on average in humans, and in one individual 170 times. Thus, we are approaching the anniversary of at least the third decade of fraudulent suppression of health research and education efforts by the pHarMedgeddon industries including complicit chemical industries and federal agencies: http://www.vitalethine.org/img85.html http://www.vitalethine.org/img86.html Let me know if you'd like a more thorough analysis of the misrepresentations of the FDA, Merck, and other so-called experts like the current safety czar for the FDA that merely rationalizes away known carcinogens in our food, like Monsanto's poison, glyphosate (Round-up), and carcinogenic sorbic acid and sorbates and parasorbic acid and parasorbates. They have been blatant and shameless in their deceptions and it is time to call them on their crimes against humanity and vote with our pocketbooks by buying only organic foods and striving to ban these poisons from our food supply and environments. This Wikipedia article, alone, will raise your hackles about the incestuous, NON-PARTISAN relationships between industry and government: http://en.wikipedia.org/wiki/Michael_R._Taylor
It's long past time to reassess triclosan, but it's important to remember the aspartame scare, when there were several studies that the press blew all out of proportion. When the careful reviews were performed, the studies that found health "threats" were filled with methodological defects. When only well-designed and properly analyzed studies were considered, there was no threat after all. It's also important to remember that plants and animals have been at war with each other for millions of years, and have evolved some very effective and dangerous toxins all on their own. Just because a product is "natural" doesn't mean that it's safe. Nevertheless, the best reason to avoid "antibacterial" products is that they create an environment that kills only the more sensitive bacteria, leaving an open field for more resistant varieties to proliferate. The best way to remove bacteria is "mechanically", with soap and water and thorough scrubbing. It gets 'em all.