The CDC recommends only alcohol-based hand sanitizers. They've been proven to be safe and effective against the widest array of viruses and bacteria. Conversely, alcohol-free products haven't been around as long, and there isn't enough research to say these products are as effective.
That said, the lack of alcohol does make them a more appealing option to some consumers. In fact, some U.S. schools and workplaces have recently banned traditional hand sanitizers because of their high alcohol content. In its September 2009 public recommendations about preventing H1N1 flu (swine flu), the CDC gave alcohol-free sanitizers their first tepid endorsement: "If soap and water are not available and alcohol-based products are not allowed, other hand sanitizers that do not contain alcohol may be useful." Translation: If you're in a bind and need something, these products are better than nothing.
Alcohol-free sanitizers primarily rely on plant oils to kill germs. The most popular offerings on the market consist of essential oils from thyme or lavender, or they include BAC. BAC is a compound that possesses some disinfectant properties. Some studies have shown that BAC and some essential plant oils do kill germs. However, these evaluations were conducted in lab-like settings instead of real-world scenarios, and few researchers have tested them as hand sanitizers, so their true germ-killing abilities aren't as well-known.
The most widely available essential-oil hand sanitizer is CleanWell All-Natural Hand Sanitizer (*Est. $5 for 8 oz.). Its primary ingredient is thyme oil, which some studies have found to be a natural antimicrobial. It's available at Target, Whole Foods Market, Bath & Body Works and Amazon.com, where it gets good reviews from users who appreciate that CleanWell uses natural ingredients, although a few say its spearmint-lime fragrance is odd and too strong.
One BAC-based hand sanitizer, HandClens Alcohol-Free 2 in 1 Foaming Hand Sanitizer and Lotion (*Est. $24 for six 8-oz. bottles) also gets good reviews at Amazon.com. Users say they enjoy the product because it doesn't dry their skin, but some say HandClens can be hard to find in stores.
BAC is known to work against many viruses and bacteria, including flu viruses. However, experts at the CDC say BAC isn't very effective against E. coli and salmonella bacteria -- to the point where these sanitizers are prone to becoming contaminated themselves. In the past, people have used BAC products thinking they're killing germs, only to later learn the sanitizer has spread the bacteria around. These kinds of occurrences have led to "several outbreaks of infection," CDC experts say, which is why BAC has historically not been used as a hand sanitizer in the United States.
Additionally, it's important to note that the CDC continues to say these products are not as effective as alcohol-based sanitizers. Bottom line: The CDC and other public health authorities stop short of recommending alcohol-free hand sanitizers, saying they need more research. For this reason, we do not include these products in our Best Reviewed.