Hand sanitizer is a liquid generally used to decrease infectious agents on the hands.[2] Formulations of the alcohol-based type are preferable to hand washing with soap and water in most situations in the healthcare setting.[3] It is generally more effective at killing microorganisms and better tolerated than soap and water.[4] Hand washing should still be carried out if contamination can be seen or following the use of the toilet.[5] The general use of non-alcohol based versions has no recommendations.[3] Outside the health care setting evidence to support the use of hand sanitizer over hand washing is poor.[6][7] They are available as liquids, gels, and foams.[4]