The Dosage amount This is the volume of hand sanitizer (liquid, gel, foam) required for safe hand disinfection. It must be sufficient to disinfect all hand surfaces during the time specified by the manufacturer. Exposure time to completely wet and is in addition to the Rubbing-in technique the decisive factor for reliable germ reduction.

Recommended dosage

The optimal amount according to current recommendations and the individual anatomy of the hands:

• Recommendations: According to the S2k guideline at least [number] are required for hygienic hand disinfection. 3 ml recommended. KRINKO/RKI recommendations cite a range of 3 to 5 ml.
• Individual needs: The actual amount needed can vary depending on hand size. Larger hands tend to require more hand sanitizer to ensure all areas are thoroughly covered. [Fig. 2].

Relevance of correct dosage

Precise dosing protects both the patient (safety) and the user (skin health):

1. Underdosing: Using too small an amount leads to premature drying of the hands. The contact time specified by the manufacturer (usually 30 seconds) cannot be observed, resulting in insufficient germ reduction.
2. Overdose: Applying too much disinfectant leads to unnecessary consumption and dripping. Furthermore, a consistently excessive amount can increase lipid loss in the skin and compromise its natural barrier function.

Methods for determining the individual dosage amount

Measuring methods help to objectively determine the amount of disinfectant needed for one's hand size. This allows you to determine how many milliliters are required and simultaneously develop a feel for how much disinfectant needs to be dispensed into the palm of your hand.

DesiCoach® method

DesiCoach® is a visual training method for hand disinfection – based on a dye and a dye remover solution.

• The dye is dispensed into the palm of the hand. After rubbing, the hands become stained. The visible distribution shows whether the dispensed amount and the rubbing technique are sufficient to reach all areas of the hand [Fig. 3].
• The achieved color intensity can be visually compared with a color scale [Fig. 4].

Stopwatch method

Here, the time until drying is measured with a stopwatch.

• Conventional disinfectant is dispensed into the palm of the hand using a dosing pipette. The time until the hands are completely dry is measured while rubbing the disinfectant in.
• If the hands are dry before the required exposure time (usually 30 seconds) has elapsed, the amount must be increased and measured again with a stopwatch.

Rules of thumb – practical tips for everyday life

„"A handful"“

The hollow hand as an individual measuring cup: The WHO recommends using a palmful of hand sanitizer to thoroughly wet all palms.¹ The cupped palm serves as an individual measuring tool, allowing for dosage adapted to hand size. Scientific studies show that the required amount of hand sanitizer is related to hand size.^{2 3} Training beforehand can help develop a feel for the individually required dosage amount in one's own palm.

„"Counting pump strokes"“

Pump strokes are not a reliable measure of quantity: The dosage is often specified in "pump strokes." However, this method is considered inaccurate. Studies show that the actual amount dispensed per pump stroke can vary both between different dispenser systems and even with the same dispenser – depending, among other things, on the product, fill level, and usage frequency.⁴ Without knowledge of the specific dosing volume of the dispenser, counting pump strokes does not provide a reliable guideline for the required amount of liquid for hand disinfection.

Influence of the dosage form

Depending on the specific properties of the product, there are particular application requirements. The respective manufacturer's instructions, especially regarding dosage and contact time, must be observed.

• Liquid preparations: Liquid hand sanitizers are considered the standard for rapid wetting and are widely used in medical facilities. They spread easily over the entire skin surface. However, if too much is used, they can drip more easily.
• Gels: Gels are thicker and don't drip as easily. They need to be rubbed in carefully to ensure all areas of the hands are covered. The amount applied should not be reduced just because the gel feels more concentrated.
• Foam: When using foam preparations, the visible foam volume should not be used as a guideline. A palmful of foam does not automatically correspond to the required amount of product. The crucial factor is that sufficient product is applied and that all areas of the hand remain completely wet during the application time.

Sources:

1. World Health Organization (WHO): WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge – Clean Care is Safer Care. Geneva: World Health Organization, 2009, pp. 152, 155. Accessed on 26.08.2026.
   https://iris.who.int/bitstream/handle/10665/44102/9789241597906_eng.pdf ↩︎
2. Zingg W, Haidegger T, Pittet D: Hand coverage by alcohol-based handrub varies: Volume and hand size matter. American Journal of Infection Control. 2016;44(12):1689–1691. DOI: 10.1016/j.ajic.2016.07.006. Accessed August 26, 2026.
   https://pubmed.ncbi.nlm.nih.gov/27566875/ ↩︎
3. Bellissimo-Rodrigues F, Soule H, Gayet-Ageron A, Martin Y, Pittet D: Should Alcohol-Based Handrub Use Be Customized to Healthcare Workers' Hand Size? Infection Control & Hospital Epidemiology. 2016;37(2):219–221. DOI: 10.1017/ice.2015.271. Accessed August 26, 2026.
   https://pubmed.ncbi.nlm.nih.gov/26598073/ ↩︎
4. Bánsághi S, Soule H, Guitart C, Pittet D, Haidegger T: Critical Reliability Issues of Common Type Alcohol-Based Handrub Dispensers. Antimicrobial Resistance & Infection Control. 2020;9:90. DOI: 10.1186/s13756-020-00735-4. Accessed August 26, 2026.
   https://pubmed.ncbi.nlm.nih.gov/32571388/ ↩︎