How Bad Is It Really to Skip Washing Your Hands After Using the Bathroom?

It's a lesson that has been drummed into our brains since potty training: "Always wash your hands after you go to the bathroom." But a January 2020 YouGov poll found that 42 percent of Americans don't consistently soap up after a trip to the toilet at home.

So fess up: Do you ever cut corners? On occasion, do you give your hands a perfunctory rinse without actually sudsing up, or even bypass the sink altogether?

You might wonder, hey, how much harm could it actually do? Doesn't the kitchen have more germs than the bathroom anyway? Well, hold onto your pants because you're about to learn the dirty truth.

If you're sitting on your home throne, the answer is probably not. Even if you were carrying a pathogen in your feces, urinary tract or genital skin that was transferred onto your hands while using the toilet, you should be in the clear.

"It won't infect you because you have that organism in your system already," says Philip Tierno, PhD, clinical professor of microbiology and pathology at NYU Langone and author of ​​First, Wear a Face Mask: A Doctor's Guide to Reducing Infection During the Pandemic and Beyond​​.

(One exception is staph aureus, which some people carry in their intestines. "You could theoretically contaminate your hands with staph while using the bathroom," Tierno says. "If the bacteria got into a cut or open wound, then you could contract a staph infection." But that's pretty unlikely.)

Using a public restroom is a different story. "A toilet facility is a harbinger of organisms, since there are many people going in and out, and not all of them are washing their hands," Tierno says.

It is also a high-contact area. "You are touching the doorknob to get in and out, opening and closing the latch, perhaps lowering the toilet seat and pressing the flusher," Tierno says. So if you pop a squat and then don't soap up, you could be picking up all sorts of germs.

That includes the novel coronavirus, which can linger on bathroom surfaces that an infected individual has either touched or coughed or sneezed on (if they weren't wearing a mask). The Centers for Disease Control and Prevention (CDC) reports that the coronavirus can stay on surfaces for days, while other types of pathogens can stick around for weeks, according to Tierno.

And that's not all. "The coronavirus can be in the intestines and can spread via fecal matter," Tierno says.

Ready to get grossed out? "When you flush a toilet, the churning and bubbling of water aerosolizes fecal matter, [creating] particles that will float in the air," wrote Joseph Allen, associate professor of exposure assessment science at Harvard T.H. Chan School of Public Health, in a September 2020 ​Washington Post​ op-ed.

Toilet water particles can spray as far as 15 feet, Tierno says, and some of the aerosolized feces settle on bathroom surfaces that you might then touch with your hands.

Ultimately, the greatest health risk posed by skipping the sink isn't germs in your pee and poop, but rather pathogens you've picked up from everything you've handled along the way — whether at home or when you're out.

Tierno emphasizes that there are two situations when you absolutely must scrub up in order to protect yourself from contamination. "First, you have to wash your hands before eating, drinking or preparing food," Tierno says. "You also must wash them prior to touching your face — your eyes, ears, nose and mouth are the conduits of entry into your body."

Since humans touch their faces about three to four times an hour, according to a February 2013 ​Clinical Infectious Diseases​ article, sticking to Tierno's guidelines requires frequent hand cleaning, including after using the bathroom.

Maybe, maybe not. "You can literally spoon-eat human feces without any deleterious effect as long as there are no pathogens in the content," Tierno says. "However, you can't guarantee that it is pathogen-free."

Basically, if you're not carrying any harmful viruses or bacteria in your system, then you won't spread infection to others. But there's no way to know for sure what germs you might be harboring.

And if you do have disease-causing microorganisms in your intestines or genital area, and some were transferred to your hands while in the bathroom? Then you could potentially pass them along to another person via surfaces you later touch. "For the protection of others, you must wash your hands after using the toilet," Tierno says.

Even if you're home alone, remember that germs can linger for weeks, putting future visitors at risk. "Not washing at home will probably have very little effect on you, but it could have a big effect on others," Tierno says.

That said, exposure alone doesn't mean that illness is inevitable. If an individual touches a contaminated surface, their body might be able to fight off infection.

"There is a seesaw relationship between man and microbe as to whether you will get sick when exposed to a pathogen," Tierno says. "The normal flora in your bowels is very powerful — it competes with whatever organism you have taken in and can prevent it from taking hold."

Another factor that determines whether or not someone will become sick is what type of pathogen they come into contact with. "Some organisms are more virulent than others," Tierno says. For example, you need 10,000 salmonella cells in order to initiate an infection, while it only takes 100 shigella cells to contract a disease.

"By not washing your hands, you are choosing not to protect others. And if we don't care for each other, then we have lost a part of our humanity."

The person's health also plays a role. Some people have hardier immune systems than others and are better equipped to fend off infection. Older folks and those who are immunosuppressed are more vulnerable.

If someone did get a high enough bacterial or viral load to become infected, they might experience anything from mild tummy trouble to severe illness, depending on the type of contaminant, volume of cells they took in and their existing health.

"Norovirus could cause diarrhea and vomiting," Tierno says. "Salmonella and shigella can lead to systemic and intestinal infection, some of which can be serious, especially in older adults and the immunocompromised."

Hands down, it's crucial to get clean.

Nope. "One is not worse than another," says Kelly Mudon, MD, a physician specializing in family medicine at Community Health of South Florida.

Sure, your feces can contain concerning organisms like salmonella, shigella, campylobacter, norovirus and pathogenic strains of E. coli. But urine isn't any better.

"There can be STIs like gonorrhea and syphilis in the content of the genital urinary tract," Tierno says. "There are also skin pathogens [in the genital area] such as candida and staph."

We all likely know by now that it's important to scrub with soap and water for at least 20 seconds, per the CDC. "Still, even those who are practicing good hygiene are often not thorough enough," Dr. Mudon says.

Here are a few other best practices:

​1. Wash your whole hand.​ Pay special attention to your fingertips, the webbing in between your fingers, all sides of your thumbs and the backs of your hands. These are the most commonly missed areas, according to an August 2019 study in the ​Journal of Environmental and Public Health​.

​2. Clean under your nails.​ Per the CDC, particularly high concentrations of microbes are found under the nails, so clean well there, too. You can do so by soaping up your hands and then scratching your nails against your opposite palm.

​3. Dry your hands with a paper towel.​ Germs are spread more easily from wet hands, according to the CDC. Although there is some conflicting evidence about whether hand dryers or paper towels are more hygienic, a systematic review of 12 studies in the August 2012 issue of ​Mayo Clinic Proceedings​ suggests that paper towels are the most sanitary. Tierno even brings his own paper towel with him when using a public restroom, just in case.

​4. Hang onto your paper towel after you rinse.​ "Touching a dirty doorknob negates your wash, so I use my paper towel to turn off the faucet and open the bathroom door before I leave," Tierno says. "I deposit it outside the bathroom door on the floor — if there is no receptacle there yet, there soon will be."

It is a serious problem, according to Dr. Mudon. "Addressing hand washing is more pertinent than ever in the times of COVID," she says, "Although it's also important for preventing the spread of small-scale infection, like colds."

Skipping the sink in a public restroom puts your health on the line. "We are our own worst enemy sometimes," Tierno says. "A pandemic is the time to step up our hygiene."

And when it comes to potentially contaminating someone else, Tierno views not washing up as an act of disrespect. "You are choosing not to protect others," he says. "And if we don't care for each other, then we have lost a part of our humanity."

In his opinion, this is about more than just cleanliness; our bathroom behavior reflects a spirit of compassion and benevolence for our community. "The integrity of our society is affected by the way we deal with our personal hygiene," Tierno says. "If we don't respect one another [by washing our hands], then we as a society fail, all hell breaks loose and it is every man for himself."

The verdict is clear: For the benefit of humankind, wash your hands, people!