Reviewed by Dr Sumbal Safi Ullah✓, MBBS
By Abu Bakar Saadat5 min readPublisher: Saadat Rafiq
Last updated: 31 October 2026References
IllustrationWet your hands, add soap, then rub palms, backs, between the fingers, thumbs and fingertips for about 20 seconds. Rinse and dry completely. Use alcohol gel only when there's no soap and water.
Most people rinse their palms and stop. The parts that get missed are the backs of the hands, between the fingers, the thumbs and the fingertips. The full routine takes about 20 seconds. Below, one example runs from dirty hands to clean, dry ones, with a drawing for every step.
Every step below follows one story, and each drawing shows that exact moment. Amira gets home on the bus and goes to the kitchen to start dinner. Before she touches any food, she washes her hands at the sink. Her daughter joins in and they sing Happy Birthday twice together.
In our story: Amira slips off her ring, puts it on the windowsill and wets both hands under the tap.
Remove rings and bracelets if you can (NHS). Wet your hands with clean, running water (CDC).
In our story: She presses the soap pump once into her palm.
Use enough soap to cover both hands (NHS). CDC says to turn off the tap before you apply soap.
In our story: Amira rubs her palms together until they're covered in lather and starts singing Happy Birthday.
Rub your hands together to work up a lather (NHS).
In our story: She rubs her right palm over the back of her left hand, fingers between fingers, then swaps.
Use one hand to rub the back of the other and clean between the fingers, then swap (NHS).
In our story: Palm to palm, she slots her fingers together and slides them back and forth.
Rub your hands together and clean between your fingers (NHS).
In our story: Amira hooks her fingers into each other and rubs the backs of her fingers against her palms.
Grip the fingers of each hand together (NHS), so the backs of the fingers get scrubbed too.
In our story: She wraps one hand around the other thumb and twists, then swaps.
Rub one thumb using your other hand, then the other thumb (NHS).
In our story: Amira bunches her fingertips and rubs them on the opposite palm, which also cleans under her nails.
Rub the tips of your fingers on the palm of your other hand (NHS). CDC also says to clean under your nails.
In our story: The second Happy Birthday ends, and she rinses off all the soap.
Rinse your hands well under clean, running water (NHS, CDC). The scrubbing should have taken about 20 seconds (NHS).
In our story: She dries her hands with a paper towel and uses it to turn off the tap.
Dry your hands completely with a disposable towel and use it to turn off the tap (NHS). CDC says a clean towel or an air dryer also works.
In our story: Amira's daughter climbs onto her step stool and washes too. They sing Happy Birthday twice, and she doesn't stop rubbing until the song ends.
Happy Birthday twice is about 20 seconds (NHS), a good timer for children. A step stool helps them reach the tap, and showing each step yourself is easier than explaining it (our advice).
What if Amira couldn't get to a sink? At the bus stop, she'd use hand gel from her bag, then wash properly when she got home.
Use an alcohol-based gel with at least 60% alcohol when soap and water aren't available (CDC). The NHS also says to use gel only when you can't get to soap and water. Use enough to cover your hands and rub until they're dry, about 20 seconds; don't wipe it off first (CDC). Supervise young children with gel so they don't swallow it (CDC).
| Situation | Use | Why |
|---|---|---|
| Most of the time | Soap and water | The best way to get rid of germs in most situations (CDC) |
| No sink nearby | Gel, at least 60% alcohol | Next best thing (CDC) |
| Hands visibly dirty or greasy | Soap and water | Gel may not work as well (CDC) |
| Someone at home has a vomiting bug | Soap and water | Soap and water work better than gel against norovirus (CDC) |
| After handling garden chemicals | Soap and water | Gel might not remove chemicals such as pesticides (CDC) |
| What happens | Likely cause | What to do |
|---|---|---|
| Children stop after a few seconds | No timer | Sing Happy Birthday twice together (NHS) |
| Skin gets dry and sore | Washing often | Dry completely and use a hand cream; see a pharmacist if it cracks or bleeds (our advice) |
| No paper towels | Ran out | A clean towel or an air dryer also works (CDC) |
| Gel feels sticky, hands still wet | Wiped off or not rubbed long enough | Rub until dry, about 20 seconds (CDC) |
About 20 seconds, as long as singing Happy Birthday twice (NHS). CDC says scrub for at least 20 seconds.
Not always. CDC says soap and water are the best way to get rid of germs in most situations, and work better than gel against some germs, such as norovirus. Gel may also not work as well on visibly dirty or greasy hands.
An alcohol-based one with at least 60% alcohol; check the label (CDC).
The NHS and CDC steps say water, or clean running water, and don't ask for hot. Use a temperature that's comfortable so you keep going for the full 20 seconds.
If possible, yes. The NHS says to remove rings and bracelets before washing.
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