“Are handkerchiefs more hygienic than tissues?”
(and other questions)
#1: Are handkerchiefs more hygienic/sanitary than tissues?
It comes down to how you use it and what you use it for: Do you dispose of used, snotty tissues straightaway? Do you carry more than one hankie (as you would a packet of tissues)? Or do you change your cloth hankies frequently?
For obvious reasons, my household is an all-hankie household. Despite a member being immunosuppressant, we have used hankies, and even right through the Covid pandemic. We have not been worse off than those who only used paper tissues.
The advisory had been to “sneeze into your sleeve” or something else that catches whatever you are sneezing. A cloth hankie is just the “something else” that would work.
Either you scrunch up the bit that has been sneezed on, or you refold it with a dry surface ready to catch your next sneeze. To that end, the snot is not, and has never been, the issue (pardon the puns); it is what we do with it.
Iron your hankies if you can, but this is optional. Most bugs, known or unknown, will be killed under a hot iron, I imagine. I iron mine because I like to look neat and tidy. When was the last time you ironed paper tissue??
To start off, carry a spare hankie. On a day when I anticipate a higher mucus flow, I carry a few more.
Like I said, roll or fold up those bits of the hankie which are mucky.
Remove used hankies to wash basket or special hankie bag at the end of the day. Husband has a “hankie bag” because he likes washing his hankies at 60 degrees. Mine go into the normal wash.

Or you can use a pocket pouch with clean hankies, just like a paper tissue packet.
Elsewhere on the internet you will find scientists claiming that paper tissues are definitely more hygienic. I have no evidence to argue with them apart from knowing full well that hankies even during the pandemic had not been a setback for us.
Maybe this is because I have grown up using hankies, and I loved to receive hankies as a gift when I was young. I’m also steeped in the philosophy 病从口入( bìng cóng kǒu rù), that is “illness/disease enters through the mouth“. Conversely, what comes out of us does not harm us!
It may harm others, though, and that is why we keep the hankies to ourselves, instead of throwing them (like used tissues) into places where we cannot control their disposal. Who knows which animal (or even human being) might come rummaging through the bins? Or what about the municipal workers who have to come empty these? It’s a bit like wearing a cloth mask — remember those times? — to reduce spreading possible infection to others, rather than to prevent our own infection.)
Note: There was a time when I used paper tissues exclusively, when I suffered severe sinusitis. I went through a box of tissues in two days, I kid you not. Now I wonder if there was something in the tissue that aggravated my condition. I will never know.
#2: How many hankies do you need?
Apparently, when asked, “How much money is enough?”, John D Rockefeller answered, “Just a little bit more!”
It makes me feel very Rockefeller when trying to answer the question, “How many hankies do you need?” In my opinion: not enough! But don’t mind me.
Seriously, from question #1, I would say at least two a day. Depending how frequently you do wash them, perhaps 8 to 15 would be a good start.
The husband has enough to last a month. No kidding! Don’t forget, you need at least two while the rest are being washed.
You might also wish to consider whether or not to co-ordinate colours with your outfit. We have different weights of hankies for different seasons as well.
You know what they say, a journey of a thousand miles begins with a first step. Start with two hankies. See how you feel.
#3 Why I’m not using a cloth hankie again
It is expensive to throw away after just one use.
It requires washing. (See answer to question #1)
It catches all the icky stuff that comes out of your nose when you could simply be using a sleeve. (See answer to question #1)
It might not be hygienic, although even medics think hankies are OK.
It does not require cutting down trees (thus releasing captured carbon) for making paper tissue. Let’s See How Many Trees You Can Save From Not Using Tissue Paper

It comes in pesticide-free (ie organic) fabrics. (See this webpage)
It comes in different weights for different seasons. (See this webpage)
It comes in different colours to match your clothes. (See this website)

It does not leave fluff on your face, brows and beard when you have to wipe your perspiration. (In fact the idea for organic●ally™ started after paper tissue in my son’s pocket messed up the whole wash.) Now we know why sweaty, beardy orchestra conductors and other musicians do not use tissue paper on their faces!!
#4: How should I wash cloth hankies?
Like I said, everyone in my household uses hankies, and despite the husband being immunosuppressed, using hankies has never been a problem, healthwise.

The above poster, a public health poster, no less, advises the British to use a handkerchief instead of simply dispersing their water droplets everywhere when coughing and sneezing. It was probably created between 1939 and 1945, to “keep the nation fighting fit”. (See source.)
I simply throw my used hankies into a standard wash in a bog-standard washing machine. With the current concern to reduce our carbon footprint, we have been using a 30-degree wash instead of 40-degree. We do not own a tumble-dryer. Once hankies are dried I iron them with the rest of the laundry.
Note that most of the time our hankies are for wiping away perspiration or food remnants from our faces and hands, not to catch snot, as such.
Husband’s hankies are collected in a bag until there is enough sunshine to power our solar panels and for him to do a high temperature wash. They are dried naturally and then folded up. He does not even bother with ironing.

Son’s hankies goes in an ordinary eco-wash. He does not iron anything (!!). [Correction: He now irons his work shirts.]
Extra-snotty hankies. Ah! Allow me to be completely honest and truthful here.
During hayfever season or when I have a severe cold, my hankies are soaked with snot. I soak the really snotty hankies in hand-hot water in the sink. The dried-up snot floats away. Chuck out the water. Rinse again if you must. Hankies go in the wash. You can skip the soaking step. The hankies will still come out sanitized by a wash, but you might see some dark stains.
Covid-19. We all had Covid-19. We continued to use cloth hankies. We did not suffer worse than other people we know. In fact, we have not caught Covid twice as most of our friends had. We cannot be sure whether these friends use hankies or tissue paper.