The handshake represents a deeply established social custom. In recent years, however, there has been increasing recognition of the importance of hands as vectors for infection, leading to formal recommendations and policies regarding hand hygiene in hospitals and other health care facilities.1 Such programs have been limited by variable compliance and efficacy.1,2 In an attempt to avoid contracting or spreading infection, many individuals have made their own efforts to avoid shaking hands in various settings but, in doing so, may face social, political, and even financial risks.