Always wash - If can't wash then use antibac-gel (milton one is good but just found the carex one which actually smells nice!! Northern essence one doesn't rub in well), - and if I'm being paranoid will wash my hands, then antibac too!!
Am paranoid about germs on hands tho' - you wouldn't believe it if you saw what a scruffy mess my house is but honestly, I must wash my hands at least 10times while making tea if I've touched meat, sneezed, rubbed my nose etc etc... No wonder they're sore!!
Am trying the soap Ali mentioned but it stings
Lush handcream is fab tho'...