Chlorhexidine is a broad-spectrum antiseptic used in medicine to treat wounds, gargle, disinfect the skin and mucous membranes, as well as in gynecology and urology. This drug is effective against most bacteria, fungi and viruses, has a prolonged effect and does not lose its effectiveness in the presence of organic substances (for example, blood and pus). In this article, we will analyze how chlorhexidine works, in what cases it can be used, and also consider its benefits and limitations.
What is Chlorhexidine and how does it work?
Chlorhexidine is a powerful antiseptic that is widely used in medicine due to its ability to destroy bacteria, viruses and fungi. It was developed back in the 1950s and has since become one of the most sought-after disinfectants.
The drug is effective in a variety of areas – from wound treatment to the prevention of sexually transmitted infections. Its peculiarity lies in the ability to maintain an antiseptic effect even after application to the skin or mucous membranes. Thanks to this property, it prevents the reproduction of microbes for several hours.
Unlike alcohol antiseptics, chlorhexidine does not cause burning or dry out the skin, making it convenient for regular use. However, despite its safety, it is not without limitations – for example, it cannot be used to treat eyes or deep wounds, as this can cause irritation.
Composition and main properties
The main active ingredient in the drug is chlorhexidine digluconate. Depending on the concentration, its content in the solution may vary. For example, in a common 0.05% solution, 0.25 ml of 20% chlorhexidine digluconate solution per 100 ml, the rest is purified water.
Additionally, the composition may include excipients that improve the solubility and stability of the drug. In the case of gels or sprays, thickeners and components are added to ensure an even distribution over the skin.
The main properties of chlorhexidine:
- Antiseptic effect – destroys bacteria, some viruses and fungi.
- Long-lasting effect – retains activity on the skin and mucous membranes for up to several hours.
- No irritation – does not cause burning, unlike alcohol-containing antiseptics.
- Compatibility with the skin – does not penetrate into the blood, so it is safe when used externally.
However, it is important to keep in mind that chlorhexidine is not compatible with soap and some alkaline compounds – their interaction can reduce the effectiveness of the drug.
Mechanism of antiseptic action
Chlorhexidine acts on microbial cells at the molecular level. Its active components destroy the membranes of bacteria, which leads to leakage of intracellular contents and the death of microorganisms.
The drug is especially effective against gram-positive and gram-negative bacteria, as well as some protozoa and viruses. At the same time, it does not lose its activity even in the presence of organic contaminants such as blood or pus.
An interesting feature of chlorhexidine is its ability to adsorb on the surface of the skin and mucous membranes. This means that once applied, it continues to work, creating a protective barrier against infection.
However, there are limitations – for example, against some viruses, such as rotavirus or adenovirus, chlorhexidine is ineffective. In such cases, it is recommended to use alcohol or chlorine-containing solutions for disinfection.
In what forms is it produced?
Chlorhexidine comes in different forms, each with its own characteristics and scope of application.
- The solution is the most common form, available in concentrations of 0.05%, 0.1% and higher. It is used for skin treatment, gargling, genital hygiene, and even for disinfecting medical instruments. Different concentrations are designed for different purposes – for example, a 0.05% solution is suitable for rinsing the mouth, while more concentrated solutions are suitable for surgical debridement.
- The spray is convenient for disinfecting hands and surfaces. Unlike a solution, it allows you to apply an antiseptic without the use of cotton pads or tampons. Most often, such sprays contain additional substances that ensure even distribution and better absorption.
- Gel – often used in dentistry and dermatology. It has a thicker consistency, which allows it to linger longer on the mucous membranes or skin. For example, chlorhexidine in gel form is used in the treatment of gum inflammation, as well as for the prevention of infections after dental procedures.
- Suppositories are used in gynecology and urology. They are convenient for treating vaginal infections, urethritis and some other diseases. Suppositories with chlorhexidine are prescribed for bacterial vaginosis, thrush, as well as for the prevention of infection after medical manipulations.
Thanks to such a variety of forms, chlorhexidine remains a universal antiseptic that can be used in a variety of situations – from everyday hygiene to serious medical procedures.
Treatment of wounds and skin injuries
Chlorhexidine is widely used to disinfect damaged skin. It helps prevent the development of infection, eliminates pathogens and accelerates healing. Unlike hydrogen peroxide, it does not cause active foaming, but at the same time effectively cleans the surface of the wound.
It is used for various types of injuries: abrasions, cuts, deep wounds, burns and postoperative sutures. Due to the absence of burning, the drug is suitable for treatment in both adults and children.
Can it be applied to an open wound?
Yes, chlorhexidine can be applied to an open wound, but it is important to consider several points. It does not damage tissues and does not cause necrosis, so its use is justified during the primary treatment of the wound. However, for a deep wound surface, it is better to use it with caution, as it does not have regenerating properties.
To disinfect small cuts or scratches, it is enough to moisten a cotton pad or gauze swab with a 0.05% solution and gently treat the damaged area. In the case of more serious wounds, a sterile bandage impregnated with chlorhexidine can be applied and secured with a bandage or plaster.
Hand disinfection
Chlorhexidine is a popular hand sanitizer, especially in healthcare settings. It provides long-lasting antiseptic protection, destroying microbial flora and preventing reinfection.
For everyday use, %-0,1% solution is used. It can be applied to the skin of the hands with a cotton swab or simply sprayed in the form of a spray. If it is necessary to enhance the effect, hands are pre-washed with soap, dried and only after that treated with an antiseptic.
Treatment of burns
In case of burns, it is important to prevent infection of the affected area, as the damaged skin becomes vulnerable to bacteria. Chlorhexidine can be used for superficial burns (1st and 2nd degree) by gently applying it to the skin with a sterile cotton swab.
If the burn is accompanied by blistering or affects a large area, the treatment should be carried out carefully. In such cases, it is best to consult a doctor first.
Gargling for sore throat and stomatitis
Chlorhexidine is an effective gargling agent for infectious and inflammatory diseases. It helps with sore throat, pharyngitis, laryngitis, and is also used in dentistry to treat gingivitis, stomatitis and periodontal disease.
The antiseptic properties of chlorhexidine allow not only to destroy bacteria, but also to create a protective barrier, preventing their reproduction. Gargling with this solution reduces inflammation, relieves pain and promotes faster recovery.
For rinsing, %-0,1% solution is usually used, which can be used undiluted. However, if the solution seems too concentrated or causes discomfort, it can be slightly diluted with boiled water.
Gargle 2-3 times a day, avoiding swallowing the solution. After the procedure, it is advisable not to eat or drink for 30-40 minutes so that the antiseptic effect lasts longer.
How to rinse properly after tooth extraction?
After tooth extraction, it is important to be careful when using any antiseptics. Chlorhexidine in this case is the best fit, as it does not irritate the mucous membrane and has a long-lasting antiseptic effect.
However, it is important to rinse correctly:
- Do not make sudden movements. Rinsing should be gentle, without an active “rinsing” effect, so as not to wash out the blood clot that promotes healing.
- Use a warm solution. Liquids that are cold or too hot can cause discomfort and increase inflammation.
- Take the solution into your mouth and hold it for 30-60 seconds, then gently spit it out.
Rinsing is carried out 2-3 times a day for several days after tooth extraction. At the same time, it is recommended to avoid hard food and mechanical irritation of the gums so as not to provoke complications.
If severe pain, swelling or bad breath appear after tooth extraction, it is necessary to urgently consult a dentist.
Use in gynecology
Chlorhexidine is actively used in gynecology due to its powerful antiseptic effect. It is effective against most pathogens of sexually transmitted infections, as well as fungi and bacteria that cause inflammatory diseases of the female reproductive system.
This drug does not affect the normal microflora of the vagina, which makes it safe for women. However, prolonged or uncontrolled use can lead to a violation of the natural balance of microflora, so it is important to follow the doctor’s recommendations.
Chlorhexidine douching
Chlorhexidine douching is used in the treatment of bacterial vaginosis, vaginitis and other infectious diseases. The procedure helps to reduce the number of pathogens and reduce the inflammatory process.
The procedure is carried out as follows:
- The vagina should be cleaned beforehand (preferably before going to bed).
- A 0.05% solution of chlorhexidine is used, which is injected into the vagina using a special nozzle.
- The liquid is injected in small portions, after which it is necessary to lie down for 10-15 minutes.
- The course of douching is usually 5-7 days, depending on the doctor’s recommendations.
Despite the effectiveness of the method, douching should not be used too often, as this can lead to an imbalance in the natural microflora of the vagina.
Chlorhexidine suppositories
Vaginal suppositories with chlorhexidine are used for the treatment of sexually transmitted infections (for example, trichomoniasis, chlamydia), as well as for the prevention of inflammatory diseases.
Suppositories are usually inserted into the vagina 1-2 times a day for 7-10 days. They are easy to use, do not cause irritation and provide a prolonged effect.
Chlorhexidine for thrush and infections
Chlorhexidine is not the main drug for the treatment of candidiasis (thrush), as it does not have a pronounced antifungal effect. However, it can be used as an adjuvant, for example, to eliminate inflammation and itching.
In bacterial infections of the vagina (bacterial vaginosis, gardnerellosis), chlorhexidine can be used as part of complex therapy. It helps to destroy pathogens and reduce the severity of symptoms.
In addition, chlorhexidine is used before and after gynecological operations, as well as before childbirth to reduce the risk of infectious complications.
Use in Urology
In urology, chlorhexidine is used for the prevention and treatment of infectious and inflammatory diseases of the genitourinary system. It is effective for urethritis, urethroprostatitis and sexually transmitted infections.
The drug can be used as an independent remedy or in combination with antibiotics. Its antiseptic effect extends to a wide range of pathogens, including gonococci, chlamydia, ureaplasma and trichomonas.
How is chlorhexidine used in urology?
The drug is injected into the urethra in a small amount (2-3 ml for men and 1-2 ml for women). The procedure is performed using a sterile syringe without a needle or a special applicator.
After injecting the solution, it is recommended to hold it in the urethra for 2-3 minutes, then the liquid naturally comes out. The course of treatment is usually 10 days, procedures are carried out every other day.
To prevent sexually transmitted infections, chlorhexidine treatment is carried out no later than 2 hours after unprotected contact. To do this, the solution is applied to the external genitalia, the inner thighs and injected a small amount into the urethra.
Other Uses
Chlorhexidine is a universal antiseptic that has found application not only in medicine, but also in everyday life. It is used in a variety of situations where effective disinfection is required.
- In case of excessive sweating
Chlorhexidine can be used for hyperhidrosis – excessive sweating. It not only destroys bacteria that cause bad breath, but also reduces the amount of sweat. To do this, the skin of the armpits or feet is wiped with a 0.05% solution once a day.
The use of chlorhexidine to combat sweating is especially relevant in the summer, when traditional deodorants may not be up to the task.
- Disinfection of shoes
Chlorhexidine solution is excellent for treating shoes in order to prevent fungal infections. It destroys fungal spores and bacteria, preventing them from multiplying inside the shoe.
To do this:
- Insoles and the inner surface of shoes are wiped with a cotton pad soaked in a solution of chlorhexidine.
- Then the shoes are left overnight to dry completely.
This procedure is especially useful for athletes, people suffering from nail or foot fungus, as well as those who wear closed shoes in the hot season.
- Medical Instrument Processing
Chlorhexidine is used in healthcare settings and in home practice to disinfect tools such as manicure supplies, tweezers, and thermometers.
To do this:
- Tools are soaked in the solution for 10-15 minutes.
- After that, they are washed with clean water and dried.
This method allows you to effectively destroy germs and prevent infection through tools.
- Surface and hand treatment
Chlorhexidine can be used to disinfect work surfaces, mobile phones, doorknobs, and other items that come into frequent contact with hands. It does not leave a sticky film and does not damage surfaces, unlike alcohol antiseptics.
It is also used for hygienic treatment of hands, especially in conditions where it is not possible to use water and soap.
Instructions for use
Chlorhexidine is a broad-spectrum antiseptic, and its use varies depending on the purpose of application. The drug comes in a variety of concentrations, and it’s important to understand when it can be used undiluted and when dilution is needed. Improper use can lead to a decrease in effectiveness or, conversely, cause irritation and side effects.
How to use the mortar correctly?
Chlorhexidine is used in the form of an aqueous or alcoholic solution of various concentrations.
- 0.05% solution is universal and the most common, suitable for treating the skin, mucous membranes, rinsing the mouth and throat. It can be used without dilution.
- 0.1% solution – used for disinfection of medical instruments, as well as in gynecology and urology. It can be used without dilution, but requires caution when treating mucous membranes.
- 0.2% and 0.5% solutions are intended for the treatment of surgical wounds, burns and skin infections.
- 1% solution is used to disinfect medical equipment and surgeon’s hands before surgery.
- 5% and 20% concentrates are not used in their pure form, they are diluted to the desired concentration before use.
How to use chlorhexidine for different purposes?
- For the treatment of wounds and skin
A solution of 0.05-0.1% is applied to the damaged surface using a cotton swab or sterile napkin. Dressings soaked in the solution can be applied.
- For rinsing the mouth and throat
A 0.05% solution is used, which does not require dilution. Rinse your mouth and throat for 30-60 seconds 2-3 times a day.
- For hand sanitizing and disinfecting objects
A 0.5-1% solution is suitable for hands. For disinfection of instruments, 1% or more concentrated solutions are used.
- For gynecological use (douching, suppositories)
A 0.05% solution is used, which is injected into the vagina using a special nozzle.
- For Urological Procedures
A 0.05% solution is used, which is injected into the urethra for the treatment of urethritis and urethroprostatitis.
It is important to remember that chlorhexidine should not be mixed with soaps and alkaline substances, as this reduces its effectiveness.
Features of external and internal use
Chlorhexidine is intended mainly for external use, but in some cases it is allowed to be used on mucous membranes, in urology and gynecology.
External use includes:
- treatment of wounds, burns, scratches,
- skin disinfection,
- use in surgical practice to prepare the surgical field,
- hygienic treatment of hands.
Chlorhexidine does not penetrate through intact skin and is not absorbed into the bloodstream, so it can be used even with long-term use.
Internal use is possible only in strictly defined cases:
- in the treatment of infections of the genitourinary system (injection into the urethra),
- gynecological procedures (douching, vaginal suppositories),
- when gargling and mouth.
If the solution is accidentally swallowed, it is necessary to immediately flush the stomach with water or milk. In large doses, chlorhexidine is toxic, so its internal intake is strictly prohibited.
Can chlorhexidine be used by pregnant women and children?
Chlorhexidine can be used during pregnancy and lactation, but with caution. It is not absorbed into the blood and does not have a systemic effect on the body, so it is prescribed for infections of the genitourinary system, dental diseases and for antiseptic treatment.
During pregnancy
- Approved for external use (treatment of skin, hands, wounds).
- Can be used for gargling with sore throat, stomatitis and pharyngitis.
- Use in gynecology (douching, suppositories) is permissible only by prescription of a doctor.
When breastfeeding
- It is not recommended to apply chlorhexidine to the breast area before feeding.
- For disinfecting hands and objects, it can be used without restrictions.
Can children do it?
- Chlorhexidine is not recommended for children under 12 years of age, especially for gargling, as the child may accidentally swallow the solution.
- In rare cases, it is used to treat skin and wounds in children, but only in minimal concentrations (0.05%).
- If an antiseptic for the throat is required, it is better to use special baby solutions.
If you have any doubts about the use of chlorhexidine in pregnant women or children, consult your doctor.
Contraindications and side effects
Chlorhexidine is considered a safe antiseptic, but its use is not always acceptable. Some people may experience side effects associated with individual intolerance to the drug.
Who should not use an antiseptic?
Chlorhexidine is contraindicated in the following cases:
- Allergy and hypersensitivity – if a person has allergic reactions to the drug, its use is prohibited.
- Dermatological diseases – in case of eczema, dermatitis and viral skin lesions, an antiseptic can aggravate the situation.
- Viral skin infections – for example, with herpes or chickenpox, the use of chlorhexidine is ineffective.
- Open wounds with extensive tissue damage – although the drug can be used to treat the skin, in deep wounds or burns, it can slow healing.
- Use in ophthalmology – chlorhexidine should not be used to rinse the eyes, as it can cause irritation and burn of the cornea.
Particular caution should be exercised when using the drug in childhood and in pregnant women.
Can chlorhexidine cause burns or allergies?
Chlorhexidine is rarely irritating, but in some cases, the following may occur:
- redness and dryness of the skin,
- itching and burning sensation,
- allergic rashes.
With long-term use in dentistry, dark staining of tooth enamel and temporary violation of taste sensations are possible.
As for burns, chemical burns are possible at high concentrations (more than 1%) and prolonged contact with mucous membranes. Therefore, it is impossible to use concentrated solutions on the skin and mucous membranes – they are intended only for disinfecting instruments.
How long can I use it?
Chlorhexidine can be used for a long time when it comes to external skin treatment. However, when treating mucous membrane infections or mouthwashes, the course of treatment usually does not exceed 10-14 days to avoid side effects.
In dentistry, it is used for no more than 2 weeks, otherwise there is a risk of tooth discoloration.
In gynecology and urology, the course of treatment with chlorhexidine is also limited to 7-10 days, since longer use can disrupt the microflora of the mucous membranes.
How is Chlorhexidine different from hydrogen peroxide and other antiseptics?
There are many antiseptics on the market, and each has its own advantages and disadvantages.
| Criterion | Chlorhexidine (0.05–0.2% aqueous) | Iodine (povidone-iodine 5–10%) | Ethyl/isopropyl alcohol 60–96% |
| Type of agent | Biguanide-based antiseptic | Halogen-containing antiseptic | Alcohol-based antiseptic/disinfectant |
| Antiseptic action (bacteria, viruses, fungi) | Bacteria (Gram±), yeasts, some enveloped viruses; not active against spores | Very broad spectrum: bacteria, viruses, fungi, some spores | Bacteria, most viruses (especially enveloped), fungi; spores — no |
| Speed of action | Fast (tens of seconds — about a minute) | Fast/medium (1–2 min) | Very fast (10–30 s) |
| Duration of action (residual effect) | Present (up to 4–6 h on skin) | Short; only while it remains on the surface | None (evaporates) |
| Skin irritation potential | Low/moderate | Moderate; may cause burning | Drying; may irritate |
| Use on mucous membranes | Limited, with caution (mouth, throat — do not swallow) | Permissible with care (risk of iodine absorption) | No (marked irritation/burn) |
| Use in children | Yes, external use; avoid swallowing | With caution; undesirable in neonates/infants | Spot use only on small areas; not recommended for infants |
| Treatment of open wounds | Minor wounds, cuts | Allowed (if no contraindications) | Undesirable (painful; tissue damage) |
| Skin staining | No | Yes, brown | No |
| Alcohol content | Usually no (aqueous solutions), alcohol-based forms exist | May be included, but more often aqueous | Yes |
| Risk of allergic reaction | Low, but dermatitis is possible | Present (iodine allergy), possible thyroid dysfunction | Low; more often dryness/irritation |
| Price | Low | Medium | Low/medium |
| Availability | High, over the counter | High, over the counter | High, over the counter |
| Indications for use | Skin and hand antisepsis, minor wounds, mucous membranes (oropharynx) | Disinfection of skin and mucous membranes, surgical field preparation, wounds | Hand antisepsis, skin prep before injections, rapid surface disinfection |
| Contraindications | Hypersensitivity, eyes/ears; do not mix with alkalis/iodine | Iodine allergy, thyrotoxicosis, dermatitis, infants | Damaged mucous membranes, extensive burns, hypersensitivity, children under 1 year (large areas) |
Note: Data is generalized for typical pharmacy concentrations. Always check the instructions for the specific product.
Comparison with hydrogen peroxide, furacilin and miramistin
- Hydrogen peroxide has a foaming effect, which helps to mechanically clean wounds from dirt and pus. However, its antiseptic effect is short-lived, and it is less effective in killing bacteria compared to chlorhexidine.
- Furacilin is mainly used to rinse the mouth and throat, as well as to treat the mucous membranes of the eyes. It has antibacterial properties, but is inferior to chlorhexidine in terms of duration of action.
- Miramistin is a wider spectrum of antiseptic action, including viruses. However, it is much more expensive than chlorhexidine and is not always justified in routine use.
Thus, chlorhexidine is the best choice of drug for skin treatment to put in the first-aid kit.
Can Chlorhexidine be used instead of other antiseptics?
Chlorhexidine can replace hydrogen peroxide in most cases, but it does not have a hemostatic effect, so peroxide will be more effective in case of capillary bleeding.
Instead of furacilin, chlorhexidine can be used to gargle, but it can cause dryness of the mucous membrane, so it is not always used in long-term treatment.
Miramistin is a more universal antiseptic, but in most cases, chlorhexidine copes with similar tasks, while its price is much lower.
Chlorhexidine is an affordable and effective antiseptic, which in most cases can replace other means. However, its use should be appropriate for the specific task and type of infection.
FAQs
Can chlorhexidine be used on children?
Yes, it can be used to treat skin and minor wounds in children, but it is better to use low concentrations (0.05%) and avoid contact with the eyes, ears, and inside the body. Children are only allowed to rinse their mouth or throat with it on the recommendation of a doctor and under adult supervision to ensure that the child does not swallow the solution.
What effect can be expected and why do doctors choose it?
Chlorhexidine is a broad-spectrum antiseptic: it quickly reduces the number of bacteria, fungi, and some viruses and has a residual effect on the skin for several hours. Doctors value it for its effectiveness, affordability, low absorption into the bloodstream, and stability of action even in the presence of biological fluids.
Can it be used for the throat, intimate hygiene, oral cavity, skin, wounds, and piercings?
Yes, but with some nuances: for the throat and oral cavity — short courses without swallowing; for the intimate area — only externally and not every day, so as not to dry out the mucous membranes; for the skin, fresh punctures, and minor wounds — suitable for antiseptic treatment. Do not use on the eyes or ear canal, and do not mix with iodine or alkaline agents. If irritation or allergy occurs, discontinue use and consult a doctor.
Literature:
- Chlorhexidine: Its Properties and Effects (https://rjptonline.org/HTMLPaper.aspx?Journal=Research%20Journal%20of%20Pharmacy%20and%20Technology;PID=2016-9-10-52)
- Chlorhexidine gluconate, its properties and applications in endodontics (https://pmc.ncbi.nlm.nih.gov/articles/PMC3834637/)
- Biocide resistance in Acinetobacter baumannii: appraising the mechanisms (https://www.sciencedirect.com/science/article/abs/pii/S0195670121003340)
Author: Natalia Kandybey, Candidate of Pharmaceutical Sciences, Quality Director of PJSC Pharmaceutical Factory “VIOLA”
The information provided is not medical advice and does not replace professional health recommendations.
The information is based on scientific literature and is provided for informational purposes only.
