Topical antiseptic (biguanide) Pregnancy: No harmful effects in human pregnancy have been reported; nevertheless, like all medicines, care should be exercised during pregnancy and lactation (SPC section 4.6).

Chlorhexidine (Burns / Wound Antiseptic)

Brand names: Hibiscrub, ChloraPrep, Unisept

Chlorhexidine is a topical antiseptic used for skin disinfection, wound cleansing, and bathing of burns patients to reduce microbial colonisation and cross-infection.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: For general use, apply freely and smooth gently into the skin. For cuts, abrasions, burns etc. spread freely and, if necessary, cover with a dressing

Route: Topical (cutaneous) - cream applied to the skin

Frequency: As needed - the SPC states 'There are no recommended dosage schedules as the product is for use as needed'

SOURCE: UK SPC (eMC) for Acriflex 0.25% w/w Cream, a chlorhexidine-containing antiseptic cream, section 4.2 (https://www.medicines.org.uk/emc/product/4877/smpc). The SPC gives NO numeric dose, no fixed application frequency, no maximum quantity, no treated body-surface-area limit and no treatment duration - the entire posology is the 'apply freely / as needed' wording quoted above. No burns-specific quantity or dressing interval is stated. SAFETY LIMITS ON WHERE IT MAY BE APPLIED (section 4.4): must not come into contact with the eye - serious cases of persistent corneal injury, potentially requiring corneal transplant, have been reported after accidental ocular exposure to chlorhexidine-containing medicinal products despite eye-protective measures, due to migration of solution beyond the intended surgical preparation area; extreme care must be taken during application to ensure the product does not migrate beyond its intended application site into the eyes; particular care is needed in anaesthetised patients who are unable to immediately report ocular exposure; if it contacts the eyes, wash out promptly and thoroughly with water and seek an ophthalmologist's advice. Avoid contact with the brain, meninges and middle ear. Not for use in body cavities. Chlorhexidine is known to induce hypersensitivity, including generalised allergic reactions and anaphylactic shock; the prevalence is not known but available literature suggests this is likely to be very rare, and the product should not be administered to anyone with a potential history of an allergic reaction to a chlorhexidine-containing compound. No paediatric posology appears anywhere in this SPC - verify paediatric use against a children's formulary. The US openFDA entry in this bundle is a DIFFERENT product (Chlorhexidine Gluconate Solution 0.75% Antiseptic, Bajaj Medical, LLC) whose directions cover healthcare-personnel handwashing only (about 5 mL into cupped hands, wash vigorously for 30 seconds, rinse and dry) and which warns to use with care in premature infants and infants under 2 months of age as these products may cause irritation or chemical burns; it was not used for the dose on this page.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Known hypersensitivity to the product or any of its components, especially in those with a history of possible chlorhexidine-related allergic reactions

Side effects

Skin disorders (frequency not known): allergic skin reactions such as dermatitis, pruritus, erythema, eczema, rash, urticaria, skin irritation and blisters
Immune system disorders (frequency not known): hypersensitivity including anaphylactic shock
Eye disorders (frequency not known): corneal erosion, epithelium defect / corneal injury and significant permanent visual impairment
Post-marketing cases of severe corneal erosion and permanent significant visual impairment due to inadvertent ocular exposure have led to some patients requiring corneal transplant

Interactions

None known (SPC section 4.5)

Clinical monograph

How it works

Its cationic biguanide structure binds negatively charged bacterial cell membranes, disrupting them and causing leakage of cell contents, giving broad activity against Gram-positive and Gram-negative organisms.

Prescribing in practice

Chlorhexidine can cause anaphylaxis, and the MHRA has warned of this risk with medical and antiseptic products, so a history of reaction must be sought and exposure avoided in sensitised patients.
It is for external use only and should be kept away from the eyes, middle ear, and meninges as it is neurotoxic and ototoxic to those tissues.
Contact dermatitis and local irritation can occur with repeated application to broken skin.

Monitoring

Monitor for hypersensitivity reactions and for local skin irritation with repeated use.

Counselling the patient

This wash or solution helps reduce germs on the skin and wounds.
Tell staff immediately about any rash, swelling, or breathing difficulty, and keep it away from the eyes.

Evidence & guidelines

Chlorhexidine is a standard antiseptic for skin and wound antisepsis; the MHRA has issued safety advice on the risk of anaphylactic reactions.

Reference: PHE MRSA Decolonisation Guidelines; NICE CG74 Surgical Site Infection; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways