Chlorhexidine Gluconate Myths Busted

Where do medical myths come from? More than a half century ago, a myth circulated that polio might be caused by summer air. Another myth was that anything that entered bodily tissues would ultimately be rejected (even though there had been limited success with hip implants). As a result, people often stayed indoors on summer evenings and implantable devices were considered a foolish notion until about 60 years ago. Today, it is known that polio spreads via fecal-oral transmission of the polio virus, and new materials have made implantable devices commonplace.

More recently, myths about cotton neutralizing chlorhexidine gluconate (CHG), CHG irritation, and CHG “washing off in the shower” are circulating because of a lack of understanding of how CHG works and from pervasive misinformation. The purpose of this article is to “bust” these myths.

The myth that cotton neutralizes CHG probably started because of confusion about how CHG binds to the stratum corneum of skin. One might assume that CHG would also bind to cotton or other materials often used to apply CHG antiseptics.

The neutralization myth was given some credibility by Dr. Graham Denton, a well-known CHG researcher who reported that CHG in solutions can bind to cotton. In discussions with Denton, he clarified that the amount of CHG that would likely be bound to a cotton washcloth during normal use would be minuscule, perhaps even undetectable. His research on CHG binding to cotton was performed on low-concentration CHG formulations packaged with towels of different materials for long periods of time.