Hexachlorophene is a chemical compound that was historically used as an antibacterial agent in various personal care products and antiseptic preparations. Its chemical formula is C13H6Cl6O2, and it is a white crystalline powder that is insoluble in water.

Hexachlorophene was commonly employed in soaps, lotions, and other skincare products due to its antimicrobial properties. It was particularly popular as a surgical scrub and for handwashing in healthcare settings. However, its use has significantly declined due to concerns about its safety and potential neurotoxic effects.

In the past, hexachlorophene was linked to cases of poisoning, especially in infants, leading to a condition known as "hexachlorophene toxicity" or "hexachlorophene poisoning." This led to the U.S. Food and Drug Administration (FDA) restricting its use in over-the-counter consumer products in 1972. Today, hexachlorophene is generally not used in common household products, and alternative antimicrobial agents are preferred.

Hexachlorophene was previously a common ingredient of many over the counter products including soaps (Dial Soap), toothpaste (Ipana), cosmetics (Watkins Cologne for Men), and antibacterial skin cleansers (phisoderm and phisohex). The effect of the active ingredient, hexachlorophene, on brains of young children that resulted in 39 deaths in France and 15 deaths in the United States in 1972 lead to the discontinuation of the product.

Hexachlorophene Uses:

• It was previously used as a surgical scrub and as a bacteriostatic skin cleanser.
• It was used to control an outbreak of gram-positive infection when other procedures were unsuccessful.

Dose in adults:

• All products containing the drug have been discontinued for more than a year because of the serious and sometimes fatal side effects.
• It was used as a 5 ml solution applied to wet hands and arms followed by rubbing it over the skin for a few minutes.

Dose in Children:

• All the products that contain the active ingredient have been discontinued.
• It should be strictly avoided in children because it may cause serious brain injury and death.

Pregnancy Risk Factor X

• Using hexachlorophene during pregnancy can be risky.
• Studies on animals have shown negative effects on reproduction.
• When hexachlorophene is applied on the skin, it gets absorbed into the body.
• If it's used as an antiseptic during vaginal exams for childbirth, it can be found in the mother's blood and the baby's cord blood.
• It's not recommended to use hexachlorophene in the vagina or on mucous membranes like with packs, tampons, or direct application.

Use during breastfeeding:

• We're not sure if hexachlorophene passes into breast milk.
• If a nursing mother is using hexachlorophene, she should weigh the importance of treatment against the potential risks for the baby.
• It might be necessary to choose between stopping breastfeeding or discontinuing the use of the drug, considering the potential for serious adverse reactions in the nursing infant.

Side effects of Hexachlorophene (Dermisan):

Local application-site related side effects:

• Skin irritation
• itching
• hives
• redness

CNS side effects:

• Irritability
• confusion
• jitteriness
• drowsiness
• seizures

Contraindication to Hexachlorophene (Dermisan):

• Don't use hexachlorophene if you're allergic to similar chemicals or hexachlorophene itself, if your skin is burned or damaged, or if you're applying it as a wetpack, lotion, or occlusive dressing.
• Avoid using it on mucous membranes or as a vaginal pack or tampon.
• Also, it's not meant for regular whole-body bathing just for prevention.

Warnings and precautions

Cerebral irritability:

• If you notice signs of cerebral irritability (such as increased irritability or agitation in the brain), stop using the product containing hexachlorophene.

Hexachlorophene: Drug Interaction

Monitoring Parameters:

None mentioned. Observe for allergic reactions such as itching, urticaria, and redness after application.

How to apply Hexachlorophene (Dermisan)?

• It is applied to wet hands and forearms before a surgical procedure.
• About 5 ml of the solution is poured into the palm and rubbed over the exposed forearm and hands thoroughly (including the interdigital areas).
• The process may be repeated twice or thrice to ensure adequate antiseptic measures.

Mechanism of action of Hexachlorophene (Dermisan):

• Hexachlorophene is a type of chemical that stops bacteria from growing.
• It does this by interfering with enzymes on the cell membrane and messing up the structure of the cell membrane itself.

Absorption:

• Hexachlorophene gets into the body through the skin.
• This can happen even if the skin is damaged or healthy.

Half-life elimination:

• In infants, the time it takes for half of the hexachlorophene to leave the body ranges from 6.1 to 44.2 hours.
• Half-life elimination is a measure of how long it takes for the substance to reduce by half in the body.

International Brand Names of Hexachlorophene:

• Phisohex Topical
• Aknefug-simplex
• Dermisan
• Jabon Antiseptico
• Phisohex
• Ritosept

Hexachlorophene Brand Names in Pakistan:

No Brands Available in Pakistan