From the Guidelines
Topical ethanol is recommended as an effective antiseptic for skin disinfection, particularly at concentrations between 60-90%, with 70% ethanol being optimal for its ability to penetrate cell membranes and kill microorganisms. The use of ethanol as an antiseptic is supported by its ability to denature proteins in microorganisms, effectively killing bacteria, fungi, and some viruses on contact 1. For antiseptic use, applying 70% ethanol to a cotton ball or pad and wiping the skin area thoroughly, allowing it to air dry completely before any procedure, is a common practice. This typically takes 30 seconds to 1 minute, during which time the ethanol evaporates rapidly without leaving residue.
Key Considerations for Use
- Ethanol is particularly useful for quick disinfection due to its rapid evaporation and lack of residue.
- It should not be used on open wounds as it can damage tissue and delay healing; instead, antiseptics like povidone-iodine or chlorhexidine are more appropriate for wound care.
- Repeated use of ethanol can cause skin dryness, so moisturizing afterward may be beneficial.
- Ethanol should never be ingested and should be kept away from children.
Efficacy Against Microorganisms
- Ethanol has been shown to reduce titers of enveloped viruses and bacteria effectively 1.
- It is less effective against nonenveloped viruses, bacterial spores, and protozoan oocysts.
- The addition of chlorhexidine, quaternary ammonium compounds, octenidine, or triclosan to alcohol-based solutions can result in persistent activity against microorganisms.
Practical Application
- For skin preparation before injections or medical procedures, 70% ethanol is a recommended concentration due to its optimal balance between efficacy and tissue penetration.
- Always follow the application instructions and ensure the skin is completely dry before proceeding with any medical procedure to maximize the antiseptic effect of ethanol.
From the Research
Ethanol Topical Use
- Ethanol is used as a topical antiseptic to prevent surgical wound infections and intravascular-catheter-related infections 2, 3, 4, 5.
- The effectiveness of ethanol as a topical antiseptic depends on its concentration, with 80% ethanol being highly effective against enveloped viruses 6.
- Ethanol can be used in combination with other antiseptics, such as povidone-iodine or chlorhexidine, to enhance its antimicrobial efficacy 3, 4, 5.
Comparison with Other Antiseptics
- Chlorhexidine-alcohol was found to be more effective than povidone iodine-alcohol in preventing intravascular-catheter-related infections 4.
- Povidone-iodine-ethanol was found to have a higher log reduction factor than chlorhexidine gluconate-ethanol immediately after handwashing, but the difference decreased over time 5.
- Ethanol at 95% was found to have a broader spectrum of virucidal activity than ethanol at 80% 6.