Brand Names of Hexachlorophene Soaps
Hexachlorophene soaps are available by prescription only in the United States, with pHisoHex being the most well-known brand name of 3% hexachlorophene soap formulation. 1
Available Formulations
Hexachlorophene has been formulated in several preparations:
- pHisoHex - The most common brand name, containing 3% hexachlorophene in a detergent base 1, 2
- Septisol - A 0.23% hexachlorophene concentration in alcohol-based foam 3
- 2.5% soap gel formulations - Shown to have broader antimicrobial spectrum and faster killing action than 3% detergent formulations 4
Safety Concerns and Regulatory Status
Hexachlorophene soaps have significant safety concerns that have led to regulatory restrictions:
- The FDA has classified hexachlorophene as "not generally recognized as safe and effective" for use as an antiseptic handwash 1
- These products are available by prescription only in the United States 1
- Hexachlorophene is absorbed through the skin with repeated use 1
- Healthcare workers regularly using 3% hexachlorophene preparations have shown blood levels of 0.1-0.6 ppm 1
- In the 1970s, infants bathed with hexachlorophene developed neurotoxicity (vacuolar degeneration), leading to FDA warnings against routine use 1, 5
Clinical Applications
Despite safety concerns, hexachlorophene soaps have specific limited applications:
- Historically used for surgical scrubs and hygienic handwashing 1
- Used during staphylococcal outbreaks in nurseries, though no longer recommended for routine infant bathing 1, 6
- Shows cumulative antimicrobial effect with repeated use, particularly against Staphylococcus aureus 1
Contraindications
Hexachlorophene should not be used:
- For patients with burns or extensive areas of susceptible skin 1
- For routine bathing of neonates, especially premature infants 1, 5
- As a vaginal lubricant during labor (pHisoHex has been used this way but is not recommended due to absorption concerns) 2
Antimicrobial Properties
- Bacteriostatic with good activity against S. aureus
- Relatively weak activity against gram-negative bacteria, fungi, and mycobacteria 1
- Single handwash shows modest efficacy, but has residual activity for several hours 1
- Gradually reduces bacterial counts on hands after multiple uses (cumulative effect) 1
Hexachlorophene soaps, particularly pHisoHex, remain available by prescription for specific clinical scenarios despite significant safety concerns that have limited their widespread use.