How to Use Hexigel (Chlorhexidine) for Minor Skin Conditions
For minor skin conditions, apply dilute chlorhexidine (1:5000 or 0.02%) solution to gently cleanse wounds and intact skin, allow it to air dry completely, then apply an appropriate emollient or protective barrier ointment over the area. 1
Application Method
Wound Cleansing
- Gently irrigate the affected area using warmed sterile water, saline, or dilute chlorhexidine (1:5000 concentration) 1
- Use a single application only—repeated applications are unnecessary and may increase complication risk 2
- Allow the solution to dry completely before applying any dressings or proceeding with further treatment 1, 2
Concentration Guidelines
- For wound cleansing and skin antisepsis: use 1:5000 (0.02%) chlorhexidine solution 1
- For intact skin preparation before procedures: 0.5-2% chlorhexidine in 70% alcohol is preferred 1
- Avoid alcohol-based preparations on open wounds or broken skin as they cause tissue damage and burns 1
Post-Cleansing Care
Emollient Application
- After chlorhexidine cleansing and complete drying, apply a greasy emollient such as 50% white soft paraffin with 50% liquid paraffin over the entire area, including any denuded skin 1
- Avoid preparations containing sensitizers or irritants 1
Protective Barriers
- For moisture-related skin irritation (minor breakdown, redness), apply a protective barrier ointment like zinc oxide-based products after chlorhexidine cleansing 3
- Apply thin layers to clean, dry skin and reapply as needed 3
Critical Safety Considerations
Age Restrictions
- Do not use chlorhexidine in infants under 2 months of age due to FDA restrictions and risk of systemic absorption, contact dermatitis, and chemical burns 1, 2
- In premature infants (24-26 weeks gestation), alcohol-based chlorhexidine preparations have caused burns 1
Anatomical Precautions
- Never apply chlorhexidine to eyes, inner ears, or mucous membranes 4
- Avoid direct application into deep wounds or third-degree burns 3
- Most severe anaphylactic reactions have occurred with mucous membrane application 1
Allergic Reactions
- Be aware that chlorhexidine can cause contact dermatitis (especially with prolonged/repeated use), contact urticaria, and rarely anaphylaxis 1
- The incidence of contact dermatitis in atopic patients is approximately 2.5-5.4% 5
Common Pitfalls to Avoid
- Do not apply topical antimicrobials to healthy granulating tissue—reserve antimicrobial agents for sloughy or infected areas only 1
- Never allow pooling of alcohol-based chlorhexidine solutions as they are flammable and can cause burns, especially with concurrent use of electrocautery 6
- Do not submerge chlorhexidine-treated areas under water immediately after application 1
- Avoid using chlorhexidine as a substitute for proper wound drainage when indicated—the primary treatment for abscesses is drainage, not antiseptic application alone 4