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1 May 2026Drugs for external use and antisepticsSource update: January 2026

Chlorhexidine 4%, soap

Chlorhexidine soap guidance for surgical hand scrubbing, preoperative cleansing, and wound cleansing.

This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.

Therapeutic action

Antiseptic.

Indications

  • Surgical handscrubbing.
  • Surgical skin preparation (i.e. patient preoperative showering, antiseptic cleansing of the surgical site).
  • Antiseptic cleansing of wounds.

Forms and strengths

4% chlorhexidine (CHX) (di)gluconate antimicrobial soap (scrub solution).

Use

Surgical handscrubbing

There are different protocols, for information:

  • Wet hands and forearms; apply 5 ml of solution on hands and forearms and rub for 1 or 2 mins (i.e. 30 seconds or 1 min for each side); scrub the nails of each hand for 30 seconds; rinse.
  • Apply 5 ml of solution again on hands and forearms and rub for 2 mins; rinse thoroughly; dry with a sterile towel.

Patient preoperative showering

As close as possible to the time of surgery:

  • Wet the whole body and wash head, face and genital area with plain soap (do not use CHX soap), rinse.
  • Apply CHX soap (except to head, face and genital area) and rub until the foam is white. Start at the neck and move down, finishing with the feet.
  • Leave in contact a few minutes and rinse; dry with a clean towel; put on clean clothes.

Antiseptic cleansing of surgical site

Swab the surgical site for 1 or 2 mins, using sterile gauze soaked with sterile water and solution; rinse with sterile water; dry with sterile gauze.

Antiseptic cleansing of wounds

Clean the wound; rinse thoroughly with sterile water or sterile 0.9% NaCl.

Contra-indications, adverse effects, precautions

  • Do not use with soap, creams, lotions or a different antiseptic (risk of incompatibility). Given the possible interactions between different antiseptics, CHX soap can only be used with other CHX-based products (e.g. CHX solutions).
  • Do not bring in contact with body cavities, brain and meninges, eyes (risk of eye damage), middle and inner ear (risk of deafness if ear drum is perforated). Avoid use on mucous membranes, especially on genital mucous membranes.
  • Use with caution in neonates, in particular preterm or low birth weight neonates (risk of chemical burn and skin irritation). Follow national infection prevention and control guidelines or seek specialist advice.
  • May cause skin irritation and rarely hypersensitivity reactions.
  • In case of contact with eyes, rinse immediately with water.
  • Pregnancy and breast-feeding: no contra-indication.

Source

MSF Essential drugs practical guidelines (January 2026)

This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.

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