I replied to this question earlier (3 Sep 2022), but today I`m going to reply to it again because I think here I might be able to provide a shorter answer.
Good question and one that I have been thinking about addressing in a larger blog/article. Specific to PI, the times that I see professionally recommended range from 2 minutes (eyes at 5%) to 5 minutes (nostrils/nares at 5%) to 15 minutes for the teeth (I think that might be at 10%, which is impressive but I learned that from a respected dentist who does CME) and for skin sometimes longer duration is used. So, for skin and outside the body, I think 5 to 10 is plenty of time for 5%* PI, again provided that it's not causing significant irritation and nothing that appears to be the so-called and largely disproved "allergy." Using it in the shower is generally easiest -- apply with hand or washcloth, let it sit and dry while listening to a few songs, then rinse it down the drain. If the skin lesions are severe and widespread, then we have more concern about systemic absorption. I have looked for evidence/cases of harm from systemic absorption from topical/external skin application but have only seen a few cases among people with literally open wounds, such as this one: West J Med. 1987 Jan;146(1):43-5.
Iodine absorption after topical administration
Absorption from povidone-iodine preparations after topical administration has been reported to be negligible, but an elderly woman had increased serum iodine levels with possible metabolic complications after povidone-iodine solution was applied to decubitus ulcers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1307179/ *I mention 5% here instead of the more common 10% because I'm trying to be "on the safer side" and also because lower potency may actually be more effective. Disclaimer as usual "this is not personal medical advice" but is something that I am still reviewing and will post some details soon. Again a few minutes should be enough and no need to use for longer than that
One last question: I have 1.5 large bottles - 32 oz each of Hibiclens (chlorhexidine gluconatw 4.0%) I was given to use before surgery... would this work the same as PI?
Chlorhexidine is also widely used, and is commonly used as an option to PI for pre-surgical cleaning. Chlorhexidine is antifungal and antibacterial, but not antiviral which is not an issue unless it is being used to treat mucosal viral infections such as herpes, and even then internal treatments (eg, antiviral nutrition protocol) would probably be better. https://www.chlorhexidinefacts.com/mechanism-of-action.html Chlorhexidine is a broad-spectrum biocide effective against Gram-positive bacteria, Gram-negative bacteria and fungi. Chlorhexidine inactivates microorganisms with a broader spectrum than other antimicrobials (e.g. antibiotics) and has a quicker kill rate than other antimicrobials (e.g. povidone-iodine).1 It has both bacteriostatic (inhibits bacterial growth) and bactericidal (kills bacteria) mechanisms of action, depending on its concentration.
The U.S. Food and Drug Administration (FDA) is warning that rare but serious allergic reactions have been reported with the widely used skin antiseptic products containing chlorhexidine gluconate. Although rare, the number of reports of serious allergic reactions to these products has increased over the last several years. As a result, we are requesting the manufacturers of over-the-counter (OTC) antiseptic products containing chlorhexidine gluconate to add a warning about this risk to the Drug Facts labels. Prescription chlorhexidine gluconate mouthwashes and oral chips used for gum disease already contain a warning about the possibility of serious allergic reactions in their labels.
Patients and consumers should stop using the product that contains chlorhexidine gluconate and seek medical attention immediately or call 911 if they experience symptoms of a serious allergic reaction. These reactions can occur within minutes of exposure. Symptoms include wheezing or difficulty breathing; swelling of the face; hives that can quickly progress to more serious symptoms; severe rash; or shock, which is a life-threatening condition that occurs when the body is not getting enough blood flow. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-about-rare-serious-allergic-reactions-skin-antiseptic
more from that same FDA report: "We identified 52 cases of anaphylaxis, a severe form of allergic reaction, with the use of chlorhexidine gluconate products applied to the skin. In the 46 years between January 1969 and early June 2015, FDA received reports of 43 cases worldwide.* More than half of the 43 cases were reported after 2010, and after our 1998 Public Health Notice. This number includes only reports submitted to FDA, so there are likely additional cases about which we are unaware. The serious allergic reaction cases reported outcomes that required emergency department visits or hospitalizations to receive drug and other medical treatments. These allergic reactions resulted in two deaths. Eight additional cases of anaphylaxis were published in the medical literature between 1971 and 2015,1-3 and one case was identified in the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance (NEISS-CADES) database between 2004 and 2013."
Thanks. I’ll be using PI, I have a herpes facial that is low grade.. small spots of them that never completely goes away...Aciclovir creme (I use it every couple of months) keeps it from major eruptions and from itching too much. I’m hoping the PI stops it from the pesky minor ongoing eruptions and I won’t need the creme anymore. Thanks again
Hi,
Do we cleanse with the PI, leave it on a few minutes, then rinse? Or apply and leave it on overnight?? Thanks
Good question and one that I have been thinking about addressing in a larger blog/article. Specific to PI, the times that I see professionally recommended range from 2 minutes (eyes at 5%) to 5 minutes (nostrils/nares at 5%) to 15 minutes for the teeth (I think that might be at 10%, which is impressive but I learned that from a respected dentist who does CME) and for skin sometimes longer duration is used. So, for skin and outside the body, I think 5 to 10 is plenty of time for 5%* PI, again provided that it's not causing significant irritation and nothing that appears to be the so-called and largely disproved "allergy." Using it in the shower is generally easiest -- apply with hand or washcloth, let it sit and dry while listening to a few songs, then rinse it down the drain. If the skin lesions are severe and widespread, then we have more concern about systemic absorption. I have looked for evidence/cases of harm from systemic absorption from topical/external skin application but have only seen a few cases among people with literally open wounds, such as this one: West J Med. 1987 Jan;146(1):43-5.
Iodine absorption after topical administration
Absorption from povidone-iodine preparations after topical administration has been reported to be negligible, but an elderly woman had increased serum iodine levels with possible metabolic complications after povidone-iodine solution was applied to decubitus ulcers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1307179/ *I mention 5% here instead of the more common 10% because I'm trying to be "on the safer side" and also because lower potency may actually be more effective. Disclaimer as usual "this is not personal medical advice" but is something that I am still reviewing and will post some details soon. Again a few minutes should be enough and no need to use for longer than that
Thank you!
One last question: I have 1.5 large bottles - 32 oz each of Hibiclens (chlorhexidine gluconatw 4.0%) I was given to use before surgery... would this work the same as PI?
Chlorhexidine is also widely used, and is commonly used as an option to PI for pre-surgical cleaning. Chlorhexidine is antifungal and antibacterial, but not antiviral which is not an issue unless it is being used to treat mucosal viral infections such as herpes, and even then internal treatments (eg, antiviral nutrition protocol) would probably be better. https://www.chlorhexidinefacts.com/mechanism-of-action.html Chlorhexidine is a broad-spectrum biocide effective against Gram-positive bacteria, Gram-negative bacteria and fungi. Chlorhexidine inactivates microorganisms with a broader spectrum than other antimicrobials (e.g. antibiotics) and has a quicker kill rate than other antimicrobials (e.g. povidone-iodine).1 It has both bacteriostatic (inhibits bacterial growth) and bactericidal (kills bacteria) mechanisms of action, depending on its concentration.
The U.S. Food and Drug Administration (FDA) is warning that rare but serious allergic reactions have been reported with the widely used skin antiseptic products containing chlorhexidine gluconate. Although rare, the number of reports of serious allergic reactions to these products has increased over the last several years. As a result, we are requesting the manufacturers of over-the-counter (OTC) antiseptic products containing chlorhexidine gluconate to add a warning about this risk to the Drug Facts labels. Prescription chlorhexidine gluconate mouthwashes and oral chips used for gum disease already contain a warning about the possibility of serious allergic reactions in their labels.
Patients and consumers should stop using the product that contains chlorhexidine gluconate and seek medical attention immediately or call 911 if they experience symptoms of a serious allergic reaction. These reactions can occur within minutes of exposure. Symptoms include wheezing or difficulty breathing; swelling of the face; hives that can quickly progress to more serious symptoms; severe rash; or shock, which is a life-threatening condition that occurs when the body is not getting enough blood flow. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-about-rare-serious-allergic-reactions-skin-antiseptic
more from that same FDA report: "We identified 52 cases of anaphylaxis, a severe form of allergic reaction, with the use of chlorhexidine gluconate products applied to the skin. In the 46 years between January 1969 and early June 2015, FDA received reports of 43 cases worldwide.* More than half of the 43 cases were reported after 2010, and after our 1998 Public Health Notice. This number includes only reports submitted to FDA, so there are likely additional cases about which we are unaware. The serious allergic reaction cases reported outcomes that required emergency department visits or hospitalizations to receive drug and other medical treatments. These allergic reactions resulted in two deaths. Eight additional cases of anaphylaxis were published in the medical literature between 1971 and 2015,1-3 and one case was identified in the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance (NEISS-CADES) database between 2004 and 2013."
Thanks. I’ll be using PI, I have a herpes facial that is low grade.. small spots of them that never completely goes away...Aciclovir creme (I use it every couple of months) keeps it from major eruptions and from itching too much. I’m hoping the PI stops it from the pesky minor ongoing eruptions and I won’t need the creme anymore. Thanks again