1. About chlorhexidine
Chlorhexidine is an antiseptic and disinfectant. It helps reduce the number of germs (bacteria) in your mouth or on your skin.
It can help with:
- mouth infections, mouth ulcers and gum disease
- sore throats
- denture care
- skin infections
Chlorhexidine is usually combined with other ingredients. Some sore throat treatments have a local anaesthetic to help numb pain.
Mouth and throat treatments come as mouthwashes, lozenges, gels and sprays.
Skin treatments come as creams, ointments and lotions.
Many chlorhexidine treatments are available to buy in pharmacies, and some in shops and supermarkets.
For nose infections, there is a nasal cream that contains chlorhexidine and neomycin, an antibiotic. This medicine is available on prescription only and is known by the brand name Naseptin.
Chlorhexidine is also used in hospitals and clinics to clean skin or surgical equipment before surgery. It can be used in some bladder procedures, including cleaning catheters.
2. Key facts
- You’ll usually use chlorhexidine treatments for up to 4 weeks.
- You’re unlikely to have any side effects with the skin creams and lotions.
- Common side effects with the throat spray, lozenges and dental treatments include a dry mouth and stained teeth.
- When using the lozenges, spray, mouthwash or dental gel, wait at least 30 to 60 minutes before having something to eat or drink. This gives the medicine a chance to work properly.
- Do not use bleach on clothes, bedding or other fabrics that have been in contact with chlorhexidine. It will leave yellowish-brown stains.
3. Who can and cannot use chlorhexidine
Chlorhexidine throat spray, lozenges and dental treatments (including mouthwash and dental gel) can be used by adults and children aged 12 or older.
Chlorhexidine skin treatments can be used by adults and children.
To make sure chlorhexidine is safe for you, tell a pharmacist or doctor before using it if you:
- have ever had an allergic reaction to chlorhexidine or any of the other ingredients
- have ever had an allergic reaction to any other medicine
- cannot drink or need to avoid alcohol. Some chlorhexidine sprays and mouthwashes may contain very small amounts of alcohol. Ask a pharmacist, doctor or dentist about medicines without alcohol.
4. How and when to use chlorhexidine
If you buy a chlorhexidine treatment in a pharmacy or supermarket, follow the instructions that come with it. For prescription medicines, follow the advice from your doctor, dentist or a pharmacist.
Wash your hands before and after using chlorhexidine. Keep it away from your eyes and ears. If chlorhexidine gets into your eyes or ears, rinse well with water.
Dosage and how to use lozenges
The usual dose for children aged 12 and older is up to 5 lozenges a day. Adults can have up to 10 a day.
Put a lozenge in your mouth and let it melt slowly.
Wait at least 30 to 60 minutes before having something to eat or drink.
Dosage and how to use mouthwash
The usual dose is 10 ml, twice a day.
Pour 10ml into the measuring cup. Rinse the mouthwash around your mouth for about 1 minute. Spit out the mouthwash, do not swallow it.
Wait at least 30 to 60 minutes before having something to eat or drink.
Dosage and how to use mouth spray
The usual dose is 2 squirts at a time, up to 12 times a day.
Aim the spray onto your affected tooth, gum, ulcer or the sore part of your mouth.
Wait at least 30 to 60 minutes before having something to eat or drink.
Dosage and how to use throat spray
The usual dose is 3 to 5 squirts. You can repeat this dose up to 10 times a day.
Wait at least 30 to 60 minutes before having something to eat or drink.
How to use dental gel
You’ll usually use the gel once or twice a day.
Put a small amount of gel onto your fingertip or a cotton bud. Gently wipe it across the surface of your mouth ulcer, gum or the sore part of your mouth.
Wait at least 30 to 60 minutes before having something to eat or drink.
How to use sore throat treatments
Only use chlorhexidine lozenges and sore throat spray for a short time. Do not keep using them continuously.
Contact a doctor if your symptoms do not improve after 3 to 4 days.
How to use dental treatments
Use your dental treatment at a different time of day to when you brush your teeth. This is because toothpaste can stop chlorhexidine working properly.
If you cannot use it at a different time, then rinse your mouth thoroughly with water after brushing your teeth. Wait at least 5 minutes before using chlorhexidine.
If your symptoms do not improve after one week, or if they get worse at any time, stop using chlorhexidine and contact your dentist or doctor.
Important
Carry on using chlorhexidine until you have finished the course, even if you feel better. If you stop your treatment early, the infection could come back.
Check with your dentist, doctor or pharmacist if you’re not sure how long to use it for.
Chlorhexidine skin treatments
Keep chlorhexidine skin treatments away from your eyes and mouth.
Skin treatments are usually used short-term for a few weeks, but occasionally you may have to use them for longer.
You can use treatments like Dermol lotion as both a body wash (soap substitute) and moisturising skin lotion.
How to use skin cream or lotion
Apply a thin layer of chlorhexidine cream or lotion to the affected areas of your skin. Follow the directions included in the packet.
Important: Fire warning
Skin cream can dry onto your clothes and bedding. This can make them more likely to catch fire. Avoid naked flames.
How to use chlorhexidine as soap substitute or wash
Use your chlorhexidine treatment instead of soap or shower gel when you wash. You use it in the same way as an ordinary soap or gel. However, it may not be as foamy.
Be careful not to slip in the bath or shower, or on a tiled floor, when using the cream or lotion.
If you are going into hospital, you may be sent a chlorhexidine product to wash with before you come into hospital to reduce the chances of infection. This should come with instructions on how to use it.
What if I forget to use my chlorhexidine treatment?
If you forget your chlorhexidine dental or sore throat treatment, use it as soon as you remember, unless it's nearly time for your next dose. In this case, just skip the missed dose and have your next one as normal.
If you forget to use your chlorhexidine skin treatment, that’s okay. Just start your routine again after the missed treatment and carry on as before.
If you have been prescribed chlorhexidine and forget to take it or apply it on a regular basis, it may help to set an alarm to remind you. You could also ask your pharmacist for other ways to remember your medicine.
What if I use too much?
Chlorhexidine is usually a safe medicine if you follow the instructions that come with it. However, do not use more than the recommended dose.
Speak to your doctor or a pharmacist now if you or your child has swallowed too much.
Urgent advice: Contact 111 now for advice if:
- you or child have swallowed too much chlorhexidine and feel unwell
5. Side effects
Chlorhexidine treatments are generally very safe. Many people use them without having any side effects at all.
Side effects with skin treatments
There are no common side effects with chlorhexidine skin treatments. However, in rare cases, some people may get red, itchy or irritated skin. It may be because you are using too much lotion or cream where you have folds or creases in your skin, such as around your groin.
Talk to a doctor or pharmacist if this bothers you or does not go away.
Common side effects with sore throat and dental treatments
Some people get peeling skin inside their mouth when using chlorhexidine. If this happens to you, stop using the medicine and the side effect will usually clear up. Speak to your dentist or doctor, who may be able to recommend a different medicine.
Common side effects happen in more than 1 in 100 people. They're usually mild and do not last long.
Talk to a doctor, dentist or pharmacist if these side effects bother you or last for more than a few days:
- dry mouth
- short bursts of a mild burning, tingling or strange taste in your mouth
- your tongue changes colour
- stained teeth
Serious side effects
Stop using chlorhexidine dental treatments and speak to a dentist, doctor or pharmacist if your mouth is:
- sore
- swollen
- irritated
- widespread skin rash
If you have any of the following symptoms, it may be a sign of a more serious infection. Stop using chlorhexidine sore throat treatments and speak to a doctor if you:
- have problems swallowing
- have a severe sore throat
- have had symptoms for more than 2 days
- have a high temperature
- have a headache
- are feeling or being sick (nausea or vomiting)
Stop using chlorhexidine products if you get a widespread skin rash.
Serious allergic reaction
It’s extremely rare to have an allergic reaction (anaphylaxis) to chlorhexidine.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of chlorhexidine. For a full list, see the leaflet inside your medicines packet.
You can report any suspected side effect using the Yellow Card safety scheme.
6. How to cope with the side effects of chlorhexidine
What to do about:
- dry mouth – have sips of water, or try sugar-free gum or sugar-free sweets. If this still bothers you, talk to your doctor, pharmacist or practice nurse They may be able to recommend a spray, gel or lozenges to keep your mouth moist
- mild burning, tingling or strange taste in your mouth – this sometimes happens when you first start treatment but improves as you keep using chlorhexidine. If it does not go away, talk to your doctor about it. It may be an allergy
- your tongue changes colour - this is not permanent and will go when the treatment stops
- stained teeth – make sure you brush your teeth regularly
- skin reactions such as redness, itching and irritation – try using smaller amounts or stop using it completely. Avoid clothes that irritate your skin, such as wool or manmade fabrics. If the skin area is itchy, pat or tap the area rather than scratching
7. Pregnancy and breastfeeding
Chlorhexidine and pregnancy
It's generally thought to be OK to use chlorhexidine lozenges or sore throat spray. There's very little information on safety in pregnancy, however, they are not thought to be harmful.
Chlorhexidine and breastfeeding
All chlorhexidine treatments are ok to use while breastfeeding. Although, if chlorhexidine is being used on the skin, make sure the treatment has been washed off from the nipple and breast before feeding.
If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
- pregnant
- breastfeeding
8. Cautions with other medicines
Chlorhexidine dental, sore throat and skin treatments are not known to cause problems if you take them at the same time as other medicines.
Speak to a doctor or pharmacist if you have any questions.
Mixing chlorhexidine with herbal remedies and supplements
It’s not possible to say whether herbal medicines and vitamins are safe to take with chlorhexidine. They are not tested in the same way as other medicines.
Important: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
9. Common questions about chlorhexidine
How does chlorhexidine work?
Chlorhexidine is an antiseptic and disinfectant. It works against a wide range of bacteria by stopping them growing and spreading. It also works against some fungi and viruses, particularly the ones found in your mouth and on your skin.
With the dental treatments, chlorhexidine helps prevent the build-up of plaque for up to 12 hours by forming a protective coating over your gums and teeth. This helps prevent or treat mouth infections and gum disease. It also helps ease your symptoms if you have a mouth ulcer or sore throat.
How long does it take to work?
Chlorhexidine will start to work as an antiseptic straight away. The time it takes to feel other benefits will depend on what you’re using chlorhexidine for. Ask your doctor or dentist about what to expect with your treatment.
If your symptoms get worse at any time during your treatment, speak to your doctor, dentist or a pharmacist.
How long will I use it for?
This depends on the type of chlorhexidine you’re using and what you’re using it for.
Chlorhexidine is an antiseptic medicine and is for short-term use only. If you use it for too long, it may not work as well.
With all chlorhexidine treatments, if you're not feeling better after you finish your prescribed course, tell your doctor or healthcare professional.
Dental treatments
You’ll usually use these for up to 4 weeks, as they can stain your teeth if used for longer. For gum disease, use it for 4 weeks. For mouth ulcers and oral thrush, continue using the mouthwash for 2 days after your symptoms have gone.
Skin treatments
Treatment can vary, depending on what other ingredients are in the medicine and why you’re using it. Follow the instructions that come with your medicine. Ask your doctor or a pharmacist for advice if you’re not sure how long to use it for.
Lozenges or sore throat spray
Treatment is short-term. You can take the lozenges or use the spray for up to 4 days only.
Can I drink alcohol with this medicine?
Yes, you can drink alcohol when using chlorhexidine.
Some chlorhexidine treatments, such as the dental spray or sore throat spray contain alcohol already. Although the amount that passes into your blood is small, the additional alcohol may make you feel sleepy, dizzy or give you a headache.
If this happens, do not drink alcohol while you're taking chlorhexidine.
Is there any food or drink I need to avoid?
When using dental chlorhexidine treatments, the lozenges or sore throat spray, wait at least 30 to 60 minutes before eating or drinking.
There is no specific food or drink to avoid when using chlorhexidine. However, be aware that some of the dental sprays and mouth sprays contain alcohol.
Will it affect my contraception?
Chlorhexidine treatments are unlikely to affect any type of contraception, including the combined pill and emergency contraception.
Will it affect my fertility?
There is no clear evidence that chlorhexidine treatments affect fertility in men or women.
Can I drive or ride a bike?
Yes, you can drive a car, ride a bike, or use tools and machinery while using chlorhexidine.
Can lifestyle changes keep my mouth and teeth healthy?
You can help your oral hygiene by following these tips:
- brush your teeth for about 2 minutes last thing at night before you go to bed, and on one other occasion every day. It does not matter if you use an electric or manual toothbrush, but some people find it easier to clean their teeth thoroughly with an electric toothbrush
- use a toothpaste that contains the right amount of fluoride, a natural mineral that helps protect against tooth decay
- floss your teeth or use interdental brushes regularly. It’s best to do this every day, before brushing your teeth
- quit smoking
- visit your dentist regularly – at least once every 1 to 2 years, but more often if you need to