Antiseptics and Disinfectants

Antiseptics and disinfectants (see definitions) share common skin side effects, i.e., irritation, allergic contact dermatitis, and eventually immunological contact urticaria. Some antiseptics fall into disuse, due to their lack of efficacy (dyes) or their strong allergic properties (mercurials), except thiomersal, the indications of which remain important. Current antiseptics (i.e., povidone-iodine or chlorhexidine) are of great importance, due to the emergence of MRSA and CA-MRSA, leading to a decrease in the use of topical antibiotics to which Gram-positive and Gram-negative bacteria are more and more resistant. Silver-based wound and burn dressings may lead to new cases of allergic contact dermatitis, mainly related to the incorporation of new antiseptics, such as octenidine or PHMB. Disinfectants are a common source of occupational irritant and/or allergic contact dermatitis. Aldehydes are widely used as disinfectants. Formaldehyde, glutaraldehyde, and glyoxal are responsible for many cases of allergic contact dermatitis. Quaternary ammonium compounds, and particularly benzalkonium chloride, are disinfectants provoking irritant and/or allergic contact dermatitis. The interpretation of patch tests is difficult, and the use of ROATs is advised