Chlorhexidine: A Study in Microbial and Macrobial Superheroes

Microbial and Macrobial Superheroes

In the realm of superheroes, there is the back story that explains how the hero came to be, how he or she received their power(s), what their purpose is in life.  This is known as the origin story.

Origin Story of Chlorhexidine

Chlorhexidine was discovered around 1950 by Imperial Chemical Industries, Limited.  Scientists in the UK were working with anti-malarial agents and discovered an organic compound that, today, is on the World Health Organization’s (WHO) Model List of Essential Medicines. This is basically a list of our world’s superheroes to date.  Our friend chlorhexidine has a long and varied history.  Its accomplishments have been made under the radar of the general public but the more I learn about it, the bigger fan I become.

In the early 1950s, chlorhexidine was introduced in the UK as a disinfectant and antiseptic.  It quickly became the Superman of antibacterial agents because it is a chlorine that is safe for use on human and animal tissue.  While the agricultural industry adapted it to sanitization practices as early as 1955, it took another fifteen years to be accepted in the US healthcare industry. Even then, it was underestimated; regarded as a mild-mannered Clark Kent or a neighborly Peter Parker. Its immigration here parallels my own fascination with supers.  I was a fan of The Amazing Spiderman (insert web slinging sound effect here) in the late 70s when chlorhexidine was first used as an oral agent to combat plaque.  

In the early 80s, I was enthralled by the Bionic Woman (insert bionic sound effect here) while the FDA approved a urology lubricant with chlorhexidine. (Not sorry I was oblivious to that one.)

By the late 80’s, something amazing happened, and I’m not just talking about Transformers.

Calling All Autobots!

If you, as I, believe that the combination of a vehicle and an alien life force dedicated to protecting humans is inspiring, wait until I tell you about chlorhexidine combined with alcohol.  There is more than meets the eye.  You see, (heh heh), alcohol is a quick-kill (within 15 seconds) that stops working when it dries.  Chlorhexidine not only takes up the battle but is even able to destroy some of the microorganisms that alcohol wasn’t able to handle, often within 30 seconds. That might be the only reason they never created a cartoon superhero based upon antimicrobials.  The battles don’t last long, and you always know who wins.   Wait.  That’s every cartoon superhero!

Chlorhexidine and alcohol combine to produce a “synergistic residual antimicrobial effect,”1 which is fun to say when talking to medical professionals.  Try it sometime.  But when we’re just hanging out, you and I can call it the dynamic duo.  Speaking of the dynamic duo, by the time Batman: The Animated Series hit television screens in the early to mid-90s, chlorhexidine was being used in FDA-approved catheters and surgical dressings, and I had (temporarily) outgrown cartoons. 

Honey, where is my super suit?

What makes chlorhexidine so special is that it is effective against bacteria (and bacterial spores), fungi, and enveloped viruses (herpes simplex virus, HIV, influenza, and RSV for example).  It even prevents the growth of biofilm.  Chlorhexidine has the unique ability (superpower) to bind to the proteins in human skin and mucous membranes but manages to avoid bodily absorption.  It is encased in a protein shield which causes it to be released slowly for prolonged antimicrobial action.  It is just as effective on surfaces, killing more microorganisms more quickly than other antimicrobials, which is why it is applied as a disinfectant to medical devices, food preparation tables, feed and water troughs, and a number of other applications that require sanitization.  

Add shapeshifting to chlorhexidine’s super abilities.  It can be used as a powder or in a liquid solution and is commonly found in chlorhexidine gluconate or digluconate form.

Chlorhexidine's Kryptonite

Even chlorhexidine has a weakness. As effective as it can be in surgical scrubs and healthcare washes, its ability to fight off germs is inactivated by carbomers, which can be found in alcohol-based hand sanitizers.  Look on the label under “inactive ingredients.” A carbomer is a polymer usually made from acrylic acid and is used as thickening agent transforming a liquid like ethyl alcohol into a gel.  (Hold on a minute.  Have you been reading this like “car-bomber?”  Stop.  It’s pronounced cárbo-muhr. Ok.  Proceed.) The irony here is that while carbomers rob chlorhexidine of its persistent antimicrobial activity, the gel hand sanitizer still stops killing germs when it dries.  I’m pretty sure that makes gel hand sanitizers with carbomer a Super-Menace, or maybe a Bizarro for those of you who are tracking with the whole superhero theme I have going on here.

Also, there is an allergy alert released by the FDA that warns of anaphylactic shock concerns.  Though rare, this serious, life-threatening reaction is usually first demonstrated by the appearance of redness or rash, at which point the use of chlorhexidine should be avoided.  The FDA stated in 2017 that in over 46 years, there have been 43 severe reaction cases reported globally.  That is less than one case per year for the entire world.  Also, the number of times the Teenage Mutant Ninja Turtles didn’t want pizza for dinner.

A Gift for Hand Hygiene

Chlorhexidine has protected human and animal life on this planet (and maybe even Cybertron) for over seventy years and in a variety of industries including agriculture, veterinary science, healthcare, dentistry, and cosmetics.   

Finally, chlorhexidine has been chosen to join an extraordinary team of ingredients in a cleanser called COMPEL.  It functions as a preservative that inhibits the growth of microorganisms in the water that makes up the COMPEL formula.  Its antibacterial, antifungal, and antiviral properties empower the COMPEL formula to help humans maintain a healthy skin barrier. As a first line of defense, the skin barrier is this mere mortal’s superpower.  COMPEL has proven to be its faithful sidekick.

To Infinity and Beyond

To be fair, I still enjoy cartoons, I mean, animated movies.  I still revel in epic battles of good versus evil. I still get goosebumps when I hear the voice of Optimus Prime.  But Jesus is and always will be my Superhero, my Creator, Redeemer, Defender. He paid the ultimate price to free us.  He’s the only One with the power to rescue us.  His salvation is the truth to which all heroes aspire.  Let me encourage you to examine His origin story and see if He doesn’t become your favorite as well.

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