Editing Chlorhexidine (section)

== Side effects ==
Side effects may include skin irritation, [[Human tooth|tooth]] discoloration, and [[allergic reactions]],<ref name="BNF69" /> although apart from discoloration the risk appears to be the same as [[povidone-iodine]].<ref name=":1" /><ref name=":2" />

Chlorhexidine is [[Ototoxicity|ototoxic]] (toxic to the inner ear). If put into a ruptured ear canal it may lead to deafness.<ref>{{cite journal | vauthors = Lai P, Coulson C, Pothier DD, Rutka J | title = Chlorhexidine ototoxicity in ear surgery, part 1: review of the literature | journal = Journal of Otolaryngology–Head & Neck Surgery | volume = 40 | issue = 6 | pages = 437–440 | date = December 2011 | pmid = 22420428 }}</ref>

Chlorhexidine does not meet European specifications for a hand disinfectant. Under the test conditions of the [[European Standard]] EN 1499, no significant difference in the efficacy was found between a 4% solution of chlorhexidine digluconate and soap.<ref name="disinfectants" /> In the US, between 2007 and 2009, [[Hunter Holmes McGuire Veterans Administration Medical Center]] conducted a cluster-randomized trial and concluded that daily bathing of patients in intensive care units with washcloths saturated with chlorhexidine gluconate reduced the risk of hospital-acquired infections.<ref>{{cite web |publisher=Agency for Healthcare Research and Quality |url=https://innovations.ahrq.gov/profiles/daily-bathing-antiseptic-agent-significantly-reduces-risk-hospital-acquired-infections |title=Daily Bathing With Antiseptic Agent Significantly Reduces Risk of Hospital-Acquired Infections in Intensive Care Unit Patients |date=23 April 2014 |access-date=29 April 2014 |url-status=live |archive-url=https://web.archive.org/web/20170113133136/https://innovations.ahrq.gov/profiles/daily-bathing-antiseptic-agent-significantly-reduces-risk-hospital-acquired-infections |archive-date=13 January 2017 }}</ref>

Whether prolonged exposure over many years may have carcinogenic potential is still not clear. The US [[Food and Drug Administration]] recommendation is to limit the use of a chlorhexidine gluconate mouthwash to a maximum of six months.<ref>{{cite journal | vauthors = Below H, Assadian O, Baguhl R, Hildebrandt U, Jäger B, Meissner K, Leaper DJ, Kramer A | title = Measurements of chlorhexidine, p-chloroaniline, and p-chloronitrobenzene in saliva after mouth wash before and after operation with 0.2% chlorhexidine digluconate in maxillofacial surgery: a randomised controlled trial | journal = The British Journal of Oral & Maxillofacial Surgery | volume = 55 | issue = 2 | pages = 150–155 | date = February 2017 | pmid = 27789177 | doi = 10.1016/j.bjoms.2016.10.007 }}</ref>

When ingested, chlorhexidine is poorly absorbed in the gastrointestinal tract and can cause stomach irritation or nausea.<ref>{{cite web|url=https://www.poison.org/articles/chlorhexidine-adverse-effects-172|title=Chlorhexidine Adverse Effects|website=www.poison.org|access-date=4 July 2018|archive-date=5 July 2018|archive-url=https://web.archive.org/web/20180705033148/https://www.poison.org/articles/chlorhexidine-adverse-effects-172|url-status=live}}</ref><ref name=":0">{{cite web|url=https://pubchem.ncbi.nlm.nih.gov/compound/chlorhexidine#section=Human-Toxicity-Excerpts|title=Chlorhexidine|work=Pubchem|publisher=U.S. National Library of Medicine|access-date=4 July 2018|archive-date=5 July 2018|archive-url=https://web.archive.org/web/20180705062731/https://pubchem.ncbi.nlm.nih.gov/compound/chlorhexidine#section=Human-Toxicity-Excerpts|url-status=live}}</ref> If aspirated into the lungs at high enough concentration, as reported in one case, it can be fatal due to the high risk of [[acute respiratory distress syndrome]].<ref name=":0" /><ref>{{cite journal | vauthors = Hirata K, Kurokawa A | title = Chlorhexidine gluconate ingestion resulting in fatal respiratory distress syndrome | journal = Veterinary and Human Toxicology | volume = 44 | issue = 2 | pages = 89–91 | date = April 2002 | pmid = 11931511 | quote = An 80-y-old woman with dementia accidentally ingested approximately 200 mL of Maskin (5% chlorhexidine) in a nursing home and then presumably aspirated gastric contents. }}</ref>