Where Should You Not Use CHG Wipes? A Guide to Safe Usage

October 10, 2025 •

4 min read

On any given day, about one in 31 hospital patients has at least one healthcare-associated infection [1.11.3]. While Chlorhexidine Gluconate (CHG) wipes are a key tool in preventing these infections, knowing where should you not use CHG wipes is critical for patient safety.

Quick Summary

CHG wipes are a powerful antiseptic but must be used with caution. Avoid contact with the head, face, eyes, ears, mouth, and genital areas. Do not use on deep wounds, infants under two months, or if you have a known CHG allergy.

Key Points

Eyes, Ears, and Face: Never use CHG wipes on the head or face, especially avoiding contact with eyes and ears to prevent irreversible corneal damage and hearing loss [1.4.1, 1.4.3].
Mucous Membranes: Do not apply CHG to sensitive mucous membranes, including the mouth, nose, and genital or rectal areas, to avoid severe irritation [1.3.3, 1.5.5].
Deep Wounds: Avoid using CHG on deep cuts, large open wounds, or near the spinal cord, though it may be used on some superficial wounds under medical guidance [1.6.1, 1.6.3].
Infants: CHG is not recommended for infants under 2 months of age due to the risk of chemical burns and skin irritation [1.7.1, 1.3.3].
Allergies: A known allergy to chlorhexidine is an absolute contraindication, as rare but life-threatening anaphylactic reactions can occur [1.3.2, 1.8.1].
Medical Procedures: Special care must be taken during procedures involving the head, neck, or spine to prevent accidental dripping into the eyes or ears [1.4.3].
After Application: Do not rinse CHG off unless irritation occurs, and avoid applying lotions or creams afterward, as this can negate its antiseptic effect [1.2.2].

Understanding Chlorhexidine Gluconate (CHG)

Chlorhexidine Gluconate (CHG) is a broad-spectrum antiseptic agent prized for its ability to significantly reduce the number of microorganisms on the skin [1.9.1]. It is a cornerstone of infection prevention protocols in hospitals, particularly for pre-surgical skin preparation and daily bathing of patients in intensive care units (ICUs) [1.3.3]. Unlike regular soap, CHG has a residual effect, meaning it continues to kill germs for hours after application [1.9.1]. This persistent activity helps lower the risk of dangerous surgical site infections (SSIs) and other healthcare-associated infections (HAIs) [1.10.1]. On any given day, approximately 1 in 31 hospital patients acquires an HAI, making effective antiseptics like CHG vital [1.11.3]. However, its potency also means there are critical guidelines on its use.

Absolute Contraindications: Where Not to Use CHG Wipes

To prevent serious injury and adverse reactions, there are specific areas and situations where CHG wipes must be avoided. Misapplication can lead to severe and sometimes irreversible damage.

Head, Face, and Sensory Organs

Do not use CHG wipes on the head or face [1.5.1]. This is the most frequently cited warning. Specific areas of concern include:

Eyes: Contact with the eyes can cause severe and irreversible corneal damage, potentially leading to vision loss [1.4.1, 1.4.5]. The chemical can cause epithelial edema, bullous keratopathy, and damage to corneal endothelial cells that may necessitate a corneal transplant [1.4.1, 1.4.2].
Ears: If CHG enters the ear canal, especially if the eardrum is perforated, it can cause ototoxicity, leading to permanent sensorineural hearing loss [1.4.3].
Mouth and Nose: CHG should not be used in or around the mouth or nose [1.5.2, 1.5.3]. Ingestion is dangerous, and application to these mucous membranes can cause significant irritation [1.3.3].

Mucous Membranes and Genital Areas

CHG wipes should not be used on mucous membranes [1.5.4]. This includes the genital and rectal areas [1.5.5, 1.2.4]. Application to these sensitive tissues can cause severe irritation [1.3.3]. Patient instructions for pre-surgical bathing consistently advise avoiding these "private areas" [1.2.1, 1.2.2].

Open Wounds and Broken Skin

There is some nuance regarding CHG use on broken skin. While many patient instructions state not to apply CHG to deep cuts, scrapes, or open skin wounds [1.6.4, 1.3.5], some clinical guidelines permit its use on superficial wounds. According to the Agency for Healthcare Research and Quality (AHRQ), CHG can be applied to superficial wounds, stage 1 and 2 decubitus ulcers, and superficial burns [1.6.1]. However, it is not recommended for large, deep, or packed wounds [1.6.1, 1.6.2]. It should also never come into contact with the meninges (the membranes covering the brain and spinal cord), such as during a lumbar puncture, as this can cause permanent damage [1.6.3].

Patient Populations and Special Considerations

Certain individuals are at higher risk for adverse effects from CHG and require special precautions.

Infants and Children

CHG bathing is generally not used for infants younger than 2 months old [1.3.3, 1.7.1]. The U.S. Food and Drug Administration (FDA) advises using CHG with care in premature infants and those under 2 months of age, as it may cause irritation or chemical burns [1.7.4]. Preterm infants have more permeable skin, which can lead to systemic absorption of CHG, although the clinical relevance of this is still under investigation [1.7.4].

Patients with Allergies

Allergy to chlorhexidine is a serious contraindication [1.2.1]. While rare, severe, life-threatening allergic reactions (anaphylaxis) have been reported and can occur within minutes of exposure [1.3.2, 1.8.1]. Symptoms can include hives, wheezing or difficulty breathing, swelling of the face, and shock [1.8.4]. Before using CHG, healthcare providers should always ask patients if they have ever had a reaction to any antiseptic [1.3.2]. If an allergy is known or suspected, alternative antiseptics like povidone-iodine or alcohol should be used [1.8.2].

Comparison of Common Antiseptics

Understanding how CHG compares to other common skin antiseptics helps clarify its role and why alternatives are sometimes necessary.


Feature	Chlorhexidine Gluconate (CHG)	Povidone-Iodine	Isopropyl Alcohol
Onset of Action	Rapid, especially when combined with alcohol [1.10.3].	Slower; requires at least 2 minutes of contact time [1.10.3].	Immediate [1.10.4].
Residual Effect	Excellent; binds to skin and remains active for hours [1.10.3].	Minimal; effectiveness diminishes once dry [1.10.3].	None; evaporates quickly [1.10.4].
Effectiveness	Often superior in reducing SSIs compared to povidone-iodine [1.10.1, 1.10.2].	Broad-spectrum (bacteria, viruses, fungi), but can be inactivated by blood [1.10.3].	Good immediate effect, but lacks sustained action [1.10.4].
Key Contraindications	Eyes, ears, brain/meninges, infants <2 months, known allergy [1.4.1, 1.4.3, 1.7.1].	Known iodine allergy, some thyroid conditions.	Open wounds (causes tissue damage), mucous membranes.
Toxicity Profile	Can cause corneal damage, ototoxicity, and rare severe allergic reactions [1.4.2, 1.8.1].	Less likely to cause irritation but can be absorbed systemically [1.10.3].	Can dry out skin and is flammable.

Conclusion: Prioritizing Safety Through Proper Use

Chlorhexidine gluconate is an invaluable tool in the fight against healthcare-associated infections. Its superior efficacy and residual activity make it a first-choice antiseptic for many clinical applications [1.10.1]. However, its power demands respect and a thorough understanding of its limitations. Strictly avoiding its use on the face, head, ears, mucous membranes, and in patients with known allergies is non-negotiable to prevent severe harm [1.5.1, 1.3.2]. By adhering to these critical safety guidelines, healthcare providers and patients can effectively leverage the benefits of CHG while minimizing its significant risks. Always follow the specific instructions provided by your healthcare team [1.2.3].

Authoritative Link: FDA Drug Safety Communication on CHG

Frequently Asked Questions

No, you should never use CHG wipes on your face or head. Contact with eyes can cause serious, permanent corneal damage, and contact with ears can lead to hearing loss [1.5.1, 1.4.1, 1.4.3].

No, CHG wipes are generally not recommended for infants under 2 months of age due to the risk of skin irritation and chemical burns [1.7.1, 1.3.3].

If CHG gets in your eyes, you should flush them thoroughly with water immediately and seek medical attention. It can cause severe and irreversible damage to the cornea [1.4.1, 1.2.1].

You should not use CHG wipes on deep cuts, scrapes, or open skin wounds [1.3.5]. While some guidelines permit use on very superficial wounds, it's best to consult a healthcare provider [1.6.1].

Signs of a serious allergic reaction include hives, severe rash, wheezing or difficulty breathing, facial swelling, cold sweats, and severe dizziness. If you experience these, stop use and seek immediate medical help [1.8.4].

No, you should not use CHG wipes on your genital or rectal areas (private parts). These are mucous membranes and can become severely irritated by the chemical [1.5.5, 1.3.3].

A sticky feeling is normal after using CHG wipes and usually goes away after your skin air-dries [1.2.3, 1.2.5]. This is due to the residual antiseptic and moisturizers in the cloth. Do not rinse it off, as this removes the protective effect [1.2.2].