Hexachlorophene emulsions and antiseptic skin care of newborn infants
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Routine antiseptic skin care with 3% hexachlorophene emulsions is safe for normal newborns. Premature infants may experience central nervous system vacuolation, but it does not cause long-term harm.
Area of Science:
- Neonatal care
- Dermatology
- Neurology
Background:
- Hexachlorophene emulsions have been used for antiseptic skin care in newborns.
- Concerns exist regarding potential central nervous system (CNS) effects of hexachlorophene.
Purpose of the Study:
- To evaluate the safety of 3% hexachlorophene emulsions in routine newborn antiseptic skin care.
- To investigate the occurrence and consequences of central nervous system vacuolation in infants.
Main Methods:
- Retrospective review of 81,756 live births and 858 infant deaths from 1959-1969.
- Analysis of clinical data, including infant weight, prematurity, hyperbilirubinemia, and neurological development.
Main Results:
- Sixty-three cases of CNS vacuolation were reported, exclusively in premature infants.
- Prematurity and hyperbilirubinemia were identified as risk factors for CNS vacuolation.
- No long-term detrimental effects on clinical progress or development were observed in affected infants.
- Normal newborn infants weighing over 2,000g did not exhibit CNS vacuolation.
Conclusions:
- Routine use of 3% hexachlorophene emulsions is safe for normal newborn infants.
- The benefits of hexachlorophene use in routine skin care outweigh potential risks of CNS vacuolation in premature infants.
- No regulatory restrictions are warranted for the use of 3% hexachlorophene emulsions in normal newborn skin care.
Abstract:
This paper reviews 81,756 live births and 858 infant deaths occurring during the years 1959 to 1969. Sixty-three instances of central nervous system vacuolation are reported. Prematurity is shown to be a necessary prerequisite for central nervous system vacuolation to occur during routine antiseptic skin care of newborn infants with 3% hexachlorophene emulsions. Hyperbilirubinaemia is a contributory factor in such premature infants. Long-term clinical follow-up studies show that, should central nervous system vacuolation occur in premature infants, there is no resultant detriment to their immediate clinical progress and physical and neurological development. Normal newborn infants weighing more than 2,000 g do not develop such central nervous system vacuolation during routine antiseptic skin care. The writers conclude that there is no rationale for regulations to restrict the use of 3% hexachlorophene emulsions in routine antiseptic skin care of normal newborn infants and that the benefits of such use far outweigh any possible risks from central nervous system vacuolation.