During the 1960s, hexachlorophene was among the most widely used antibacterial antiseptics available to the consumer without a prescription. The ubiquitous use of this wildly successful drug abruptly ended in 1972, when a manufacturing error led to the death of several dozen infants.
Hexachlorophene first appeared in the early 1940s, used as a preservative in cosmetics at low concentrations (0.1 percent). In 1961, it reappeared in much higher concentrations (1–3 percent) in cleansing products (pHisoHex) used for babies and in hospitals and operating rooms to protect patients and healthcare workers against staphylococcus infections. Soon after, it was included in literally hundreds of nonprescription cosmetic and medicinal products, including antibacterial soaps (most notably, Dial deodorant soap) and gels, baby powders and lotions, shampoos, toothpastes, shaving creams, anti-acne products, and even vaginal and underarm deodorants.
Although hexachlorophene was clearly effective in reducing the population of disease-causing Gram-positive bacteria, many extravagant claims, unsubstantiated by fact, were made about its benefits. The high degree of effectiveness of hexachlorophene against Gram-positive microbes after repeated applications, and its ineffectiveness against their Gram-negative competitors, led to a disruption in the normal bacterial balance on the skin. Overgrowth of Gram-negative bacteria and difficult-to-treat infections resulted.
Late in the 1960s, hexachlorophene was found to be absorbed across injured skin—a finding later extended to the skin of premature infants—causing nervous system toxicity. In 1972, several dozen infants in France between one and fifteen months of age showed signs of twitching and seizures and died after being treated with talcum powder containing hexachlorophene. The powder was supposed to contain 3 percent of the drug, but because of an innocent manufacturing error, it contained twice this concentration. Abnormalities in the brains of these children were seen on autopsy.
Hexachlorophene was withdrawn from use in maternity wards, and outbreaks of staph infections rapidly ensued. Nevertheless, regulatory officials in many countries have imposed restrictions on its use, including requiring a prescription for purchase.
SEE ALSO Phenol (1867), Ampicillin (1961).
For decades, hexachlorophene was used in nurseries and homes to clean and powder newborns. After it was removed from the market because of nervous system toxicity, outbreaks of staph infections have ensued.