How to prep with chlorhexidine? Your complete guide

October 2, 2025 •

4 min read

According to the CDC, proper skin antisepsis is a critical step in preventing healthcare-associated infections. This authoritative guide will walk you through exactly how to prep with chlorhexidine, ensuring maximum effectiveness while prioritizing patient safety.

Quick Summary

Using chlorhexidine involves cleaning with a specific protocol, ensuring special care around sensitive areas, and allowing the antiseptic to dry completely before any procedure. This process reduces the bacterial load on the skin, which is a vital step in preventing surgical site infections.

Key Points

Start Clean: Always wash your hair and face with regular soap first, and rinse completely before using chlorhexidine.
Protect Sensitive Areas: Never apply CHG to your face, eyes, ears, mouth, or genitals to avoid serious injury.
Allow Drying Time: For alcohol-based applicators, a 3-minute minimum air-dry time is crucial to prevent fire hazards, especially in a clinical setting.
Mind Your Product Type: Shower scrubs require rinsing, while pre-moistened wipes are left on the skin to air dry.
Avoid Contaminants: Do not apply any lotions, powders, or makeup after using CHG, as they can reduce its effectiveness.
Check for Allergies: Be aware of the rare risk of allergic reactions; if irritation or a rash occurs, stop use and contact your doctor.

What is Chlorhexidine and Why Use It?

Chlorhexidine gluconate (CHG) is a powerful, broad-spectrum antiseptic agent used to kill bacteria and prevent infection on the skin. Unlike regular soap, CHG binds to the skin and provides a persistent, long-lasting antimicrobial effect. This sustained activity makes it superior for use in preparing the skin before surgical procedures, injections, and central line insertions. Its use has been shown to be more effective than standard iodophors in reducing surgical site infections (SSI).

Types of Chlorhexidine Products

Chlorhexidine comes in several forms, each with its own application method:

Solutions and Scrubs (4%): These are typically used for pre-operative showers or bathing. Brands like Hibiclens are common examples. A user wets their body, applies the solution from the neck down, scrubs, and then rinses it off thoroughly.
Pre-moistened Wipes or Cloths (2%): These rinse-free wipes are convenient for bedridden patients or for at-home use. The CHG solution remains on the skin to continue its antimicrobial action after application.
Applicators and Swabs (2%): For preparing a specific, smaller area of skin, such as for an injection or catheter insertion. These applicators usually combine CHG with alcohol for a more rapid and effective kill.

Step-by-Step Guide for Pre-operative Chlorhexidine Shower Prep

For many surgical procedures, patients are instructed to take a CHG shower the night before and the morning of the surgery. Always follow your healthcare provider's specific instructions, as they may vary.

Use Normal Products First: Start your shower by washing your hair and face with your regular shampoo and soap. Rinse everything off completely to ensure no residue remains.
Prepare the CHG: Turn off the shower water. Pour the prescribed amount of CHG solution into your hands or a clean washcloth. It may not lather like normal soap.
Apply from the Neck Down: Gently wash your body from the neck down to your toes. Pay special attention to areas with skin folds, such as armpits, groin, and between the toes. Avoid sensitive areas like your face, eyes, ears, and genitals.
Allow Contact Time: For maximum effectiveness, allow the solution to remain on the skin for at least 2 to 5 minutes, depending on manufacturer recommendations.
Rinse Thoroughly: Turn the water back on and rinse your entire body thoroughly to remove all the CHG solution.
Pat Dry with a Clean Towel: Do not rub your skin. Use a fresh, clean towel to pat yourself dry. This helps prevent irritation and avoids reintroducing bacteria.
Do Not Apply Other Products: After your CHG shower, avoid applying any lotions, powders, deodorants, perfumes, or makeup, as these can interfere with the CHG's effectiveness.
Wear Fresh Clothing: Dress in fresh, clean pajamas or clothing and sleep on clean sheets.

Using Chlorhexidine Wipes or Applicators

For specific procedures or for patients who cannot shower, CHG wipes or applicators are used. The technique is slightly different:

For Wipes: Use one wipe per body area, starting from the neck and moving downward, following the same principles of avoiding sensitive areas and using fresh wipes for different sections. Allow the skin to air dry completely. Do not rinse the solution off.
For Applicators: Open the package and use the applicator without touching the sponge tip. Apply the solution in a back-and-forth motion over the intended site for the recommended time (e.g., 30 seconds). Allow the area to air dry completely (e.g., 3 minutes).

Comparison of Chlorhexidine Products


Feature	4% CHG Solution (e.g., Hibiclens)	2% CHG Wipes (e.g., Sage)	2% CHG with Alcohol Applicator (e.g., ChloraPrep)
Application	Lather and rinse in shower	Wipe, do not rinse	Swab, air dry
Primary Use	Pre-operative full-body cleansing	At-home prep, bedridden patients, ICU bathing	Surgical site prep, injections, catheter sites
Residual Activity	Excellent, binds to skin	Excellent, stays on skin	Excellent, binds to skin
Drying Time	Not applicable (rinsed)	Air dry (sticky feeling is normal)	Air dry for 3+ minutes, mandatory for fire safety
Target Area	Entire body (neck down)	Entire body (neck down), specific wiping order	Small, localized area
Key Benefit	Comprehensive full-body coverage	Convenience, no-rinse formula	Fast-acting, persistent kill

Safety Precautions and Potential Side Effects

While generally safe, chlorhexidine must be used with caution.

Flammability: Alcohol-based CHG products are flammable. Allow the skin to dry completely (a minimum of 3 minutes for hairless skin) before using any ignition source, such as cautery or lasers, in a medical setting.
Sensitive Areas: Never use CHG on the face, eyes, ears, genitals, or in the mouth unless specifically instructed for a mouth rinse. Contact with these areas can cause serious injury.
Allergic Reactions: Rare but serious allergic reactions, including anaphylaxis, can occur. Stop use immediately and seek medical attention if you experience rash, wheezing, or swelling.
Hair Removal: Avoid shaving with a razor 24 hours before using CHG to prevent skin irritation.
Deep Wounds: Do not use CHG on open wounds or deep scrapes unless directed by a healthcare professional.
Staining: Contact with regular bleach can cause permanent brown staining on fabrics. Wash linens with non-chlorine bleach.

For more information on safe surgical practices, consult authoritative organizations like the Association of periOperative Registered Nurses (AORN) at https://www.aorn.org.

Conclusion

Preparing with chlorhexidine is a crucial step for preventing infections associated with medical procedures. By following the correct procedure for your specific product—whether it's a shower scrub, no-rinse wipes, or a swab applicator—you can effectively reduce the risk of surgical site infections and ensure a safer patient experience. Always remember to prioritize patient safety by adhering to specific application methods, allowing adequate drying time, and avoiding sensitive body areas.

Frequently Asked Questions

No, you should never use chlorhexidine solution on your face, head, or near your eyes, ears, or mouth. Always use your regular face wash and shampoo before applying CHG to the rest of your body.

For alcohol-based applicators used for injections or surgery, a minimum of 3 minutes of air-drying is required on hairless skin. For CHG wipes, the solution is designed to air-dry and be left on the skin, so no drying time is needed before getting dressed.

The sticky feeling is normal and is a sign that the chlorhexidine solution is binding to your skin, providing its persistent antimicrobial effect. The feeling usually subsides as the solution dries completely.

After rinsing off the CHG solution in the shower, you should pat yourself dry with a clean, fresh towel. Do not reuse a towel that has been used previously, as it can reintroduce bacteria to your clean skin.

If you experience a rash or skin irritation after using chlorhexidine, stop using the product immediately and contact your healthcare provider. Allergic reactions, though rare, can occur.

Chlorhexidine products are generally not recommended for use on children under 2 months of age. Always consult a pediatrician or follow hospital guidelines before using CHG products on children.

Unless specifically instructed by a healthcare professional, chlorhexidine should not be used on open wounds, deep scrapes, or burns. It is intended for use on intact skin.