Which antiseptic is absorbed through the skin and may cause toxicity, with possible first-degree and second-degree burns in iodine-sensitive patients?

• A. Hexachlorophene
• B. Iodophors
• C. Alcohols
• D. Chlorhexidine gluconate (CHG)

Answer: (B)

Topical antiseptics differ in how much they are absorbed through the skin. Iodophors release iodine, and a portion of that iodine can be absorbed systemically, especially over large treated areas, on broken skin, or with prolonged exposure. In patients who are iodine-sensitive, this uptake can lead to iodine toxicity and irritation from the chemical itself, which may present as skin burns ranging from first-degree to second-degree due to the caustic effect of iodine on tissue. This is the key reason why an iodinated antiseptic is the option that fits the scenario.

Other agents behave differently. Hexachlorophene has risks mainly related to neurotoxicity with improper use; alcohols act quickly and largely evaporate, so systemic toxicity from skin absorption is unlikely though they can cause chemical burns with prolonged contact; chlorhexidine gluconate is generally well tolerated but can cause skin irritation and rare severe reactions, and it isn’t specifically tied to iodine sensitivity.