Triclosen and Its Alternatives in Antibacterial Soaps.

Abstract

In 2017, the Food and Drug Administration banned the marketing of triclosan and triclocarban in antibacterial soaps, citing inefficacy and concerns of systemic absorption and antibacterial resistance. As a result, there is an anticipated decrease in the number of triclosan-containing products on the market with an associated increase in antibacterial alternatives (eg, benzalkonium chloride, benzethonium chloride, chloroxylenol, chlorhexidine) and cases of allergic and irritant contact dermatitis. The aims of the study were to determine the extent that triclosan and triclocarban are being used in the consumer and medical industries after the Food and Drug Administration marketing ban and to appraise the risk of allergic contact dermatitis to triclosan alternatives. The National Drug Code Directory (NDCD), Google, Amazon, Target, Walgreens, Walmart, CVS, and Colorado hospitals were surveyed for antibacterial soap use. Antibiotics surveyed include triclosan, triclocarban, benzalkonium chloride, benzethonium chloride, chloroxylenol, and chlorhexidine. The most common antibiotics reported by the NDCD, consumer sites, and Colorado hospitals were benzalkonium chloride, chloroxylenol, and triclosan, respectively. Triclosan accounted for the second most prevalent antibacterial in the NDCD- and consumer site-surveyed products. The triclosan marketing ban may instigate increased exposure to triclosan alternatives. The addition of antibacterial products to hand soaps does not improve soap effectiveness and may cause harm by contributing to antibiotic resistance and the development of allergic conditions. Additional studies are needed to elucidate the benefits and harms of antibacterial soaps.