No doubt about it: bad hygiene is the biggest killer of humans in the history of ever. Soap and water will get you a long way. So will careful water and waste treatment. There’s one more important chapter in this story though. It’s what you pull out when it’s time to pull out the Big Stick in the cleanliness department: Antiseptics.
I’m still not a physician. This is meant as information, not medical advice.
What are, and aren’t, antiseptics?
Translate ‘antiseptics’ out of the tortured latin of science and you get ‘against infection’. Antiseptics are chemicals that kill microbes. More specifically, they’re chemicals that are safe enough to put on human skin but will kill a wide variety of different microbes.
Antiseptics are antibiotics. Antibiotics are drugs that interfere with specific biochemical pathways in particular kinds of microbes. No one antibiotic works against every germ, but antibiotics are the most potent tool we’ve got against specific germs. Consider antibiotics to be the masterful specialists (useless outside their specialty) and antiseptics more the ‘jack of all trades, master of none’.
Also, one often swallows antibiotics, or injects them. Only a few work as surface applications. Antiseptics are always applied to the surface with the intent of killing the germs on the surface.
Common prepper-relevant antiseptics
I define an antiseptic as ‘prepper-relevant’ if it’s easy to buy, easy to use safely and effectively, and has a good shelf life. (Safety is relative. Antiseptics do have risks and if you do stupid you can do damage with them. But with reasonable care, these antiseptics are safe.)
Ok, here’s a listing of the top prepper-relevant antiseptics. Then I’ll tell you a bit more about some of them: Alcohols, including ethanol, isopropanol, and n-propanol. Chlorhexidine. Bleach. Iodine and providone-iodine. Ammonia solutions. Hydrogen peroxide (barely qualifies as prepper-relevant because of limited shelf-life.)
Alcohols
The old Western movie scenes of pouring whiskey on wounds? Yeah, that’s an actual thing. Hurts like a bear and does some tissue damage, but not that much damage and way better than an infection. Ethanol is an effective antiseptic. It works best at 60-90% (120 – 180 proof), so vodka would do the trick but don’t waste the beer.
Lots of isopropanol, a little chlorhexidine, a little something to slow evaporation: effective.
Isopropanol (rubbing alcohol) is also effective as an antiseptic. So is n-propanol, which I read is available in Europe. Haven’t seen it for sale in U.S. drugstores.
Alcohols are good against bacteria, viruses, and fungi; and work pretty fast. They don’t tend to kill spores. Spores are essentially ‘hibernating’ germs; due to their lack of metabolism many antiseptics have trouble killing them.
Alcohols can also make some other antiseptics work better. Chlorhexidine and alcohol is a good combo, found in many hand cleaner gels. Other ingredients in those gels slow their evaporation, which helps them work better.
Chlorhexidine
This antiseptic is found in a lot of hand washing products (5% solutions) and mouthwashes (at 0.12%, usually). It’s takes out lots of kinds of bacteria nicely, but is not as good against viruses and mycobacteria. Mycobacteria are an especially well protected group that includes leprosy and tuberculosis germs.
Chlorhexidine isn’t as irritating as alcohols to most people. A few people are allergic. Let’s put it this way: the Red Cross has recently gone to a chlorhexidine antiseptic for blood donations. It doesn’t stain like the iodine they used to use and fewer people are allergic. (So what do *you* chat about with your phlebotomist during blood donations?)
One caveat: Chlorhexidine doesn’t work well if there’s a lot of organics (read, Dirt) on the surface to be de-germed.
Bleach
I’ve written on this one before; you can find that post here. Good stuff, but more often used on surfaces than skin (making it more a disinfectant than an antiseptic). I’ll just add here that it is one of the few things that does kill spores, if used in high concentration. It’s also one of the few things (strong lye being another) that has any hope of getting rid of prions.
Iodine
Iodine can be used either as a tincture (10% iodine solution) or mixed with another chemical to make providone-iodine, better known as Betadine. The tincture is highly effective against most bacteria, mycobacteria, and fungi. Pretty good against spores and viruses. It’s also more irritating to the skin and less stable than the providone-iodine. I notice that health providers always ask if you’re allergic to shellfish before using iodine, in case that influences your choices.
Why and how would one use antiseptics?
Antiseptics, in my eyes, are kind of a ‘tweener.
Soap and water and general cleanliness are in the “Now is always a good time” category.
Antiseptics could be over-used. You do have microbes living on your skin and mucus membranes that you don’t want to kill. Their presence helps protect you from disease-causing germs by, basically, taking up the same real estate with harmless species. Also, many antiseptics are somewhat irritating. They’re harder to store in large quantity than soap, too.
Minor breaks in the skin and situations where you know you’re about to break skin are good times to use antiseptics, in my opinion. If I need to dig out a splinter, I’ll apply antiseptic first. If I had to lance a boil, ditto.
As a care provider, I’d wash in antiseptic before any procedure that was going to contact disturbed skin or internal bits. That’s especially important if I had no gloves.
First careful soap and water, then antiseptic is my rule if I’m going to handle broken skin. Gloves if I’ve got them.
Antiseptics applied to tools or surfaces are technically called ‘disinfectants’, but they work that way too.
Antibiotics vs. antiseptics
Antibiotics, in a prepper situation, could probably not be spared ‘just in case’; as a way to avoid infection. Antiseptics star in that role. In fact, what got me on this topic was a book about Joseph Lister. He’s the dude who talked late-1800s surgeons into using germ theory and antiseptics, reducing the surgery fatality rates from ‘horrendous’ (say, 75%) to ‘Much Better!’ (under 25%).
I’m not usually into the Great Man thing, but Joseph Lister’s antiseptic procedures saved *a lot* of lives. Still do.
Although asepsis (sterile technique) was theoretically possible by the end of Lister’s career, he didn’t trust it. Not on theoretical grounds — he just didn’t trust it to be complete. Careful use of antiseptics dramatically reduced infection rates even when sterility could not be hoped for. Sounds like a prepper situation to me…
If you Know you’ve got an infection already, it may well be too late for antiseptics to help. Time to break out the antibiotics if you have them.
Is there resistance to antiseptics?
We hear a lot (some of it coming from us at 3BY) about antibiotic resistance. That’s where antibiotics have become useless due to evolution by the microbes. Do antiseptics have the same problem?
Not really. Although there are some indications of reduced effectiveness of some antiseptics after mutation by some germs, it’s not a big thing. Cases are both far more rare and far more mild than cases of antibiotic resistance. And they’re likely to stay that way. It’s hard to find a genetic mutation that’ll get you past ‘dissolves your cell membrane’.
Now, there Is one thing worth watching for. High use of some antiseptics (chlorhexidine and ammonia compounds) might be encouraging genetic mutations that make the antiseptics a little less effective but reduce the effectiveness of methicillin and gentamicin antibiotics by a lot. That’s another reason not to overuse these generally very useful compounds.
Some of my sources for this piece
McDonnell, G., & Russell, A. D. (1999). Antiseptics and disinfectants: activity, action, and resistance. Clinical microbiology reviews, 12(1), 147–179.
Albert T. Sheldon, J. (2005). Antiseptic “resistance”: Real or perceived threat? Clinical Infectious Diseases, 40(11), 1650-1656. doi:10.1086/430063
Roberts, L. G., Dabbs, G. R., & Spencer, J. R. (2016). An update on the hazards and risks of forensic anthropology, part I: Human remains. Journal of Forensic Sciences, 61(S1), S5-S13. doi:10.1111/1556-4029.12947
Cheng, A., Sun, H., Tsai, Y., Wu, U., Chuang, Y., Wang, J., . . . Chang, S. (2018;2017;). In vitro evaluation of povidone-iodine and chlorhexidine against outbreak and nonoutbreak strains of mycobacterium abscessus using standard quantitative suspension and carrier testing.Antimicrobial Agents and Chemotherapy, 62(1) doi:10.1128/AAC.01364-17
Diven, Dayna G. et al. Extending Shelf Life Just Makes Sense. Mayo Clinic Proceedings, Volume 90 , Issue 11 , 1471 – 1474
*Wellcome Trust [CC BY 4.0 (https://creativecommons.org/licenses/by/4.0)]
All good information Spice. As a Surgical team member I too prefer good antiseptics for my hand wash and patient skin preps. I do have a decent stockpile but know just how much material get used up in every wound care procedure. Even a Hospital needs nearly daily truck loads of supplies to function. Our preferred supplies of antiseptics will be gone pretty fast.
My SHTF antiseptics of choice after I run out of the commercial ones are Alcohol, Vinegar, heavy saline irrigation and Soap and water. Get the DIRT out, control the bleeding, then worry about antiseptic efforts. The Roman Army medics had an effective understanding of the germ theory that was lost in the Dark Ages. They used a lot of the above quite successfully given the tendency of Barbarians using poop contaminated arrows and such. Most of Roman bandages was to hold on and cover a sponge. The sponges were washed and boiled for reuse. You can grow the Loofa Sponge and if you have too much the young fruit tastes a lot like zucchini.
Also for the deeper wounds I have found that plain white sugar is amazing in it’s ability to help the human body fight off infection with daily wash outs and repacking. Sugar beets are doable and the remainders after the chop and boil for sugar is great animal food as is the Sugar Beets tops for human foods.
I hope never to have to use my knowledge of Civil War dentistry or Roman wound care but as a Medical History buff I do find it interesting how we recreate what was done a long time ago.
That sugar trick isn’t too irritating, then? I’d read about it, and of course the osmolarity would be discouraging to about anything, but wondered if the osmolarity wouldn’t be too unfriendly to the healing tissue.
Some of those old remedies still sound like a Great idea; and some are So bad. I always hope people trying to recreate “The good old days” know, as you do, which are which.
Spice the white sugar packing thing is so good that Johns Hopkins and others are trialing it with Medically Acceptable mix in’s like Iodine as not to be accused of witch craft. Along with Sterile maggot therapy (sterile Micro Surgeons that eat only rotten flesh) and leeches (restoring micro blood flow to toes and fingers to prevent amputations) slowly some very effective old time techniques are coming back.
There IS a lot of old time medical efforts better suited for a horror movie but the fact you and I are alive to discuss this shows some of it PLUS the amazing ability of the human body to self heal and prevail under conditions we would describe AS SHTF well…..
Judging from history and current medical events in Sanctuary Cities where homeless with out basic sanitation are recreating the Medieval “Beware Slop” conditions of feces in the streets and thus return of Dangerous Medieval Diseases. All Preppers should remember the value of the 4 “S”‘s AND one A of SHTF Medicine: Safety (don’t get hurt fighting over politics, religion etc. THINK before operating that Chainsaw etc. PREVENTION is best) Sanitation (don’t get sick from human waste, keep your drinking water safe) treat Shock (proper hydration and basic medical treatments to allow an sick or injured to recover) Support (Medical Isolation to prevent transmission of disease to the rest of the tribe along with rest and recovery). And Acceptance that finally not everyone will survive bad situations.
Personally from my decades in the medical system I have seen personally some “Modern” medicines go from the wonder drug to “What were we Thinking” status. I eagerly await when Warfarin the rat poison (literally) we use to “thin” blood falls from grace.
None of this information is a substitute for modern medical treatments. Seek professional assistance and all that. Information is as useful and or dangerous as the person applying it. I seek useful information for when SHTF and modern hospitals are gone.
Any thoughts on sugardine? half sugar and half iodine or Betadine…sounds similar to what Michael referenced above.
I wasn’t familiar with this approach — and a quick look at the medical literature doesn’t show that they’re familiar with it either. Both wound packing with sugar and Betadine have value as antiseptics. Would I mix them? Personally, no. I try not to mix agents when I don’t know about interactions, and I don’t know about these. If it were me (non-physician) taking care of the wound, I’d probably start with sterile saline irrigation, use betadine, and go to packing with sugar if I was seeing signs of infection rather than using both antiseptics from the start.