News, Views, & Reviews. Update on Antibacterial Soaps: The FDA Takes a Second Look at Triclosans
April 2014 | Volume 13 | Issue 4 | Feature | 501 | Copyright © 2014
Kendra Gail Bergstrom MD FAAD
In December of 2013 the Food and Drug Administration announced it would look further into the safety and efficacy of the biocide triclosan and requested further safety data as part of a new review with the Environmental Protection Agency. The use of triclosan has increased exponentially since its introduction in in 1972, to the point that 75% of commercial soap brands contain triclosan and 76% of a nationwide sample of adults and children excrete triclosan in the urine. This announcement raised an important dialog about the appropriate use of all over the counter biocides. Particular concerns include whether these biocides are more effective than regular soaps, whether they may create new drug resistant bacteria, and whether they may also act as hormone disruptors in humans or the environment.
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Patient and health activists have raised questions about common chemical additives becoming ubiquitous in our environment, including triclosan and bisphenol A. The use of the biocide triclosan has increased exponentially since its introduction in in 1972 to the point that 75% of commercial soap brands contain triclosan1 and 76% of a nationwide sample of adults and children excrete triclosan in the urine.2 As the use of these chemicals increases, so does evidence of their presence in humans, animals, and the environment. Triclosan has been found in human serum, urine, and breast milk.
In December of 2013 the Food and Drug Administration (FDA) announced it would look further into the safety and efficacy of triclosan and requested further safety data as part of a new review with the Environmental Protection Agency (EPA). The review involves both agencies because the EPA regulates triclosan as a pesticide to slow or stop the growth of bacteria, fungi and mildew. This announcement raised an important dialogue among advocates and the lay public about the appropriate use of all over the counter biocides. The focus of the FDA's investigation is the use of triclosan for personal products. Accordingly, the investigation excludes products for medical use: “the investigation does not affect hand sanitizers, wipes or other antibacterial used in hospitals and other medical facilities.”
The FDA request for further data on triclosan on the following questions:
- Whether biocide-containing soaps are more effective than regular soaps
- Whether they may create new drug resistant bacteria
- Whether they may act as hormone disruptors in humans or the environment.
Triclosan Containing Products
The scope of products containing triclosan is not always obvious. Products may be labelled as 'anti-bacterial' rather than with a mention of the active ingredient. Many of the listed metal, plastic, and clothing products incorporate a patented form of triclosan called Microban during manufacturing and may be referred to in product labeling simply as 'Microban'.
- Cleansers and soaps, mouthwash
- Toothpaste: Colgate Total brand has FDA approval for decreasing gingivitis-causing bateria
- Acne washes including Clearasil, Bath and Body Works, Murad Acne Complex Kit3
- Deodorants including Old Spice High Endurance
- Hairbrushes, combs, earplugs
- Shaving gels
- Plastic cutting boards, trash bags, coated metal knives, ceramic tiles
- Textiles- towels, socks, underwear, shoes, mops
- Plastic foot storage containers, food coolers, cell phone covers, vacuum cleaners
- Computer keyboard, mouse, pads
- Tile grout, caulk, and adhesives for kitchens and bathrooms
- Latex paints – voluntarily removed in 2013
School and Industrial
- Pencils, binders, scissors, calculators
- HVAC and air filtration systems
- Baby changing stations
- Protective sports gear, tactical body armor
History of Antimicrobial Soaps
Antibacterial soaps and related products have been used in medical and home settings since at least the 1940's. Hexachlorophene was popularized in Dial soap at 3% in hospital