Ethanol

Skin antiseptic and disinfectant

ATC code: D08AX08

Updated 24 Sep 2026 · Methodology

Indications

Antiseptic skin and mucosal decontamination

First line

Alcohol is the basic antiseptic for intact skin: preparation before an injection, before blood sampling, hand disinfection. The AEMPS ficha técnica frames the indication in one line – a skin antiseptic, applied directly to the area and left to act for two minutes before a procedure. The 2009 hand hygiene guidelines place alcohol-based products at the core of hand hygiene in healthcare: they act faster than washing with soap and the skin tolerates them better. There are two practical limits. Alcohol is flammable, and before any procedure involving a flame or electrocautery it must dry completely. And it does not work on spores, so during Clostridioides difficile outbreaks hands are washed with soap and water. Frequent use dries the skin and causes contact dermatitis.

Sources

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

Wound healing support

Not recommended

Pouring alcohol into a wound is a first aid box habit worth leaving in the past. The AEMPS ficha técnica states the ban directly: do not apply to deep and extensive wounds and avoid contact with mucous membranes, because alcohol is strongly irritating. The reason lies in the mechanism: ethanol denatures proteins indiscriminately, and the cells at the wound edges suffer along with the bacteria while healing gains nothing. A fresh wound is first rinsed with running water or saline, contamination is removed, then the edges are treated with an antiseptic suitable for wounds and covered with a dressing. Deep, dirty and bite wounds, and wounds with gaping edges, need a doctor and a tetanus vaccination check. If alcohol is advised to be poured into the wound itself, consider seeking a second opinion.

Sources

AEMPS: Ficha técnica de alcohol etilico (2021)

ICD-10: T14.1 · ICD-11: ND56.1

COVID-19 prevention

Not recommended

In 2020 alcohol turned from a hand antiseptic into a «cure for the virus», with advice to drink spirits, gargle alcohol and spray it on oneself. The questions and answers on COVID-19 answer directly: drinking alcohol does not protect against coronavirus, and spraying alcohol on skin and clothes does not kill a virus inside the body while it harms the eyes, mouth and airways. The AEMPS ficha técnica limits use to external: skin only, do not swallow, avoid contact with mucous membranes. The mechanism explains why alcohol is useless internally: it denatures proteins on direct contact, and such concentrations cannot be created in the bloodstream without poisoning the person. If alcohol was offered to drink, gargle or spray for protection from the virus, consider seeking a second opinion.

Sources

ICD-10: Z25.8 · ICD-11: QC01.9

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

Ethanol denatures microbial cell proteins, and the AEMPS ficha técnica adds an important condition: denaturation only happens in the presence of water. That is why a 70 degree solution disinfects better than a 96 degree one – it holds enough water for the protein to coagulate rather than merely dry on the outside. The spectrum covers gram-positive and gram-negative bacteria, mycobacteria, fungi and viruses; ethanol does not act on spores. The action is fast and short with almost no residual effect on the skin – the ficha asks to let it work for two minutes before a procedure. Absorption through intact skin is negligible, while on mucous membranes and open wounds alcohol causes severe irritation and is not applied there.

Safety

Contraindications

Hypersensitivity to ethanol or excipients
Application to deep and extensive wounds
Contact with mucous membranes

Serious adverse effects

Ignition on contact with a flame or electrocautery before it has fully dried
Chemical skin burn in preterm and newborn infants at high concentrations
Poisoning if swallowed

Common adverse effects

Dry skin with frequent use
Burning on damaged skin
Contact dermatitis

Pregnancy: can you take Ethanol?

External use on intact skin is not restricted in pregnancy: absorption is negligible. The ficha técnica notes that the pregnancy section does not apply to an external antiseptic.

Breastfeeding: can you take Ethanol?

External use is acceptable while breastfeeding. The nipple area is not treated with alcohol before a feed: the infant would get it from the skin.

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

Label mentions10 mentions

Verbatim lines from the interaction sections, in the language of the label

From other drugs’ labels

Alprazolam
«Drugs Having Clinically Important Interactions with Alprazolam: Examples Psychotropic medications, anticonvulsants, antihistaminics, ethanol, and other drugs which themselves produce CNS depression.»
FDA, section 7 · Open on DailyMed
Atomoxetine
«Alcohol: Consumption of ethanol with atomoxetine did not change the intoxicating effects of ethanol.»
FDA, section 7 · Open on DailyMed
Duloxetine
«Alcohol: When duloxetine and ethanol were administered several hours apart so that peak concentrations of each would coincide, duloxetine did not increase the impairment of mental and motor skills…»
FDA, section 7 · Open on DailyMed
Metoclopramide
«Drug Interactions: Absorption of drugs from the stomach may be diminished (e.g. digoxin) by metoclopramide, whereas the rate and/or extent of absorption of drugs from the small bowel may be increased…»
FDA, section 7 · Open on DailyMed
Morphine
«La administración conjunta de Morfina Serra con el alcohol etílico produce potenciación mutua de la toxicidad, con aumento de la depresión central.»
AEMPS, section 4.5 · Open on CIMA
Olanzapine
«Potential for Other Drugs to Affect Olanzapine: Alcohol — Ethanol (45 mg/70 kg single dose) did not have an effect on olanzapine pharmacokinetics. The co-administration of alcohol (i.e., ethanol)…»
FDA, section 7 · Open on DailyMed
Paracetamol
«Alcohol etílico : Potenciación de la toxicidad del paracetamol, por posible inducción de la producción hepática de productos hepatotóxicos derivados del paracetamol.»
AEMPS, section 4.5 · Open on CIMA
Pregabalin
«DRUG INTERACTIONS: Multiple oral doses of pregabalin were co-administered with oxycodone, lorazepam, or ethanol. Although no pharmacokinetic interactions were seen, additive effects on cognitive and…»
FDA, section 7 · Open on DailyMed
Venlafaxine
«Drug Interactions: A single dose of ethanol (0.5 g/kg) had no effect on the pharmacokinetics of venlafaxine or ODV when venlafaxine was administered at 150 mg/day in 15 healthy male subjects…»
FDA, section 7 · Open on DailyMed
Warfarin
«Alcohol etílico: hay algún estudio en el que se ha registrado alteración de la respuesta al anticoagulante, especialmente a grandes dosis de alcohol o en pacientes con alguna alteración hepática, por…»
AEMPS, section 4.5 · Open on CIMA

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Frequently asked

What is Ethanol used for?

Ethanol is evaluated for the following indications with varying evidence strength: Antiseptic skin and mucosal decontamination (evidence tier B), Wound healing support (evidence tier D), COVID-19 prevention (evidence tier F). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Ethanol?

Common side effects of Ethanol (≥ 1 in 100): Dry skin with frequent use, Burning on damaged skin, Contact dermatitis. See the Safety section for uncommon and serious reactions.

Is Ethanol safe during pregnancy?

External use on intact skin is not restricted in pregnancy: absorption is negligible. The ficha técnica notes that the pregnancy section does not apply to an external antiseptic.

Is Ethanol compatible with breastfeeding?

External use is acceptable while breastfeeding. The nipple area is not treated with alcohol before a feed: the infant would get it from the skin.

Who should not take Ethanol?

Ethanol is contraindicated in: Hypersensitivity to ethanol or excipients; Application to deep and extensive wounds; Contact with mucous membranes. Full list in the Safety section.

Official sources

Direct links to regulator labels. Open in a new tab.

AEMPS / CIMA

Other drugs in this group

Chlorhexidine, Isopropanol, Povidone-iodine