Benzalkonium chloride laundry products

Benzalkonium chloride is environmentally problematic and can irritate the skin. We do not recommend it as part of a nappy routine.

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We do not recommend laundry sanitiser products that contain benzalkonium chloride (BAC). Regular sanitisation is unnecessary with a good wash routine. Laundry needs to be clean, it does not need to be sterile.

BAC is found in products such as Canesten Hygiene Laundry Rinse, Dettol Laundry Sanitiser and Persil Antibacterial Laundry Sanitiser. These products are expensive and unnecessary the vast majority of the time.

Skin irritant

There is increasing evidence that using laundry products containing BAC causes serious skin irritation.

A recent study described 45 people assessed by dermatologists in Melbourne, Australia in just one year. These people all had serious skin irritation known as hyprkeratotic flexural erythema (also known as granular parkeratosis). These skin rashes went away on their own when people stopped using laundry products containing BAC.

Granular parakeratosis (GP) is a benign skin condition first described by Northcutt et al in 1991 as pruritic, red or brown, hyperkeratotic papules and plaques confined to one or both axillae of four patients. . . 
In recent years, there has been a greater recognition of the association between GP and chemical irritants found in antiseptics, especially laundry rinse aids and detergents containing benzalkonium chloride (BAC).

Catherine JL Tian, Diana Purvis, Harriet S Cheng

Environmental aspects

BAC is a problem for the environment because it does not break down readily or quickly. It is often found in high concentrations in wastewater sludge. When this biomass is dried out and distributed as organic compost, it contaminates existing soil. When BAC makes its way into the water system it kills aquatic life.

Products containing BAC also promote antibiotic resistance because of its lack of biodegradability.

Additionally, BAC is unsuitable for use if you have a septic tank as it kills the good bacteria in the tank.

Alternative products and methods

If you do need to sanitise laundry, using heat or chlorine bleach is cheaper, more effective, septic tank safe and better for the environment. If you have a front loader washing machine, you can sanitise laundry using a 90/95°C wash cycle.

We used to recommend BAC for sanitising wool. This is no longer necessary as we have developed a stovetop sanitise method for sanitising wool.

References and further reading
  1. Wentworth, Ashley B. MD, Yiannias, James A. MD; Davis, Mark D.P. MD, Killian, Jill M. BS, Benzalkonium Chloride A Known Irritant and Novel Allergen (January 31, 2022) <https://journals.lww.com/dermatitis/Abstract/2016/01000/Benzalkonium_Chloride__A_Known_Irritant_and_Novel.5.aspx>.
  2. Aaron J Robinson, Rachael S Foster, Anne R Halbert, Emma King, David Orchard, Granular parakeratosis induced by benzalkonium chloride exposure from laundry rinse aids (January 31, 2022) <https://onlinelibrary.wiley.com/doi/abs/10.1111/ajd.12551>.
  3. Catherine JL Tian, Diana Purvis, Harriet S Cheng, Granular parakeratosis secondary to benzalkonium chloride exposure from common household laundry rinse aids (February 22, 2023) <https://journal.nzma.org.nz/journal-articles/granular-parakeratosis-secondary-to-benzalkonium-chloride-exposure-from-common-household-laundry-rinse-aids>.
  4. Paul H Mc Cay, Alain A Ocampo-Sosa, Gerard T A Fleming, Effect of subinhibitory concentrations of benzalkonium chloride on the competitiveness of Pseudomonas aeruginosa grown in continuous culture (January 31, 2022) <https://pubmed.ncbi.nlm.nih.gov/19815578/>.
  5. Adnan Hossain Khan, The University of Western Ontario, Fate of Benzalkonium Chlorides in Natural Environment and Treatment Processes (January 31, 2022) <https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=5977&context=etd>.
  6. Kampf G., Biocidal agents used for disinfection can enhance antibiotic resistance in Gram-negative species. Antibiotics (Basel), 2018; 7: 110.
  7. Kim M, Weigand MR, Oh S et al., Widely used benzalkonium chloride disinfectants can promote antibiotic resistance. Appl Environ Microbiol 2018; 84: 1–37..