why betadine on skin for those with iodine/shellfish allergy?

Nurses General Nursing

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Why is betadine rubbed onto the skin for those with shellfish/iodine allergies before surgery/procedure?

I think it's just easier for people to understand "I'm allergic to Betadine" than to have the whole it's-not-the-iodine-it's-something-else-you-wouldn't-understand conversation. I have been sensitive to Betadine ever since I first started nursing--about 35 years. Now, I dont' know what it is about Betadine that makes me break out, swell up and itch, but I'd just as soon avoid it altogether. I had thumb reconstruction surgery a couple years ago. I told everyone I met in the OR that I was "allergic to Betadine"--intake nurse, anesthesiologist, surgeon, circulator. Yeah yeah yeah...The day after surgery, when I finally got my eyes open what do I spy peeking out from under my bandage? Gold :mad: Or, I should say Greenish-gold. What I learned later is that "someone" scrubbed my arm with Betadine. "Someone else" stopped her and reminded her that I was "allergic." Rather than scrub the Betadine OFF, she then poured Hibiclens over it "to neutralize it." :mad: Of course, I didn't discover all this until I went to have the bandage removed and sheets of skin peeled off. The skin on that part of my hand looks like I've suffered burns and it will never look normal again. :mad:

So, as far as I'm concerned, i will be "allergic to Betadine". And in the future I will write that directly on the body part which is about to undergo surgery...

owwwwwwww that is all i can say to your story. and sorry that happened.

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The iodine/shellfish allergy is a myth that just won't go a way: an allergy to shellfish does not equal an allergy to iodine. Long ago, it was assumed that those with shellfish allergies were reacting to the Iodine since it was assumed that all meat was the same. We have known for some time that this is not the case and that different proteins present specific allergens.

This is on top of the fact that it is not possible to have a true allergy to iodine. Allergic reactions are caused by an over-sensitive immune response to an allergen-antibody reaction. Iodine is an elemental molecule and does not contain the complex allergen markers that are required to initiate an allergic reaction. Also, Iodine cannot be avoided, it is present an any diet and is required for the normal functioning of the body.

Actually iodine can elicit an antibody reaction by binding to proteins & thereby acting as hapten & these will be iodine-specific antibodies. Antibodies to many small molecules (like drugs) are used in ELISA & radioimmunoassays. However you're absolutely right there is no cross-reactivity between shellfish & iodine, it's a myth.

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You should NEVER apply betadine as a prep for surgery when a pt. has a known shellfish allergy. CHG-based preps should be used as well as a iodine-free drape. I have seen what can happen to a pt. with a shellfish allergy when betadine is used. It is NOT pretty. Although, it is rare, some people are actually allergic to iodine. I would rather not take the risk when CHG-based preps are available. Exercise caution also with CHG-based preps, because I am extremely sensitive to them.

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Specializes in ICU, Telemetry.

I'm not an immunologist, but I've seen a doc disregard a patient's stated iodine allergy because he didn't think a person could actually be allergic to it. Maybe he wasn't, maybe it was the preservative, or some other chemical in the solution. But that patient's skin looked like they had Steven Johnson's syndrome by the time they got back to the floor; it couldn't have been a psychological reaction because the pt's skin was blistering and peeling before they ever woke up from anesthesia (the doc tried to say it was psychosomatic, until they charting proved the pt was still unconscious when symptoms were first noted).

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Specializes in home health, dialysis, others.

Always listen to a patient when they say they are allergic to anything! Nothing is worth the 'oops' that happens when someone thinks they know better.

I had an adverse reaction to Versed and don't ever want to get it again. I tell everyone I am allergic to it. And my allergy to sulfa drug is really bad - I won't even handle the pills without gloves on.

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