What is that purple stuff? Gentian violet 1% solution
European, Eastern European, Asian, Middle Eastern, and African/North African (Egypt, Morocco, Algiers) civilizations discovered gentian violet not only was a great dye, but it also had amazing abilities to eradicate skin (umbilical cord) and mucous membrane infections as well as promote wound healing.
Pediatric practitioners were ahead of the rest of the medical/surgical community when they treated and eliminated cases of thrush (candida) infections of the mouth, even in nursing infants who were exposed to candida infections of their mother’s nipples. For decades, I’ve successfully treated lower extremity wounds, especially on elderly patients, and augmented the healing of pressure ulcers and abdominal wounds by applying gentian violet 1% solution to the wound edges to treat maceration and prevent migration of skin organisms into the wound. Gentian violet is extremely well tolerated (not a single sensitivity reaction), readily available, and inexpensive as an over-the-counter product in local pharmacies.
I find it troubling that some wound management clinicians refuse to utilize this wound management option because (according to the most common mantra) they “can’t visualize/assess the wound.” These are often the same clinicians who, contrary to national and wound association general recommendations, debride benign eschars of the foot in patients who have arterial insufficiency. The implementation of moist wound healing was a powerful and much-needed update to wound management in the 1980s, but it was never meant to replace all other options. For example, a patient with lower extremity edema and a heavily draining leg ulcer would be much more responsive to compression and a dressing such as calcium alginate that would encourage drying of the wound bed to reduce maceration and hypergranulation. However, alginate dressings do not actively reduce the bioburden in the wound, not even silver-impregnated alginates designed to prevent overgrowth of organisms in the dressing. Another option, Dakin’s solution, which destroys organisms in the wound and cuts through biofilms, also increases moisture to an already heavily draining leg wound. I find the use of gentian violet 1% solution directly applied to these wounds and their surrounding macerated skin, covered with an alginate and then 100% cotton gauze and rolled gauze, is an effective way to management these leg wounds. When the dressing is removed, the gentian violet comes off as well, providing an excellent opportunity to evaluate the wound bed.
Gentian violet 1% solution also can be used for the treatment of rashes and fungal infections around stomas and tube exit sites. Because it is water-based and dries quickly (and stoma powder can be layered over the gentian violet to make it dry even faster), the appliance will adhere with no problem, as opposed to when creams or ointments are used.
Granuloma formations that grow around Tenkoff catheters (used for peritoneal dialysis) and other critically located tubes are painful and serve as sites for infection. The use of gentian violet 1% solution daily around the sites prevents the risk of infection and eradicates the granulomas.
Veterinarians, especially those who have received special training in treating farm animals, use gentian violet 1% to treat cuts and lacerations on the animals (and, anecdotally, on their own skin lacerations), because it effectively prevents tetanus infections and the animals can’t lick it off (it will not hurt them even if they try). It does not sting, making it easier to gain the animals’ cooperation. I recently was speaking to a veterinarian at a party, and he was thrilled I knew about gentian violet 1% solution. He immediately became my vet of choice. When my dog developed a strange “skin tag” on his belly, I tried to treat with gentian violet 1%, but it didn’t help, so I consulted the vet. He laughed hysterically and informed me that it wasn’t a skin tag; it was a tick. I countered, “Well, the gentian prevented it from getting bigger!”
In summary, I encourage practitioners to give gentian violet 1% an objective trial on some wound situations similar to those mentioned. At the very least, using gentian violet will enable the patients to dress their wounds with this uncomplicated, readily available treatment.
From: Farid KJ, Kelly K, Roshin S. Gentian violet 1% solution in the treatment of wounds in the geriatric patient: a retrospective study. Geriatr Nurs. 2011;32(2):85–95.
