Skin
Treatment of Burns
1. Bunyan (1983). "The treatment of burns by hypochlorite solution." J Trop Pediatr 29(2): 93-94.
“At the beginning of the Second World War it was reported that very dilute solutions of hypochlorite were effective in the treatment of wounds and burns. Rapid reduction of traumatic oedema and inflammation appeared to be the dominant factor in preventing infection, as well as the marked proteolytic effect, whereby burn sloughs were allowed to separate without putrefaction, resulting in healthy healing or healthy granulations on which grafts could be confidently expected to take completely. Hypochlorite, in its main constituent, hypochlorous acid, acts by combining with the proteins of the wound to form chloramines, which are powerfully bactericidal and bacteriostatic. Bacterial toxins are neutralized and infection is controlled or prevented. Acute surgical infections such as gas gangrene are quickly brought under control”
2. Gray, Foster et al. (2016). "Universal decolonization with hypochlorous solution in a burn intensive care unit in a tertiary care community hospital." Am J Infect Control 44(9): 1044-1046.
“Infections are the leading cause of morbidity and mortality in burn patients. Patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) are at higher risk of developing an invasive infection, and MRSA is endemic in many burn units. The typical decolonization regimen of mupirocin and chlorhexidine bathing is not optimal in burn patients because of chlorhexidine limitations on nonintact skin. We studied the impact of universal decolonization using mupirocin and hypochlorous acid bathing on health care-associated MRSA infections in a burn intensive care unit. We show a significant decrease in total MRSA infections”
Hand Cleanser
1. Anagnostopoulos, Rong et al. (2018). "0.01% Hypochlorous Acid as an Alternative Skin
Antiseptic: An In Vitro Comparison." Dermatol Surg 44(12): 1489-1493.
“HOCL 0.01% were observed to have equal or more efficacious antiseptic properties compared with povidone iodine 5% (PI), chlorhexidine gluconate 4% (CHG), and isopropyl alcohol 70% (IPA) against common skin microorganisms, such as methicillin-susceptible Staphylococcus aureus (MSSA) and Staphylococcus epidermidis (MSSE), methicillin-resistant S. aureus (MRSA) and S. epidermidis (MRSE), Candida albicans, Corynebacterium species, Propionibacterium acnes, Pseudomonas aeruginosa, Streptococcus pyogenes, Staphylococcus capitis and Staphylococcus xylosus”
Acne, Eczema, Psoriasis, Allergic Dermatitis, Itching
1. Hypochlorous acid is effective in Atopic Dermatitis – Systematic Review
Vakharia and Silverberg (2018). "New therapies for atopic dermatitis: Additional treatment classes." J Am Acad Dermatol 78(3 Suppl 1): S76-s83.
“HOCl has been shown to decrease numerous inflammatory cytokines, including tumor necrosis factor-a, interferon gamma, IL-2, and histamine, as well as nuclear factor kappa. In a recent case series, 7 days of treatment of patients with AD with topical hydrogel containing 0.008% HOCl and 0.002% NaOCl significantly reduced pruritus. PR022 is a topical formulation of HOCl that is being studied for the treatment of mild-to-moderate AD, with preclinical studies demonstrating lesional improvement with topical application”
2. Tirado-Sanchez, et.al. (2009). Efficacy and tolerance of superoxidized solution in the treatment of mild to moderate inflammatory acne. A double-blinded, placebocontrolled, parallel-group, randomized, clinical trial. Journal of Dermatological Treatment. 20:289–292
A total of 89 patients were enrolled in this double blinded, clinical trial. Patients presented with 10–50 inflammatory lesions (papules and pustules) and an absence of nodulocystic lesions. Results: Improvement was excellent in nine patients (23%) using HOCL, compared with five patients (21%) using benzoyl peroxide (BP) (p = 0.378); good in 21 patients (54%) using HOCL and 12 patients (50%) using BP (p = 0.794), compared with four patients (18%) taking placebo (p = 0.001); and fair in six patients (15%) using SOS and five patients (21%) using BP (p = 0.415), compared with 12 patients taking placebo (55%) (p = 0.014). In three patients using HOCL (8%) the response was poor, compared with two patients (8%) using BP (p = 0.725) and six patients (27%) taking placebo (p = 0.075). We did not need to change a dose during the study period and no systemic effect was observed. Conclusions: We found that HOCL is an important choice to treat inflammatory acne, comparable with benzoyl peroxide.
3. Fukuyama, Ehling et al. (2018). "Comparison of topical tofacitinib and 0.1% hypochlorous acid in a murine atopic dermatitis model." BMC Pharmacol Toxicol 19(1): 37.
“When administered onto lesional skin of mice with atopic dermatitis, hypochlorous acid gel reduced lesions and scratching behaviour. The reduced inflammatory response was demonstrated by diminished inflammatory cytokines in affected skin tissue”
4. Fukuyama, Martel et al. (2018). "Hypochlorous acid is antipruritic and anti-inflammatory in a mouse model of atopic dermatitis." Clin Exp Allergy 48(1): 78-88.
“When administered after full development of lesions, HOCl reduced lesions and scratching behaviour. The reduced inflammatory response by HOCl treatment was demonstrated by reduced secretion of inflammatory cytokines in affected skin tissue. In addition, HOCl significantly reduced IL-12 production in neuronal cells. The diminished scratching behaviour was confirmed by impaired response to several pruritogens in dorsal root ganglia neurons. These data indicate a direct reduction in sensory response by HOCl, leading to significantly reduced itch and inflammation in vivo.
5. Leung, Zhang et al. (2013). "Topical hypochlorite ameliorates NF-kappaB-mediated skin diseases in mice." J Clin Invest 123(12): 5361-5370. “Nuclear factor-kappaB (NF-kappaB) regulates cellular responses to inflammation and aging. In cultured cells, HOCl inhibited the activity of inhibitor of NF-kappaB kinase (IKK), a key regulator of NF-kappaB activation, by oxidizing cysteine residues. For mice with acute radiation dermatitis, topical HOCl inhibited the expression of NF-kappaB-dependent genes, decreased disease severity, and prevented skin ulceration. Furthermore, these data suggest that topical HOCl reduces skin aging through IKK modulation”