Topical stabilized hypochlorous acid: The future gold standard for wound care and scar management in dermatologic and plastic surgery procedures

J Cosmet Dermatol. 2020 Feb;19(2):270-277. doi: 10.1111/jocd.13280. Epub 2020 Jan 6.

Abstract

Background: Hypochlorous acid (HOCl), a naturally occurring molecule produced by the immune system, is highly active against bacterial, viral, and fungal microorganisms. Moreover, HOCl is active against biofilm and increases oxygenation of the wound site to improve healing. Natural HOCl is unstable; through technology, it can be stabilized into an effective topical antiseptic agent.

Aim: This paper focuses on the use of topical stabilized HOCl in wound and scar management for pre-, peri-, and postprocedures-including its ability to reduce the occurrence hypertrophic scars and keloids. The role of the product in other skin conditions is beyond the scope of this article.

Methods: A panel comprising clinicians with experience in cosmetic and surgical procedures met late 2018 to discuss literature search results and their own current clinical experience regarding topical stabilized HOCl. The panel of key opinion leaders in dermatology and plastic surgery defined key insights and consensus statements on the direction of use for the product.

Results: Topical stabilized HOCl provides an optimal wound healing environment and, when combined with silicone, may be ideal for reducing scarring. Additionally, in contrast to chlorhexidine, HOCl, used as an antiseptic skin preparation, raises no concerns of ocular- or ototoxicity.

Conclusions: For wound care and scar management, topical stabilized HOCl conveys powerful microbicidal and antibiofilm properties, in addition to potency as a topical wound healing agent. It may offer physicians an alternative to other less desirable wound care measures.

Keywords: hypertrophic scars; keloid scars; scar management; stabilized hypochlorous acid; wound care.

Publication types

  • Review

MeSH terms

  • Administration, Cutaneous
  • Anti-Infective Agents, Local / administration & dosage*
  • Anti-Infective Agents, Local / adverse effects
  • Anti-Infective Agents, Local / chemistry
  • Biofilms / drug effects
  • Cicatrix, Hypertrophic / etiology
  • Cicatrix, Hypertrophic / prevention & control*
  • Humans
  • Hypochlorous Acid / administration & dosage*
  • Hypochlorous Acid / adverse effects
  • Hypochlorous Acid / chemistry
  • Keloid / etiology
  • Keloid / prevention & control*
  • Perioperative Care / standards
  • Perioperative Period
  • Reconstructive Surgical Procedures / adverse effects*
  • Standard of Care
  • Surgical Wound Infection / drug therapy*
  • Surgical Wound Infection / etiology
  • Wound Healing / drug effects

Substances

  • Anti-Infective Agents, Local
  • Hypochlorous Acid