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0.01% Hypochlorous Acid as an Alternative Skin Antiseptic

An In Vitro Comparison

Anagnostopoulos, Apostolos G. MD*; Rong, Andrew MD*; Miller, Darlene DHSc, MPH, CIC; Tran, Ann Q. MD*; Head, Trajen PhD; Lee, Michael C.§; Lee, Wendy W. MD*

doi: 10.1097/DSS.0000000000001594
Original Article

OBJECTIVE Compare the in vitro efficacy of hypochlorous acid 0.01% (HA), povidone iodine 5% (PI), chlorhexidine gluconate 4% (CHG), and isopropyl alcohol 70% (IPA) against common skin microorganisms.

MATERIALS AND METHODS Time-kill studies were conducted against methicillin-susceptible Staphylococcus aureus (MSSA) and Staphylococcus epidermidis (MSSE), methicillin-resistant S. aureus (MRSA) and S. epidermidis (MRSE), Candida albicans, Corynebacterium species (striatum and amycolatum), Propionibacterium acnes, Pseudomonas aeruginosa, Streptococcus pyogenes, Staphylococcus capitis, and Staphylococcus xylosus.

RESULTS Methicillin-resistant S. aureus: Bactericidal effect was immediate for HA and IPA. For PI and CHG, the effect occurred at 1 and 10 minutes, respectively. Methicillin-resistant S. epidermidis: Hypochlorous acid, IPA, and PI had immediate bactericidal effects, whereas CHG required 1 minute. Methicillin-susceptible Staphylococcus aureus: All agents had bactericidal effects at 1 minute. C. species, S. pyogenes, P. aeruginosa, and P. acnes: All antiseptics demonstrated immediate bactericidal effects. Methicillin-susceptible Staphylococcus epidermidis and S. capitis: Hypochlorous acid and IPA had immediate effect, whereas PI and CHG required 1 minute. C. albicans: Hypochlorous acid, IPA, and PI were immediately bactericidal, whereas CHG required 1 minute. S. xylosus: Hypochlorous acid and CHG were immediately bactericidal, whereas IPA and PI required 1 and 2 minutes, respectively.

CONCLUSION In vitro studies of HA 0.01% were observed to have equal or more efficacious antiseptic properties compared with IPA, CHG, and PI. Future studies will be needed to investigate its role in periocular use.

*Department of Ophthalmology, Oculoplastic & Reconstructive Surgery, Bascom Palmer Eye Institute, Miami, Florida;

Department of Microbiology, Bascom Palmer Eye Institute, Miami, Florida;

Department of Biochemistry and Molecular Biology, University of Miami, Miami, Florida;

§Westminster High School, Palmetto Bay, Florida

Address correspondence and reprint requests to: Wendy W. Lee, MD, Department of Ophthalmology, Oculoplastic and Reconstructive Surgery, Bascom Palmer Eye Institute, 900 NW 17th Street, Miami, FL 33136, or e-mail:

Avenova was supplied by Novabay Pharmaceuticals, Inc. for the purposes of this study.

The authors have indicated no significant interest with commercial supporters.

© 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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