Hydrogen peroxide

Author: Dr Marie Hartley, Staff Writer, 2010.

Background Uses Adverse effects Long-term adverse effects

Background

Hydrogen peroxide is a bleach and an oxidising agent, which means that when applied to tissues, oxygen is released. It is active against a wide variety of microorganisms. There are no known disease-causing bacteria or fungi that develop resistance to hydrogen peroxide.

Uses of hydrogen peroxide

Hydrogen peroxide at low concentrations has a variety of medicinal and domestic uses. At higher concentrations hydrogen peroxide has many commercial and industrial uses.

	Common uses of hydrogen peroxide
Purpose	Strength	Uses	Comments
Medicinal	1-5%	Antiseptic, topical acne treatment	1-5% hydrogen peroxide is frequently used to clean cuts, scrapes, and other minor injuries. Although it effectively kills organisms in the laboratory, there is little evidence that it is effective in reducing bacterial counts in actual wounds. Hydrogen peroxide 1% in stabilised cream (Crystacide®) can be used to treat acne. One study showed Crystacide® is as effective as benzoyl peroxide (a commonly used topical treatment for mild to moderate acne).
Domestic	3-6%	Disinfectant, contact lens disinfectant	Hydrogen peroxide is active against bacteria, yeasts, fungi, viruses, and spores on inanimate surfaces. Contact lenses must be neutralised before use to avoid pronounced stinging and possible corneal damage.
Cosmetic	Up to 10%	Peroxide-based hair dyes, hair perming products, teeth whitening	Some teeth whitening products used by dentists (office-based only) contain up to 35% hydrogen peroxide. Over-the-counter teeth whitening products contain up to 6% hydrogen peroxide.
Commercial and industrial	Above 35%	Bleach for textiles, paper, and food; a component of rocket fuel; used in the production of chemicals and foam rubber; agricultural uses	Workers in these industries may be exposed to hydrogen peroxide through inhalation or contact with the skin. Hydrogen peroxide breaks down rapidly in water and soil so does not accumulate in the food chain.

Adverse effects of hydrogen peroxide

Concentrated hydrogen peroxide can be toxic if taken by mouth, inhaled, or if it comes into contact with the eyes or skin. The main toxic effects of exposure to dilute solutions of hydrogen peroxide are irritation at the site of contact. Exposure to more concentrated solutions of hydrogen peroxide is most likely to occur in an occupational setting; personal protective equipment is recommended for workers likely to be exposed.

	Adverse effects of hydrogen peroxide
Route of exposure	Effects
By mouth	Ingestion of dilute solutions of hydrogen peroxide may result in vomiting, mild gastrointestinal irritation, gastric distension (ballooning inside the stomach due to release of oxygen), and on rare occasions, gastrointestinal bleeding or air embolism (blockage of blood vessels by air bubbles). Ingestion of solutions of 10-20% strength produces similar symptoms, but exposed tissues may also be burned. Symptoms may include abdominal pain, foaming at the mouth, vomiting (may contain blood), and gastric distension. Ingestion of even more concentrated solutions, in addition to the above, may also induce rapid loss of consciousness and can result in death.
Inhalation	Inhalation of household strength hydrogen peroxide (3%) can cause irritation to the nose, throat and respiratory tract. Inhalation of vapours from concentrated (higher than 10%) solutions may result in bronchitis and pulmonary oedema (fluid in the lungs), which can be fatal.
Eyes	Eye exposure to 3% hydrogen peroxide may result in redness and stinging, but severe injury is rare. More concentrated solution may result in ulceration or perforation of the cornea. Permanent eye injury, including blindness, can result.
Skin	Skin contact can cause irritation and temporary bleaching of the skin and hair. Contact with concentrated solutions may cause severe skin burns with blisters and ulcers.

Long-term adverse effects

Little is known about the long-term adverse effects of hydrogen peroxide. It is not known if exposure to hydrogen peroxide may cause cancer or affect reproduction in humans.

Approved datasheets are the official source of information for medicines, including approved uses, doses, and safety information. Check the individual datasheet in your country for information about medicines.

We suggest you refer to your national drug approval agency such as the Australian Therapeutic Goods Administration (TGA), US Food and Drug Administration (FDA), UK Medicines and Healthcare products regulatory agency (MHRA) / emc, and NZ Medsafe, or a national or state-approved formulary eg, the New Zealand Formulary (NZF) and New Zealand Formulary for Children (NZFC) and the British National Formulary (BNF) and British National Formulary for Children (BNFC).

References

Antiseptics on Wounds: An Area of Controversy: Hydrogen Peroxide — Medscape Dermatology
Hydrogen Peroxide Cream in Acne Vulgaris: Summary and Introduction — Medscape Dermatology
ToxFAQs™ — Agency for Toxic Substances and Disease Registry (ATSDR)
Crystacide cream — Medsafe New Zealand Medicines and Medical Devices Safety Authority, manufacturer's data sheet

On DermNet

Other websites

Consumer medicine information and data sheets — Medsafe
Drugs, Herbs and Supplements — MedlinePlus

Hydrogen peroxide — extra information