How To Clean A Cut With Hydrogen Peroxide

Why You Should Stop Using Hydrogen Peroxide on Wounds by Dr. Rachel Rader, DPM

5/30/2018

Rader Hydrogen peroxide is a chemical compound with the formula H2O2 and has been used as a first aid antiseptic for injured skin since the 1920's. The simplest peroxide, it is used as an antiseptic agent, bleaching agent and an oxidizer. It is a common 'go to' when there is a wound, and it can usually be found in most household's first aid kits.

As a young child, I remember my mom would rush to get the hydrogen peroxide to wash out our cuts and burns. The blood and other living cells found in a wound use the catalase enzyme to attack the hydrogen peroxide and convert it to (water) H2O and (oxygen) O2. In its low concentration, hydrogen peroxide will start a bubbling action which helps remove debris from the wound and work to kill bacteria cells by destroying their cell walls.

Here is where it all gets tricky. Although hydrogen peroxide is thought to be a good first aid antiseptic, the controversy remains on how beneficial it actually is in the long run. As a wound care specialist, I see wounds all the time that are stuck in a certain phase of wound healing and the wound struggles to progress forward. What it comes down to for me is giving the wound the best chance possible at healing and ultimately wound closure.

After years of research, we now know that the caustic nature of hydrogen peroxide and rubbing alcohol (another commonly used first aid antiseptic) can destroy healthy cells and therefore affect wound healing. If peroxide is used, it is definitely not recommended on a long-term basis.

The bactericidal effects of the hydrogen peroxide are great to clean the wound and kill bacteria initially, but this same benefit comes with a price in that the peroxide can damage skin cells and angiogenesis which is the process of new vessel formation. So for me, the benefits do not outweigh the risks. I see a lot of complex and chronic wounds and it is my job to not only determine the wound etiology but also deduct all aspects of what may be causing the wound to not improve, as well as manage everything that may delay wound healing.

People on certain medications will have delayed wound healing potential as well as people with other co-morbidities such as rheumatoid arthritis and diabetes. These individuals are starting the wound healing cascade already impeded by low healing potential, so pouring hydrogen peroxide on their wounds even initially can drastically affect their chance of ever healing.

For diabetic patients, especially after a skin injury, the odds of healing not only stack up against you but they do so quickly. My approach has always been to take all steps possible to heal wounds in the shortest amount of time and to decrease the risk of infection which may lead to delayed wound healing, and in some individuals limb loss.

So the question is not whether hydrogen peroxide is beneficial. That is not up for debate - there are many good uses for it, just not on wounds. Wounds can instead be cleaned with mild soap and water immediately after an injury.

On a long-term basis, there are a myriad of wound cleansing options available which will help to remove biofilm and reduce bioburden in the wound but not affect the healthy skin cells. Allowing the proliferation of fibroblast cells in the wound cells that play an important role in forming new granulation tissue and getting the wound healed.

Although the debate on the effectiveness of using hydrogen peroxide on wounds may continue, one thing that is certain is wound care has grown so much especially over the past 20 years. There are many advanced wound care modalities available, many of which we provide at the Davis Regional Medical Center Wound Healing Center.

You are also invited to our Wound Healing Educational Learning Lab on Tuesday, June 5 from 10 a.m. - 3 p.m. in the hospital classrooms. Wound Care staff will be on site to answer any questions you may have.

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