5 Things Every Nurse Should Know About Hypochlorous Acid (HOCl)
Discover the top things nurses should know about hypochlorous acid (HOCl), a powerful, safe, and non-toxic antimicrobial used in wound care, dermatology, and infection control. Learn about its efficacy, safety, healing benefits, and why it's ideal for sensitive skin and long-term use.
As front-line healthcare professionals, nurses are often the first to clean, disinfect, and treat wounds—making their knowledge about antimicrobials and antiseptics a critical factor in patient care.
One antimicrobial gaining traction for its safety, efficacy, and versatility is hypochlorous acid (HOCl), also accurately referred to as a super oxidizing saline solution. Naturally produced by the body’s immune system and used in clinical settings for over a century, HOCl is a biocompatible, broad-spectrum antimicrobial with emerging applications in wound care, dermatology, and infection control.
Five Key Things Nurses Should Know About Hypochlorous Acid (HOCl)
1. HOCl is Naturally Produced by the Body
HOCl is not a foreign chemical—it's something your body already produces as an effective part of immune response. HOCl is produced by neutrophils, a type of white blood cell, during an immune response. When the body detects an invader, neutrophils create HOCl to destroy bacteria, viruses, and fungi through oxidative damage¹. This mechanism of action is precisely why HOCl is often referred to as Super Oxidizing Saline. With advanced technologies, a shelf-stable HOCl can now be produced outside of the body, making it an ideal agent when you need an antimicrobial solution that’s gentle, yet potent.
2. HOCl is Broad-Spectrum and Fast-Acting
HOCl has been shown to kill a wide variety of pathogens, including methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and Candida albicans, among others¹⁻³. In vitro and in vivo studies demonstrate that even at a low 0.01% concentration, HOCl exhibits similar or superior antimicrobial efficacy compared to other antiseptics like chlorhexidine (CHG), povidone-iodine (PI), and isopropyl alcohol²⁻³. Notably, HOCl can reduce microbial bioburden without leading to antimicrobial resistance—a critical benefit in an era of superbugs².
3. HOCl Cleans Without Compromising Healthy Tissue
Unlike many antiseptics that can be cytotoxic (damaging to skin and tissue cells), HOCl is well-tolerated by keratinocytes and fibroblasts, which are essential for wound healing²⁻³. Studies show that wounds treated with HOCl exhibit higher re-epithelialization rates compared to saline, without the cytotoxic effects associated with PI or CHG³. In other words, it cleans wounds without compromising healing.
4. HOCl Has Anti-Inflammatory and Anti-Itch Benefits
Nurses working with patients with chronic skin conditions like atopic dermatitis or pruritus may find HOCl especially useful. Research has shown that HOCl can inhibit pro-inflammatory pathways such as NF-κB and reduce levels of cytokines like IL-19 and TNF-α¹⁻³. In murine models, topical HOCl reduced itching behaviour comparably to corticosteroids¹⁻³. This dual action—antiseptic and anti-inflammatory—makes it an excellent option for sensitive or inflamed skin.
5. HOCl Is Safe for Long-Term and Sensitive Applications
The safety profile of hypochlorous acid is one of its most significant advantages. Human and animal studies report no significant tissue irritation or systemic toxicity even at concentrations up to 1,000 ppm¹. It's also non-toxic to eyes and mucous membranes, making it suitable for facial procedures, ocular applications, and neonatal care¹⁻³. HOCl solutions are often preferred over harsher agents like alcohol or CHG in situations where tissue compatibility and patient comfort are paramount¹⁻³.
The Bottom Line: HOCl is a Nursing Essential
Whether you're irrigating wounds, prepping skin for a procedure, or managing chronic dermatological conditions, HOCl offers a safe, effective, and patient-friendly antimicrobial option¹⁻³. that can transform your clinical practice. With its biocompatible nature and gentle yet powerful action¹⁻³., it provides nurses with a versatile tool across multiple care settings. From acute care facilities to outpatient clinics, HOCl solutions can be integrated into various nursing protocols to enhance patient outcomes while minimizing discomfort and tissue damage¹⁻³.
As its applications continue to grow and evolve in healthcare settings, developing a comprehensive understanding of the science, safety profile, and practical applications of HOCl can empower nurses to make more informed, evidence-based decisions in their everyday care routines, ultimately benefiting both the practitioner and patient experience.
Explore PureCleanse™, our pure and stable super oxidizing saline (HOCl) solution for skin, wounds and burns. Learn more here.
References
- Boecker, D., Zhang, Z., Breves, R., Herth, F., Kramer, A., & Bulitta, C. (2023). Antimicrobial efficacy, mode of action and in vivo use of hypochlorous acid (HOCl) for prevention or therapeutic support of infections. GMS Hygiene and Infection Control, 18, Doc07.
- Tran, A. Q., Topilow, N., Rong, A., Persad, P. J., Lee, M. C., Lee, J. H., ... & Lee, W. W. (2021). Comparison of skin antiseptic agents and the role of 0.01% hypochlorous acid. Aesthetic Surgery Journal, 41(10), 1170-1175.
- Natarelli, N., Nong, Y., Maloh, J., & Sivamani, R. (2022). Hypochlorous acid: Applications in dermatology. Journal of Integrative Dermatology.
LEADING THE WAY IN HOCl FOR HEALTHCARE
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