Comparison of Skin Antiseptic Agents and the Role of 0.01% Hypochlorous Acid

Aesthet Surg J. 2021 Sep 14;41(10):1170-1175. doi: 10.1093/asj/sjaa322.

Abstract

Background: Hypochlorous acid (HA) has both anti-microbial and wound-healing properties with a growing role for utilization in pre-procedural care on the face.

Objectives: The authors sought to compare the antiseptic property of 0.01% HA solution, 5% povidone iodine (PI), 4% chlorhexidine gluconate (CHG), and 70% isopropyl alcohol (IPA) antiseptic on facial skin.

Methods: This was a prospective single-center clinical trial.

Results: A total of 21 participants were recruited. Bacterial growth was seen in CHG (10%), IPA (71%), PI (81%), and HA (95%) of specimens (P < 0.001). CHG had less growth compared with HA (P = <0.001), IPA (P = <0.001), and PI (P = <0.001). No difference in bacterial growth was noted between HA and IPA (P = 0.063) or HA and PI (P = 0.25). Significant differences in mono-microbial and poly-microbial growth were seen between HA and IPA (P = 0.046) and HA and CHG (P = <0.001). Staphylococcus epidermidis grew less frequently in CHG (10%), followed by IPA (29%), PI (71%), and HA (71%). Staphylococcus capitis grew less frequently in CHG (0%), followed by PI (14%), HA (24%), and IPA (29%).

Conclusions: CHG reduced the bacterial growth compared with HA, PI, and IPA. However, HA, PI, and IPA had insignificant differences in bactericidal effects. Our study provides a supporting role of HA to be considered as an antiseptic.

MeSH terms

  • 2-Propanol
  • Anti-Infective Agents, Local*
  • Chlorhexidine
  • Dermatologic Agents*
  • Humans
  • Hypochlorous Acid
  • Povidone-Iodine
  • Prospective Studies
  • Skin

Substances

  • Anti-Infective Agents, Local
  • Dermatologic Agents
  • Hypochlorous Acid
  • Povidone-Iodine
  • 2-Propanol
  • Chlorhexidine