Doctors repair stuffed animals at Teddy Bear Hospital
Emergency physicians and nurses bandaged teddy bears, stitched stuffed snakes and tended to wounded dolls at Poudre Valley Hospital in Colorado.
One of the more dangerous medical myths I frequently see in the ER is the widespread belief by patients that copious amounts of hydrogen peroxide should be used to clean cuts and scrapes of any size. With emergency rooms across the country treating 7-9 million lacerations annually, it’s no surprise that we are constantly imploring patients and their families not to do this.
Unfortunately, this deeply held belief extends across multiple cultures and generations. More often than not, patients will say “My mom (or grandma) told me to clean it out good with hydrogen peroxide.” I was also alarmed recently to see multiple TikTok videos of people excited about seeing a “fizz reaction” on their skin after dousing their wounds with hydrogen peroxide. The underlying inaccurate consensus seems to be that the level of fizz generated equates to how well the wound is cleaned.
While hydrogen peroxide does have known antiseptic properties, it may do more harm than good when it comes to wound care.
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A brief history of hydrogen peroxide
Hydrogen peroxide was discovered in 1818 by French chemist Louis Jacques Thénard and was first used commercially to bleach hats. Hydrogen peroxide occurs naturally in very small amounts so industrial processes are used to make the 1 billion pounds of hydrogen peroxide needed annually, mostly for the bleaching of paper and pulp. It is formed when atmospheric oxygen reacts with water to form H2O2.
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Hydrogen peroxide has been used as an antiseptic since the 1920s. The germ destroying properties of hydrogen peroxide are well-documented. It exhibits broad-spectrum activity against bacteria, viruses, yeasts, fungi and spores. It has long been used for the sterilization of surfaces and surgical tools and is considered an environmentally safe alternative to chlorine-based bleaches because it is broken down into oxygen and water. It has several safe home cleaning applications. Hydrogen peroxide is also safely used as a contact lens disinfectant and in hair dyes. It’s a component in some tooth whitening products as well.
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Why does hydrogen peroxide fizz?
Blood and most of our cells contain an enzyme called catalase. When hydrogen peroxide is poured on an open wound, the catalase instantly converts hydrogen peroxide into water and oxygen – these breakdown products generate the fizzing reaction we see on the skin. The fizzing does actually help remove and clear debris from the open wound.
Hydrogen peroxide can impair our body’s quick response to a cut
As the largest organ of our body, the skin performs an essential role in protecting us from foreign invaders such as the more than 1.5 trillion bacteria that live on it. When we get a cut or wound, no matter how big or small, our body quickly jumps into action.
Multiple cells are immediately involved in this initial response. Platelets release fibrin products to form a clot and seal the wound. White blood cells called macrophages rush to the area to destroy any bacteria that got past the clot and oversee the repair process. Macrophages also secrete growth factors which help repair the wound. Blood vessels then dilate to allow fresh nutrients and oxygen to flow to the area and facilitate healing.
As you can see, multiple cells are immediately involved in the wound protection and healing process. Hydrogen peroxide unfortunately does not discriminate between bacteria cells and our own cells. While you may think you are thoroughly cleaning your wound, you are causing corrosive tissue damage, significantly impairing the healing process, and irreversibly worsen the scarring process. Severe toxicity from skin application could include inflammation and blistering.
If you experience severe pain or burning sensation, contaminated skin should be immediately rinsed with copious amounts of water. And you’ll need to head to the ER as these skin lesions will need additional treatment as a thermal burn.
The bottom line is that hydrogen peroxide and other caustic first aid antiseptics like rubbing alcohol should not be used to clean fresh open wounds. I advise patients to simply irrigate the wound with water from a trusted source – from the faucet or from bottled water if you find yourself out in nature and needing to care for an injury. Contrary to another popular medical myth, there’s also no evidence that high-pressure irrigation works any better than simply rinsing the wound. Then, apply a small amount of triple-antibiotic cream and cover with a clean dressing for smaller cuts and scrapes. Seek medical attention for larger wounds that require further evaluation and primary wound closure with sutures.
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Michael Daignault, MD, is a board-certified ER doctor in Los Angeles. He studied Global Health at Georgetown University and has a Medical Degree from Ben-Gurion University. He completed his residency training in emergency medicine at Lincoln Medical Center in the South Bronx. He is also a former United States Peace Corps Volunteer. Find him on Instagram @dr.daignault