Using Hypochlorous Acid for Skin Disinfection: Safety and Concerns

Hypochlorous acid for skin disinfection?

The nursing home where the elderly resident lives has reported a scabies outbreak and was instructed by health authorities to disinfect the facility.
In early March, the institution sprayed residents with diluted hypochlorous acid three times, with intervals of about three to four days.
The spraying occurred after residents had showered, using a spray bottle in the bathroom without ventilation or masks.
The elderly resident later complained of feeling nauseous.

1.
Can hypochlorous acid be sprayed directly on the skin for disinfection against scabies?
2.
Is it possible that discomfort could arise from chlorine gas contamination when the institution used electrolyzed saline to produce hypochlorous acid?
If nausea persists, should medical attention be sought, or will it resolve on its own after some time? Thank you.

wen wen ti, 50~59 year old female. Ask Date: 2019/03/22

Dr. Wu Yuxin reply Dermatology

1.
No.
2.
This question should be directed to the Toxicology Department.

Reply Date: 2019/03/22

More Info

Using hypochlorous acid for skin disinfection has gained attention, especially in settings like nursing homes where infection control is critical. However, there are important safety considerations to keep in mind, particularly regarding the method of application and the potential for adverse reactions.

1. Direct Application on Skin: Hypochlorous acid (HOCl) is often used for its antimicrobial properties and is generally considered safe for use on the skin in diluted forms. It is effective against a variety of pathogens, including bacteria and viruses. However, the concentration and method of application are crucial. If the hypochlorous acid is too concentrated, it can lead to skin irritation or chemical burns. In your case, the use of hypochlorous acid spray on the skin after bathing, without adequate ventilation, raises concerns about both skin irritation and respiratory issues.

2. Chlorine Gas Exposure: When hypochlorous acid is produced through the electrolysis of saltwater, there is a potential risk of chlorine gas being released, especially if the solution is not properly managed. Chlorine gas can cause respiratory irritation, nausea, and other symptoms. If the nursing home environment was poorly ventilated during the spraying, this could have contributed to your elder's feelings of nausea and discomfort.
3. Symptoms of Nausea and Discomfort: If your elder is experiencing persistent nausea and discomfort after the application of hypochlorous acid, it is advisable to seek medical attention. While mild symptoms may resolve on their own, ongoing nausea could indicate a more serious reaction or exposure to irritants. A healthcare professional can assess the situation and provide appropriate care.

4. Recommendations for Future Use: For future disinfection efforts, it is essential to ensure that the hypochlorous acid is used in a well-ventilated area. Additionally, using personal protective equipment (PPE), such as masks, can help mitigate inhalation risks for both the caregivers and the residents. It may also be beneficial to consult with a healthcare professional or an infection control specialist to determine the safest and most effective methods for disinfection in a nursing home setting.

5. Alternative Disinfection Methods: If hypochlorous acid is causing adverse effects, consider exploring alternative disinfection methods that are known to be safe for skin application and effective against scabies. Options may include topical treatments specifically designed for scabies, which can be applied under medical supervision.

In summary, while hypochlorous acid can be effective for skin disinfection, its application must be handled with care to avoid adverse effects. Monitoring for symptoms and ensuring proper ventilation and PPE use are critical steps in maintaining safety during disinfection processes. If symptoms persist, medical evaluation is warranted to ensure the health and safety of your elder.

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