Hypochlorous Acid in Healthcare: A Comprehensive Review of Applications, Production and Safety

Background: Hypochlorous Acid (HOCl) is a potent oxidizing agent with broad spectrum of antimicrobial activity against bacteria, mycobacterium, fungi and viruses. It is naturally produced by neutrophils, macrophages and other cells of the innate immune system during the respiratory burst. Objective: This review examines current evidence on the efficacy, manufacture, safety and clinical applications of HOCl in healthcare, with a focus on dentistry, skin care and wound management, podiatry and infection control. Key findings: The current evidence supports HOCl as a rapid, safe, effective and highly adaptable tool in modern healthcare. Effective healthcare formulations typically contain a high percentage of HOCl and a low percentage of OCl- to limit toxicity. Further large-scale, standardized clinical studies are needed to optimize dosing strategies, assess long-term outcomes and establish regulatory consistency across commercial formulations. Clinical implication: HOCl represents a valuable adjunct in antimicrobial stewardship efforts and will be a great addition to tackle problems associated with prevention and treatment of multi-antibiotic resistant bacteria seen globally. HOCl is an emerging asset in patient care and infection prevention.