May 2018 | Volume 17 | Issue 5 | Original Article | 554 | Copyright © May 2018
Matthew J. Zirwas MDa and Jill Fichtel MDb
aOhio Contact Dermatitis Center, Dermatologists of Greater Columbus, Columbus, OH bDermatologists of Greater Columbus, Columbus, OH
Abstract
Chlorine dioxide complex™ is a new molecule to dermatology that is a unique, non-toxic, broad spectrum anti-microbial and keratolytic compound. Chlorine dioxide has been used as an antiseptic in industrial settings for decades, primarily in water treatment facilities for municipal water supplies and food preparation. The compound has exceptional antiseptic properties with no known potential for development of resistance. It is a true keratolytic and anti-inflammatory, but is non-toxic to human tissue due to its unique mechanism of action. Chlorine dioxide’s use in consumer products was previously limited because it is inherently an unstable molecule that had to be used quickly after it was produced. However, the recent development of a complexed form of chlorine dioxide that retains its antimicrobial and keratolytic activity has allowed the development of products (AsepticMD, Aseptic Plus, Nashville, TN) that take advantage of the properties of this unique molecule. Here we report a case series demonstrating its efficacy as a cleanser in keratosis pilaris. J Drugs Dermatol. 2018;17(5):554-556.
INTRODUCTION
Chlorine dioxide (ClO2) is a volatile, reactive gas at room temperature that was first synthesized in 1811. Early uses included as a pulp bleaching agent for paper making and as a disinfectant, but it was too expensive for routine industrial use until the 1940s. It has since been used in 5-10% of municipal water treatment facilities for water disinfection and deodorizing and is widely used as a food disinfectant.1,2 Although ClO2 gas is toxic at high concentrations by inhalation, when it is solubilized in water and applied to human tissue there is an absence of toxicity due to deactivation by intracellular defenses and the unique mechanism of action.3When tested for antibacterial effectiveness against other antiseptics, such as bleach, hydrogen peroxide, iodophors, chlorhexidine, quaternary ammonium compounds, and others, ClO2 is the most effective agent, both against typical organisms and against multidrug resistant Staph and Pseudomonas.4-6 It also has excellent activity against viruses, yeast and mycobacteria, as well as bacterial spores and biofilms.6-17 In addition, it is anti-inflammatory by neutralizing reactive oxygen molecules and cytokines and also acts as a true keratolytic, degrading both the inter- and intramolecular disulfide bonds that stabilize keratin.18-20While ClO2 complex™ has numerous potential applications in dermatology, early experience has demonstrated exceptional efficacy in keratosis pilaris, primarily related to its keratolytic effects.
Report of Cases
Table 1 outlines the demographics, clinical findings, and response to therapy of patients treated with chlorine dioxidecomplex wash (AsepticMD, Nashville, TN) in the authors’ practice. All patients used the foaming facial cleanser and were instructed to wash once daily, gently rubbing the affected area for 5-10 seconds with a soft cotton cloth. No additional moisturizers, abrasion, or other interventions were used.
DISCUSSION
Keratosis Pilaris (KP) is a common complaint, affecting between 10% and 30% of the population. Onset is typically in childhood and although it frequently improves with age it does commonly persist into adulthood. Typical therapies include moisturizers containing keratolytics such as salicylic acid, lactic acid (or ammonium lactate) or urea. These treatments typically take several weeks to have an effect and must be used on an ongoing basis.21,22 Additionally, more aggressive therapy with topical retinoids has been attempted, but can be limited by irritation and cost.23 Finally, several lasers have been reported to be effective, but treatment is again limited by cost.24-29Chlorine dioxide complex wash led to rapid, nearly complete resolution of keratosis pilaris in the reported patients. It presents several benefits over existing treatments, including low cost and ease of use – essentially all individuals use soap on a daily basis, while daily application of moisturizer is much less likely, especially in adolescents who have notoriously low compliance.Unlike other keratolytics, ClO2 is a highly specific oxidizer – it reacts with several specific amino acids in proteins, but does not react with or oxidize lipids, carbohydrates, or other organic
FAQs
Rapid Efficacy for Keratosis Pilaris
The compound has exceptional antiseptic properties with no known potential for development of resistance. It is a true keratolytic and anti-inflammatory, but is non-toxic to human tissue due to its unique mechanism of action.
What does chlorine dioxide do to skin? ›
Chlorine dioxide has shown a significant contribution to wound healing, infection prevention and tissue repair in ulcers and skin lesions through treatments based on a chlorine dioxide solution, with particular applications in ulcers and burns [23].
What ingredients get rid of keratosis pilaris? ›
Medicine that can help often contains one of the following ingredients:
- Alpha hydroxyl acid.
- Glycolic acid.
- Lactic acid.
- A retinoid (adapalene, retinol, tazarotene, tretinoin)
- Salicylic acid.
- Urea.
Creams containing alpha hydroxy acid, lactic acid, salicylic acid or urea help loosen and remove dead skin cells. They also moisturize and soften dry skin. These creams are called topical exfoliants. Depending on their strengths, they are available with a prescription or as a nonprescription products.
Is there a way to permanently get rid of keratosis pilaris? ›
There is no known cure for keratosis pilaris. But don't lose heart if you have it. In some cases, it goes away on its own. In others, its symptoms can be controlled and treated.
What worsens keratosis pilaris? ›
Dry skin tends to make keratosis pilaris worse.
What are the dangers of ClO2? ›
If you were to breathe air containing chlorine dioxide gas, you might experience irritation in your nose, throat, and lungs. If you were to eat or drink large amounts of chlorine dioxide or chlorite, you might experience irritation in the mouth, esophagus, or stomach.
What are the cons of chlorine dioxide? ›
Acute health effects: The following acute (short-term) health effects may occur immediately or shortly after exposure to chlorine dioxide: irritate the nose and throat, causing coughing and chest pain; eye irritation with watery eyes and seeing halos around lights; breathing chlorine dioxide can irritate the lungs ...
How long does chlorine dioxide stay in the body? ›
Most administered chlorine dioxide and its metabolites remain in plasma followed by kidneys, lungs, stomach, intestine, liver, and spleen. About 43% of orally administered chlorine dioxide is eliminated in the urine and feces within 72 h.
What is the root cause of keratosis pilaris? ›
It is thought to be caused by a genetic mutation in a protein called filaggrin, which causes the skin to produce too much keratin, the most abundant protein in our skin, hair, and nails. Excess keratin plugs the hair follicles on the skin, which is what causes the characteristic bumps seen in keratosis pilaris.
The FDA has recently approved a topical solution of 40% hydrogen peroxide to treat seborrheic keratosis. (Over-the-counter hydrogen peroxide is a 1% solution.) The solution comes in an applicator pen, which your healthcare provider will apply to your seborrheic keratosis several times in one visit.
What not to use on keratosis pilaris? ›
Avoid scrubbing your skin, which tends to irritate the skin and worsen keratosis pilaris. Apply a product called a keratolytic. After exfoliating, apply this skin care product. It, too, helps remove the excessive buildup of dead skin cells.
What can be mistaken for keratosis pilaris? ›
Keratosis pilaris may resemble the following uncommon skin conditions:
- Lichen spinulosus.
- Pityriasis rubra pilaris.
- Ulerythema ophryogenes (ulerythema)
- Ichthyosis vulgaris.
- Eruptive vellus hair cysts.
- Erythromelanosis follicularis faciei et colli.
- Keratosis follicularis (Darier disease)
- Kyrle disease.
Keratosis pilaris may have a link to vitamin A deficiency. Taking vitamin A supplements or using moisturizers or creams with small amounts of vitamin A may help treat keratosis pilaris.
Does apple cider vinegar cure keratosis pilaris? ›
Certain natural products may help your keratosis pilaris. They include: Apple cider vinegar contains an alpha hydroxy acid. You'll want to water it down to avoid irritating your skin.
Does chlorine break down keratin? ›
She's got a serious point: research also shows that chlorinated hair has a higher level of breakdown of keratin than does unchlorinated hair. And nobody wants that -- a lack of keratin can lead to brittle, dry, unmanageable hair that's hard to brush through and easy to break.
Does chlorine help skin conditions? ›
Chlorine can also cause dryness, but since it is a bleach and some research studies have recommended diluted bleach as a way of reducing bacteria on eczematous skin, its effects are not necessarily all bad – it may even be helpful for some people with eczema.
What breaks down keratosis pilaris? ›
The ingredients urea, alpha hydroxy acids, salicylic acid and glycolic acid can sometimes improve the look of keratosis pilaris. Medicated vitamin A creams, such as Retin-A®, can help decrease the buildup of keratin that causes keratosis pilaris.
