Clinical Relevance of Specific Formulations, Potential Modes of Action, and Study Outcomes.
HHypochlorous acid (HOCl), a naturally occurring molecule that is a component of the human innate immune response, is recognized as a major active component of bleach and demonstrates antimicrobial
properties supported by both in-vitro and in-vivo studies.1–9 One important function of HOCl in host immunity is its release by neutrophils to destroy pathogenic organisms (i.e., respiratory burst). Over time, a variety
of anti-inflammatory and other biologic properties of HOCl have led to applications for wound healing, pruritus, and diabetic ulcers, as well as applications for the management of some inflammatory skin disorders, such as seborrheic dermatitis and atopic dermatitis (AD).8–18 What has also come to light is that the physiochemical properties of HOCl and its impact after application to skin are highly dependent on both pH and formulation stability.8,11 The use of HOCl in the clinical setting is supported by a substantial body of research, which has led to the use of a core formulation—available in ready-to-use, approved topical vehicles— that is stable for up to two years, noncytotoxic, and, importantly, pH-neutralized to augment therapeutic activity, skin tolerability, and stability.8,11,18,19 This core formulation (often referred to in the literature as a superoxidized solution or, sometimes, slightly acidic electrolyzed water) has been termed and marketed as Microcyn® Technology (Sonoma Pharmaceuticals, Petaluma, California; also referred to in some publications as Dermacyn™ from Dyamed Biotech Pte Ltd., Singapore).8,11,20–22 In this article, we’ve summarized the available studies related to the core formulation, its available vehicles for topical application, its potential modes of action, and in-vitro and in-vivo study outcomes.