What is the use of hydrogen peroxide in pharmacy?

October 6, 2025 •

4 min read

First synthesized in 1818, hydrogen peroxide ($H_2O_2$) has been a staple in medicine for over a century, recognized for its potent oxidizing properties [1.3.5]. This article explains what is the use of hydrogen peroxide in pharmacy today, including its benefits and evolving safety guidelines.

Quick Summary

Hydrogen peroxide serves multiple roles in pharmacy, primarily as a topical antiseptic and oral debriding agent [1.2.1, 1.2.2]. Its applications also extend to disinfecting medical equipment and its use in certain dermatological treatments [1.2.3, 1.5.1].

Key Points

Primary Uses: In pharmacy, hydrogen peroxide is mainly used as a topical antiseptic, oral rinse, and for disinfecting medical equipment [1.2.1, 1.2.3].
Mechanism of Action: It works by releasing oxygen, which kills microbes and helps remove dead tissue and debris from an area [1.2.2].
Wound Care Controversy: Modern medical advice discourages using it on minor wounds as it can damage healthy cells and slow healing [1.4.1, 1.4.3].
Oral Health Benefits: Diluted hydrogen peroxide is effective for gargling to treat gum irritation, canker sores, and for teeth whitening [1.2.2, 1.8.3].
Disinfection Power: Higher concentrations (0.5% to 7.5%) are used in healthcare settings for surface and medical instrument disinfection [1.5.1].
Concentration is Key: The safety and effect of hydrogen peroxide are highly dependent on its concentration, ranging from 3% for home use to 40% for specialist medical treatments [1.5.1].
Safe Handling: It should never be swallowed, and higher concentrations can cause severe burns to the skin, eyes, and internal tissues [1.9.1, 1.9.3].

The Dual Nature of Hydrogen Peroxide in Pharmacology

Hydrogen peroxide ($H_2O_2$) is a chemical compound that has long held a place in both household first-aid kits and professional medical settings [1.3.3]. Its primary mechanism of action involves the release of oxygen when it comes into contact with tissues [1.2.2]. This process creates an oxygen-rich environment hostile to anaerobic bacteria and produces a characteristic foaming or bubbling action that helps to mechanically clean an area by loosening debris, dead skin, and blood clots [1.2.2, 1.4.3]. Its effectiveness as a broad-spectrum antimicrobial agent against bacteria, viruses, and fungi has made it a versatile tool in pharmacy [1.2.3, 1.10.2]. However, modern medical understanding has also highlighted its potential to harm healthy tissue, leading to a more nuanced approach to its use [1.4.1].

Traditional and Modern Antiseptic Use

Historically, the most common use of hydrogen peroxide in a pharmacy context is as a topical antiseptic for minor cuts, scrapes, and burns to prevent infection [1.2.2]. The typical brown bottle of 3% hydrogen peroxide solution is ubiquitous for this purpose. When applied to a wound, it works to kill pathogenic microorganisms through oxidation [1.2.5].

However, contemporary medical advice has shifted away from this practice for routine wound care [1.4.1, 1.4.5]. The reason for this change is that hydrogen peroxide is non-selective; it not only kills bacteria but also damages healthy cells, such as fibroblasts, which are crucial for the wound healing process [1.4.3]. This damage can delay healing and potentially lead to more significant scarring [1.4.1]. For minor wounds, the current recommendation is gentle cleaning with mild soap and water, followed by an antibiotic ointment and a bandage [1.4.2]. Despite this, hydrogen peroxide may still be used in specific clinical situations, such as for the initial cleaning of heavily contaminated wounds or in certain chronic wound treatments where its debriding action is beneficial [1.2.5].

Oral Health Applications

Beyond skin antisepsis, hydrogen peroxide is a key ingredient in many oral care products available in pharmacies. It functions as an oral debriding agent and oral rinse for several conditions [1.2.1]:

Gingivitis and Gum Irritation: Rinsing with a diluted hydrogen peroxide solution can help reduce bacteria and soothe irritation from braces, dentures, or other dental appliances [1.2.2].
Canker Sores: Its cleansing action can help clean canker sores and reduce the risk of secondary infection [1.2.2].
Teeth Whitening: Hydrogen peroxide is a bleaching agent and a primary active ingredient in many over-the-counter and professional teeth whitening products [1.7.2, 1.8.3].

The American Dental Association (ADA) and CDC have even advised using a 1.5% hydrogen peroxide mouth rinse to help reduce the viral load in the upper respiratory tract [1.8.3]. When used as a gargle, it must be diluted (typically a 1:1 ratio of 3% hydrogen peroxide and water) and should never be swallowed [1.8.3].

Disinfection and Sterilization

Higher concentrations of hydrogen peroxide have significant applications in disinfecting and sterilizing medical equipment. It is recognized as a potent and environmentally friendly disinfectant because it breaks down into water and oxygen [1.2.3].

Surface Disinfection: A 0.5% hydrogen peroxide solution is effective for disinfecting environmental surfaces in healthcare settings [1.5.1].
High-Level Disinfection: A 7.5% solution is used for high-level disinfection of semi-critical instruments like endoscopes that contact mucous membranes [1.5.1].
Sterilization: Vaporized hydrogen peroxide is used in specialized systems to sterilize heat-sensitive medical devices, offering a safer alternative to ethylene oxide gas [1.2.3].

Other Pharmaceutical and Medical Uses

The use of hydrogen peroxide extends into other niche areas:

Earwax Removal: It is commonly used in otic solutions to soften and break down hardened earwax (cerumen), making it easier to remove [1.7.2].
Dermatology: A high-concentration (40%) hydrogen peroxide solution is FDA-approved for the topical treatment of seborrheic keratoses, administered by a healthcare professional [1.5.1].
Pharmaceutical Manufacturing: It is used for sanitizing cleanrooms and equipment during the manufacturing process to control microbial load [1.2.3].


Antiseptic Comparison	Hydrogen Peroxide (3%)	Isopropyl Alcohol (70%)	Povidone-Iodine (10%)
Mechanism	Oxidizing agent, releases oxygen to kill microbes and debride wounds [1.2.2].	Denatures proteins and dissolves lipids in cell membranes [1.6.1].	Releases free iodine, which is broadly antimicrobial [1.6.4].
Best For	Oral rinsing (diluted), surface disinfection, and initial debridement of some wounds [1.2.2, 1.5.1].	Disinfecting intact skin before injections, cleaning surfaces and tools [1.6.2].	Pre-surgical skin preparation, disinfecting moderate wounds [1.6.5].
Wound Healing	Can damage healthy tissue and delay healing [1.4.1, 1.4.3].	Stings and can damage healthy tissue in open wounds [1.6.1].	Less damaging to tissue than the other two, but can cause skin irritation [1.6.5].
Germ Killing Speed	Slower; may require several minutes of contact time [1.6.1].	Fast-acting, kills most bacteria within seconds [1.6.1].	Moderately fast-acting.

Conclusion: A Calculated Use

While the iconic brown bottle of hydrogen peroxide may no longer be the first choice for every cut and scrape, its role in the pharmacy is far from obsolete. Its uses have become more specialized and evidence-based. In modern pharmacology, it is valued as an effective oral debriding agent, a powerful disinfectant for medical devices, and a key ingredient in specific dermatological and dental treatments [1.2.2, 1.5.1]. The key is understanding the correct concentration and application for the task at hand, balancing its potent antimicrobial power against the potential for tissue damage. As research continues, the applications for this simple yet powerful compound will likely continue to evolve. For more detailed guidance, see the CDC's Medical Management Guidelines for Hydrogen Peroxide.

Frequently Asked Questions

Most medical professionals no longer recommend using hydrogen peroxide for minor cuts because it can damage healthy skin cells essential for healing and slow down the recovery process. Plain soap and water is the preferred method for cleaning minor wounds [1.4.2, 1.4.5].

Yes, you can gargle with hydrogen peroxide, but it must be diluted. Mix 3% hydrogen peroxide with an equal part of water. Gargle for 30-60 seconds and then spit it out completely. Never swallow the solution [1.8.3].

The common brown bottle of hydrogen peroxide sold in pharmacies for household first-aid use is typically a 3% solution [1.5.4].

The bubbling is a chemical reaction. An enzyme in your tissues called catalase rapidly breaks down the hydrogen peroxide into water and oxygen gas. The bubbles are the released oxygen, which helps lift debris from the wound [1.2.2, 1.4.3].

Neither is ideal for open wounds, as both can damage tissue [1.6.2]. For disinfecting intact skin or surfaces, rubbing alcohol generally works faster, but hydrogen peroxide can be more effective against certain types of bacteria, like C. diff [1.6.1, 1.6.2].

At low (3%) concentrations, risks include skin irritation and delayed wound healing [1.4.1]. Ingesting it can cause gastrointestinal upset [1.9.3]. Higher concentrations are corrosive and can cause severe burns to the skin, eyes, and internal organs if ingested [1.9.1].

Yes, hydrogen peroxide is a common bleaching agent used in many over-the-counter and professional teeth whitening products. Rinsing with a diluted 1.5% solution has also shown whitening effects over time [1.8.3].