Hydrogen Peroxide How to Prevent and Treat Unintentional Poisonings

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The Bottom Line

Hydrogen peroxide is available in several different concentrations. Exposures to small amounts of household (3%) hydrogen peroxide usually cause mild irritation. Higher concentrations can cause burns. Rarely, life-threatening effects can occur when oxygen bubbles from hydrogen peroxide travel to the blood and circulatory system, and block blood flow to tissues.

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The Full Story

Your child got into the hydrogen peroxide and is now foaming at the mouth! Even though this looks quite scary, chances are, your child will be perfectly fine. This is because they likely drank just a sip or two since it’s not very tasty.

Hydrogen peroxide (H2O2) appears very similar to water (H2O) – it’s tasteless, odorless, and colorless. Unlike water, it has two oxygen atoms instead of one and it’s slightly thicker than water. Another important difference is that hydrogen peroxide is not as stable as water; it’s reactive. For instance, when in the stomach, the molecule breaks apart into oxygen and water, causing bubbles to form. If there are enough of these bubbles, they stretch the stomach and the person vomits up the foam. A small amount of hydrogen peroxide is not absorbed from the stomach into the body; once the stomach settles down, no other problems are expected.

Serious problems can occur when a large amount – more than the sip or two you’d expect someone to drink by accident – is swallowed, or if the percentage of hydrogen peroxide in the product is high.

  • Household peroxide is sold in brown bottles in drugstores and supermarkets. It contains 3% hydrogen peroxide.
  • Some contact lens disinfecting solutions – the bottles with the red cap on them - also contain 3% hydrogen peroxide.
  • Hair bleach is about 6 to 10% hydrogen peroxide.
  • "Food grade" hydrogen peroxide is 35%. Despite its name, "food grade" hydrogen peroxide should never be taken internally – it can cause serious internal burns if swallowed.
  • Higher concentrations of hydrogen peroxide, up to 90 percent, are used in industry.

Swallowing a small amount (a taste or a sip) of household hydrogen peroxide might cause stomach upset, an episode of vomiting, or throat irritation, but it is not expected to cause any serious symptoms. It's different if someone drinks a large amount of household peroxide (this is unlikely to happen accidentally), or if it’s a high-concentration product. This can be much more serious and result in severe stomach irritation and even burns that require a trip to the emergency room and possible hospital admission.

"Food grade" hydrogen peroxide, which is typically 35%, is sometimes marketed as an alternative therapy for a variety of conditions: allergies, arthritis, HIV, diabetes, emphysema, lupus, shingles, warts, and irregular heart rhythms, among many others. (These recommendations are not based on scientific evidence.) Users are instructed to put a few drops of the concentrated hydrogen peroxide into a glass of water. Users often store the hydrogen peroxide in the refrigerator where it can be easily mistaken for something good to drink. Children and adults who swallowed concentrated hydrogen peroxide have suffered severe injury, and some of those people have died as a result.

Another serious but rare complication that might occur with ingestion or wound irrigation of hydrogen peroxide is a gas embolism. A gas embolism occurs when bubbles of air or other gas travel to the blood or circulatory system. They then cause blockage of a blood vessel. For instance, if there is air in a blood vessel that supplies part of the brain, much-needed oxygen and nutrients cannot get to that part of the brain, and a stroke occurs. Most cases of air embolism caused by hydrogen peroxide have occurred after large ingestions or ingestions of higher concentration products. Some symptoms of gas embolism include difficulty breathing, chest pain, and confusion. Though very rare, it can be life threatening and emergent medical attention is required.

Hydrogen peroxide and its relative, carbamide peroxide, are used in tooth bleaching materials. These preparations are sold for home use and in dental offices. Because hydrogen peroxide is known to be irritating to tissues, home users must follow directions closely to avoid problems. Tooth sensitivity may occur during treatment along with gum irritation. Anyone who chooses to use a home tooth-bleaching product should first consult with a dental professional.

If you swallow hydrogen peroxide, use the webPOISONCONTROL® online tool for guidance or call Poison Control at 1-800-222-1222.

During use for any purpose, hydrogen peroxide could splash into the eyes, or contact lens solution containing hydrogen peroxide can be mistaken for regular multipurpose cleaner and accidentally applied directly into the eye prior to neutralization. If this happens, immediately rinse with plenty of running water for 15-20 minutes. Then, use the webPOISONCONTROL online tool for guidance or call Poison Control at 1-800-222-1222.

Hydrogen peroxide splashed onto the skin could cause the skin to blanch, or whiten, for a short time. The area might feel tingly for a while, too. Again, rinse with plenty of running water. Skin burns are possible if high-concentration of hydrogen peroxide was involved. Use the webPOISONCONTROL online tool or call Poison Control for advice.

At one time, hydrogen peroxide was used to disinfect skin wounds. This is no longer recommended, since research has shown that hydrogen peroxide can irritate or damage the cells needed for wound healing.

Household strength (3% in the brown bottle) hydrogen peroxide is sometimes recommended to cause dogs and cats to vomit if they swallow poison. Find out from your vet first whether vomiting should be induced and what the correct dose would be for your pet. Do not routinely induce vomiting; call your vet or animal poison control center first before causing an animal to vomit. Some substances can be more dangerous to bring up than to leave down in the stomach. Also, not all animals are capable of vomiting.

Rose Ann Gould Soloway, RN, BSN, MSEd, DABAT emerita
Clinical Toxicologist

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • For household use, buy hydrogen peroxide 3% solution.
  • "Food grade" hydrogen peroxide should never be swallowed, unless it is very dilute.

This Really Happened

Case 1: An 82-year-old woman swallowed 32% hydrogen peroxide. Her husband, who said he was a homeopath, gave her two tablespoons or less. She vomited at home and had trouble breathing. In the hospital, she had bleeding from her stomach or intestines. She was treated in the ICU for continued breathing problems and abnormal brain studies. She died after 15 days in the hospital.

Reference: Bronstein AC, Spyker DA, Cantilena LR Jr., Green JL, Rumack BH, Dart RC. 2010 annual report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 28th annual report. Clinical Toxicology. 2011;49:910–941

Case 2: A 2-year-old girl drank some hydrogen peroxide 3% that her mom had placed in a cup, with the intent of using it to treat a cut. Poison Control advised the child's mom to give her water to drink and observe for gastrointestinal upset. During a follow-up call from Poison Control a few hours later, her mom reported the child was fine.  


For More Information

Fact sheet about hydrogen peroxide (Agency for Toxic Substances and Disease Registry)


References

Agency for Toxic Substances and Disease Registry.  Medical management guidelines for hydrogen peroxide [Internet].  Atlanta: Centers for Disease Control and Prevention; 2011 Mar 3 [cited 2012 Apr 22]. 20 p. 

American Dental Association. Tooth whitening/bleaching: treatment considerations for dentists and their patients [Internet]. Chicago: American Dental Association; 2009 Sep [cited 2014 Jul 16]. 12 p. 

American Society for the Prevention of Cruelty to Animals Animal Poison Control Center. What to do if your pet is poisoned [Internet]. New York: American Society of the Prevention of Cruelty to Animals; [cited 2014 Jul 16].

Pritchett S, Green D, Rossos P. Accidental ingestion of 35% hydrogen peroxide. Can J Gastroenterol 2007;21:665-667.

Wilson JR, Mills JG, Prather ID, Dimitrijevich SD. A toxicity index of skin and wound cleaners used on in vitro fibroblasts and keratinocytes. Adv Skin Wound Care. 2005;18:373:78.

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • For household use, buy hydrogen peroxide 3% solution.
  • "Food grade" hydrogen peroxide should never be swallowed, unless it is very dilute.

This Really Happened

Case 1: An 82-year-old woman swallowed 32% hydrogen peroxide. Her husband, who said he was a homeopath, gave her two tablespoons or less. She vomited at home and had trouble breathing. In the hospital, she had bleeding from her stomach or intestines. She was treated in the ICU for continued breathing problems and abnormal brain studies. She died after 15 days in the hospital.

Reference: Bronstein AC, Spyker DA, Cantilena LR Jr., Green JL, Rumack BH, Dart RC. 2010 annual report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 28th annual report. Clinical Toxicology. 2011;49:910–941

Case 2: A 2-year-old girl drank some hydrogen peroxide 3% that her mom had placed in a cup, with the intent of using it to treat a cut. Poison Control advised the child's mom to give her water to drink and observe for gastrointestinal upset. During a follow-up call from Poison Control a few hours later, her mom reported the child was fine.