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potassium permanganate / saline soaks in eczema/dermatitis

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Potassium permanganate is used in the UK as a topical preparation for the care of wounds in the community and hospital setting

  • a licensed medicinal product does not exist in the UK, and it is available as a 'chemical product' either as a solution for further dilution or as a 'tablet' preparation which is dissolved in water to give a topical solution of 0.01% (1 in 10,000)
  • intended for external use only and serious harm can occur if ingested

British Association of Dermatologists (BAD) indicate (1)

The DermNet NZ describe the baths/soaks being used for infected eczema and blistering skin conditions with pus and/or oozing; wound cleansing, especially weeping ulcers or abscesses; fungal infections such as athlete's foot (2)

A review (3) states:

  • main indications for potassium permanganate solution can be described as the management of exuding conditions in the following dermatology or vascular conditions
    • weeping or blistering conditions secondary to eczema or cellulitis
    • weeping or blistering conditions secondary to leg or foot ulcers

  • anecdotal use of potassium permanganate preparations is widespread in the NHS for the management of weeping or blistering conditions secondary to eczema, cellulitis, leg or foot ulcers, and pseudomonas infections of the skin/wounds
    • postulated to have antiseptic and astringent action
    • a licensed medicinal potassium permanganate does not exist in the UK and a chemical compound is used for medicinal purposes
    • a Patient Safety Alert was issued in 2014 and since then incidences of patient harm continue to be reported in the NHS
  • there is a lack of published evidence for the use of potassium permanganate preparations to aid the management of weeping or blistering conditions secondary to eczema, cellulitis, leg or foot ulcers, and pseudomonas infections of the skin/wounds

  • there were limitations cited in the review (3) including:
    • this Q&A sought only to provide the published evidence base and does not make any recommendations on the use of potassium permanganate in clinical practice or its place in therapy
    • a fundamental reason to the limited discussion of potassium permanganate in the published literature may be due to its classification as a chemical rather than a medicine

Notes:

  • potassium permanganate stains the nails and skin brown - however it also is an antibacterial agent

Reference:

Last edited 08/2019 and last reviewed 02/2020

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