Hydrogen peroxide poisoning

Hydrogen peroxide can be poisonous if it is not used correctly.

Hydrogen peroxide is used in these products:

• Household hydrogen peroxide
• Hair bleach
• Some contact lens cleaners

Note: Household hydrogen peroxide has a 3% concentration. That means it contains 97% water and 3% hydrogen peroxide. Hair bleaches are stronger. They usually have a concentration of more than 6%. Some industrial-strength solutions contain more than 10% hydrogen peroxide.

Symptoms of a hydrogen peroxide poisoning may differ depending on whether it is swallowed or inhaled. Symptoms may include:

• Abdominal pain and cramping
• Airway irritation which may be severe if exposed to industrial (higher than 10%) solutions
• Breathing difficulty (if a large amount is swallowed or any is inhaled)
• Body aches
• Burns in the mouth and throat (if swallowed)
• Chest pain
• Eye burns (if it gets in the eyes)
• Seizures (rare)
• Stomach swelling
• Temporary white color to the skin
• Vomiting (sometimes with blood)

Seek medical help right away. Do not make the person throw up unless poison control or a health care provider tells you to do so. If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

Have this information ready:

• Person's age, weight, and condition
• Name of the product (ingredients and strength, if known)
• Time it was swallowed or got into eyes or on skin
• Amount swallowed, in eyes, or on skin

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may done include:

• Blood and urine tests
• Chest x-ray
• Electrocardiogram (ECG)
• Endoscopy -- camera placed down the throat to check for burns in the esophagus and stomach

Treatment may include:

• Fluids through a vein (by IV)
• Medicines to treat symptoms
• Tube down the throat into the stomach (endoscopy) to relieve gas pressure 
• Breathing support, including a tube through the mouth into the lungs and connected to a breathing machine (ventilator)

Most contact with household-strength hydrogen peroxide is fairly harmless. Exposure to industrial-strength hydrogen peroxide can be dangerous. Endoscopy may be required to stop internal bleeding.

Aronson JK. Hydrogen peroxide. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:875.

Hoyte C. Caustics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 143.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.