Potassium Permanganate: Dosing & Dilution

Available: potassium permanganate 0.1%

• All doses are suitable for adults and children.

Suppurating superficial wounds and tropical ulcers:

• A 1:7-1:10 dilution of the stock solution is used in wet dressings (a concentration of 0.01%). The dressings should be changed twice or 3 times daily. For tropical ulcers, a 2- to 4-week course of treatment with procaine benzylpenicillin is also required

Tinea pedis:

• Severe weeping lesions should be soaked in a 1:10 dilution of the stock solution every 8 hours.

Pemphigus:

• Compresses soaked in a 1:7-1:10 dilution of the stock solution are applied every 4 hours.

Impetigo:

• Superficial crusts should be gently separated with a 1:10 dilution of the stock solution.

Dosing recommendation by Use

Bath Fill

• a tubful with the solution and use for bathing.

Compress Moisten strips of cotton or gauze in the solution.

• Wrap the strips around the affected areas. Keep the strips in place for 10 minutes. If they dry out, add more solution.

Soak Fill

• a bathtub or a basin with enough solution to immerse the affected areas. Soak for about 10 minutes.

Wash Dip

• cotton or a gauze in the solution and use to wash affected areas.

Concentrated Solution

• Most recommendations suggest use of solution of 0.01% for wound
• However, some recommends a solution of 1 in 1000 (0.1%) may be used as wet soaks to blistering wounds such as ulcers and abscesses.
• Strips of cotton or gauze should be soaked in the solution and wrapped around the affected area for 20-30 minutes.
• The astringent action of potassium permanganate helps to dry out the blister and prepare the wound for other treatment
• This suggestion has to be taken with caution as higher concentration of permanganate is caustic/may damage growth of newer tissue

Precautions

• Dressings should not be applied under plastic or rubber occlusion.
• Do not make solution too concentrated or use crystals directly on affected areas as these will irritate and burn the skin.
• Dab dry after use. It is not necessary to rinse off with clean water.
• Use either warm or cool water to make the solution.

Adverse effects

• Skin irritation is common. Brown staining of the skin also occurs.

Storage

• Solutions should be stored in well-closed containers, protected from light.

References:

1. WHO Model Prescribing Information: Drugs Used in Skin Diseases
2. http://www.dermnetnz.org/treatments/permanganate.html
3. http://www.pss.org.sg/sites/default/files/public-resource/Potassium%20Permanganate_0.pdf