Ozone Therapy Is Not Safe or Effective for Medical Treatment
Ozone therapy is not recommended for medical treatment due to significant health risks and lack of proven efficacy according to current medical guidelines. 1 Multiple authoritative guidelines explicitly advise against its use for therapeutic purposes, citing poor evidence quality and potential harm.
Safety Concerns
Respiratory and Systemic Toxicity
- Ozone is highly toxic when inhaled, with serious dose-dependent effects:
- At 0.1 ppm: Stimulates upper respiratory and urinary tracts
- At 1.0-2.0 ppm: Causes rhinitis, cough, nausea, and asthma
- At 2-5 ppm: Causes breathing difficulties and retrosternal pain after 10-20 minutes
- At 10 ppm: Can be fatal after 4 hours of exposure
- At 50 ppm: Can cause death within minutes 2
Regulatory Limitations
- Multiple regulatory agencies have established strict exposure limits:
- U.S. Environmental Protection Agency: 0.08 ppm for 8 hours
- Occupational Safety and Health Administration: 0.10 ppm for 8 hours
- Food and Drug Administration: 0.05 ppm for 8 hours 2
Material Damage
- Ozone damages materials through oxidation:
- Destroys molecular chain networks in rubber products
- Causes irreversible chemical reactions with plastics
- Releases microplastic particles from damaged surfaces 2
Lack of Efficacy in Medical Applications
Wound Healing
- The International Working Group on the Diabetic Foot (IWGDF) strongly recommends against using ozone therapy for diabetic foot ulcers due to poor evidence quality 1
- A high-quality systematic review found no difference between ozone therapy and standard care for wound healing by 24 weeks 2
Other Medical Applications
- While some small studies suggest potential benefits for certain dermatological conditions, systematic reviews note significant methodological limitations and insufficient evidence for safety 3
- Most studies advocating for ozone therapy lack proper controls, standardization, and long-term safety assessments 4
Limited Legitimate Applications
Surface Disinfection
- Ozone may be effective for disinfection of surfaces and personal protective equipment when used in unoccupied settings 2
- If used for non-medical disinfection:
- Ensure no humans are present during treatment
- Allow sufficient time for ozone levels to decrease
- Use ozone decomposition devices
- Ensure proper ventilation after use 1
Specific Medical Conditions
Diabetic Foot Ulcers
- The IWGDF explicitly recommends against ozone therapy for diabetic foot ulcers 2
- Standard care remains the recommended approach
Systemic Sclerosis
- A small RCT showed some efficacy of oxygen-ozone therapy on ulcer healing in systemic sclerosis, but the follow-up period was only 20 days, and blinded placebo-controlled studies are still needed 2
Why Some Practitioners Still Use Ozone Therapy
Despite lack of evidence and safety concerns, some practitioners continue to use ozone therapy due to:
- Anecdotal reports of success
- Theoretical antimicrobial and anti-inflammatory properties
- Lack of awareness about guideline recommendations
- Limited regulation in some regions
Bottom Line
Ozone therapy should not be used for medical treatment due to significant safety concerns and lack of proven efficacy. The potential risks far outweigh any theoretical benefits, and multiple medical guidelines explicitly recommend against its use. Patients should be directed toward evidence-based treatments with established safety and efficacy profiles.