Is ozone therapy effective and safe for treating medical conditions?

Ozone Therapy: Ineffective and Potentially Harmful for Medical Conditions

Ozone therapy is not recommended for treating medical conditions due to lack of high-quality evidence supporting its efficacy and significant safety concerns including respiratory toxicity. 1

Safety Concerns

• Ozone is highly toxic when inhaled with serious dose-dependent effects:

  • At 0.1 ppm: stimulation of upper respiratory and urinary tracts
  • At 1.0-2.0 ppm: rhinitis, cough, nausea, and asthma
  • At 2-5 ppm: breathing difficulties and retrosternal pain after 10-20 minutes
  • At 10 ppm: can be fatal after 4 hours
  • At 50 ppm: can cause death within minutes 1

• 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 1

Evidence Against Ozone Therapy for Medical Conditions

Diabetic Foot Ulcers

The International Working Group on Diabetic Foot (IWGDF) strongly recommends against using ozone therapy for diabetic foot ulcers. A high-quality systematic review found no difference between ozone therapy and standard care for wound healing by 24 weeks 1. One small but high-scoring study of topical ozone on healing by 24 weeks reported no difference between intervention and control groups 2.

Other Medical Conditions

• For systemic sclerosis: A small RCT showed some efficacy of oxygen-ozone therapy on ulcer healing, but the follow-up period was only 20 days, and blinded placebo-controlled studies are still needed 1.

• For dermatological conditions: Despite some promising results, studies have methodological limitations and do not sufficiently demonstrate sound evidence for safe therapy 3.

Disinfection Applications

Ozone may be effective for disinfection of surfaces and personal protective equipment when used in unoccupied settings with proper ventilation and ozone decomposition devices 1. However, ozone is not included as an approved virucidal agent by regulatory agencies such as the Spanish Health Ministry or the US Environmental Protection Agency 1.

Material Damage Concerns

Ozone can damage various materials including rubber products, plastics, and medical equipment through oxidation and irreversible chemical reactions. Maintaining safe ozone levels in treatment environments is challenging, with oxygen-enriched environments increasing fire risk 1.

Alternative Therapies

For conditions where ozone therapy has been proposed:

1. For diabetic foot ulcers: Standard wound care remains the recommended approach 2, 1
2. For chronic wounds: Evidence supports hyperbaric oxygen therapy for nonhealing ischemic ulcers, though cost-effectiveness in all health economies is unknown (moderate quality evidence) 2
3. For respiratory conditions: Supplementary oxygen should be used with caution and only when indicated by evidence-based guidelines 2

Conclusion

Despite claims of potential benefits in various medical conditions, current high-quality evidence does not support the use of ozone therapy for medical treatment. Patients should be directed toward evidence-based treatments with established safety and efficacy profiles due to the significant safety concerns and lack of proven efficacy of ozone therapy 1.