Ozone Therapy Is Not Recommended for Any Medical Condition
Ozone therapy is not recommended for any medical condition as it lacks proven efficacy, has significant safety concerns, and is explicitly discouraged in clinical guidelines. 1, 2
Evidence Against Ozone Therapy
Strong Guideline Recommendations Against Use
The International Working Group on Diabetic Foot (IWGDF) strongly recommends against using ozone therapy for diabetic foot ulcers, stating: "Do not use other gases (e.g. cold atmospheric plasma, ozone, nitric oxide, and CO2) in comparison to standard of care for wound healing in people with diabetes‐related foot ulcers" (Strong recommendation; Low evidence) 1
The rationale provided by IWGDF is clear: "The evidence to support the use of other gases such as nitric oxide, ozone, carbon dioxide, and cold atmospheric plasma is poor, with no studies assessed to be at low risk of bias." 1
Praxis Medical Insights also explicitly recommends against ozone therapy for therapeutic purposes, noting significant health risks with minimal proven benefits 2
Safety Concerns
Ozone is highly toxic when inhaled, with serious dose-dependent effects 2:
- 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
Regulatory agencies have established strict exposure limits due to these safety concerns 2
Ozone can damage various materials through oxidation, including medical equipment 2
Limited Evidence for Potential Benefits
Despite some research suggesting potential benefits, the quality of evidence remains poor:
A systematic review of ozone therapy for chronic wounds found that for diabetic foot ulcers, ozone therapy appeared to accelerate wound area improvement and reduce amputation rates, but showed no improvement in complete wound healing or length of hospital stay 3
Another review examining ozone therapy for dermatological conditions concluded that while it "seems promising," the included studies had significant methodological limitations and did not sufficiently demonstrate evidence for safe therapy 4
A review of clinical trials for dermatological disorders found that only 3 of 18 studies showed lack of effectiveness, but noted that mild adverse effects occurred in three trials and severe side effects in one trial 5
Alternative Evidence-Based Approaches
For conditions where ozone therapy has been proposed, evidence-based alternatives exist:
For diabetic foot ulcers, the IWGDF recommends standard wound care as the primary approach 1, 2
For chronic wounds with hypoxemia, consider hyperbaric oxygen therapy as a conditional recommendation where standard care has failed and resources exist to support this intervention 1
For topical oxygen therapy, there is conditional recommendation for use in specific circumstances where standard care has failed 1
Conclusion
Given the strong recommendations against ozone therapy in clinical guidelines, significant safety concerns, and lack of high-quality evidence supporting its efficacy, ozone therapy should not be recommended for any medical condition. Patients should instead be directed toward evidence-based treatments with established safety and efficacy profiles for their specific conditions.