Ozone Therapy for Hair Loss: Evidence Assessment
Direct Recommendation
Ozone therapy should not be recommended for hair loss treatment due to the complete absence of evidence supporting its efficacy for alopecia, and patients should be directed toward evidence-based treatments instead.
Evidence Analysis
Absence of Guideline Support
The British Association of Dermatologists' comprehensive guidelines for managing alopecia areata (2012) make no mention whatsoever of ozone therapy as a treatment option for any form of hair loss 1. This absence from authoritative dermatology guidelines is significant, as these guidelines systematically reviewed available treatments and found insufficient evidence to recommend many therapies 1.
Limited Research Evidence
While ozone therapy has been studied for various dermatological conditions, there is no published clinical trial evidence specifically evaluating ozone therapy for hair loss or alopecia 2. The systematic review of ozone therapy in dermatology examined 18 clinical trials covering conditions including diabetic foot ulcers, digital ulcers, atopic dermatitis, onychomycosis, and leishmaniasis, but hair loss was not among the conditions studied 2.
A comprehensive review of complementary and alternative treatments for alopecia similarly did not identify ozone therapy as a treatment modality being investigated for hair loss 3.
Single Tangential Reference
The only mention of ozone therapy in relation to hair conditions appears in a 2025 systematic review on systemic sclerosis, where one small RCT showed oxygen-ozone therapy was effective for digital ulcer healing with only 20 days of follow-up 1. However, this study addressed wound healing in digital ulcers, not hair loss, and the evidence quality was limited by the short follow-up period and small sample size 1.
Clinical Implications
Risk of Treatment Delay
Patients pursuing unproven therapies like ozone therapy may delay seeking proper medical evaluation and evidence-based treatment 4. This is particularly concerning because early intervention with proven therapies offers the best chance of response for alopecia areata 4.
Evidence-Based Alternatives
Instead of ozone therapy, patients should be offered treatments with documented efficacy:
- For limited patchy alopecia areata: Intralesional corticosteroids (strength of recommendation B) 1
- For extensive alopecia areata: Contact immunotherapy with DPCP or SADBE, though success rates are less than 50% 1, 4
- For androgenetic alopecia in men: Oral finasteride (FDA-approved) 4
Safety Considerations
While ozone therapy appears relatively safe in dermatological applications with mostly mild adverse effects 2, safety without efficacy provides no clinical benefit. Three studies in the dermatology review showed lack of effectiveness for the conditions studied 2.
Clinical Pitfalls to Avoid
Do not recommend ozone therapy for hair loss based on its use in other dermatological conditions, as the pathophysiology of hair loss differs fundamentally from wound healing or infectious conditions 2. The oxidative and antimicrobial properties of ozone that may benefit ulcers or infections have no established mechanism of action for stimulating hair follicle regeneration 2, 5.
Counsel patients explicitly that many alopecia areata cases with limited patchy disease experience spontaneous remission within the first year, but extensive or longstanding cases require aggressive evidence-based treatment early 4.