ABSTRACT

McCray P, Johnson-Arbor K. Dermatologic medical ozone therapy complications treated with hyperbaric oxygen. Undersea Hyperb Med. 2025 Fourth Quarter; 52(4):515-519.

Introduction: Medical ozone therapy, which involves topical or systemic administration of ozone gas,
is promoted as a treatment for various infections and inflammatory conditions, although evidence supporting its clinical effectiveness in humans is limited. Medical ozone administration is also associated with serious adverse effects, including gas embolus and fatality. We present the case of a patient who experienced dermatologic complications after receiving medical ozone therapy. The complications were managed with surgical intervention and hyperbaric oxygen therapy.

Case Report: A 43-year-old female was administered medical ozone therapy injections to the temples and central forehead by a dermatologist to enhance hair growth and collagen formation. After the procedure, the patient experienced worsening alopecia and scarring in the treated areas. She eventually underwent surgical excision and closure that was performed by a plastic and reconstructive surgeon. Intraoperatively, she was noted to have significantly fibrotic, scarred, and poorly vascularized tissue, which raised concern for poor wound healing. Her plastic surgeon referred her for adjunctive hyperbaric medicine evaluation to treat presumed skin flap vascular compromise. She completed a course of forty hyperbaric oxygen treatments before returning to the plastic surgeon for scar tissue excision and local tissue rearrangement that ultimately resulted in acceptable cosmesis.

Conclusion: While medical ozone therapy may result in favorable effects on a cellular level, the treatment is associated with significant clinical risks that may outweigh its potential therapeutic benefits. Systemic hyperbaric oxygenation may enhance vascularity and improve the quality of devitalized tissue in areas previously treated with medical ozone therapy.

Keywords: alopecia; drug-related side effects and adverse reactions; hyperbaric oxygenation, ozone