Can Ozone Therapy be Useful for Anti-Ageing?

Ozone therapy comes up regularly in conversations about ageing and longevity. The reasoning behind it is genuinely interesting, and parts of the laboratory evidence are suggestive. Most of that evidence, though, is mechanistic rather than clinical - it describes what ozone appears to do inside cells, not what it has been shown to do for people over time. This article sets out both, and is clear about where one ends and the other begins.

What ozone therapy is

Ozone therapy involves the controlled administration of ozone gas, usually mixed with oxygen, by routes such as autohaemotherapy (blood is drawn, treated with ozone and returned), insufflation, or topical application. Ozone is a triatomic form of oxygen and a potent oxidant, familiar from water treatment and disinfection. The proposal in therapeutic use is that at low, controlled doses it acts as a biological signal rather than a destructive agent.

It has been studied for several decades, particularly in parts of Europe and Asia. For a general introduction, see our ozone therapy hub, or download our free home ozone therapy guide here.

The proposed mechanism: a controlled, mild oxidative challenge

Ageing is associated with accumulated oxidative damage, declining mitochondrial performance and chronic low-grade inflammation, sometimes called inflammageing. The counter-intuitive proposal behind ozone therapy is that a small, controlled dose of an oxidant provokes the body's own adaptive defences rather than adding to the damage.

When ozone meets blood, it reacts with polyunsaturated fatty acids to produce reactive oxygen species and lipid oxidation products. In laboratory work this mild stress is associated with activation of the Nrf2 pathway, a master regulator of the antioxidant response, which in turn upregulates enzymes such as superoxide dismutase, glutathione peroxidase and catalase. The proposed result is increased endogenous antioxidant capacity. This dose-dependence is the whole basis of the approach: the therapeutic window is narrow, and more is not better.

Mitochondria: what the evidence actually shows

Mitochondria are the obvious place to look, since they both produce cellular energy and sit at the centre of redox signalling. Three studies in our Scientific Literature section are worth reading directly rather than taking second-hand.

A narrative mini-review of the preclinical literature concludes that ozone can modulate mitochondrial function and redox balance, but with a distinctly non-linear dose response: very low concentrations do little, low to moderate concentrations are associated with beneficial effects, and high concentrations can produce the opposite. The authors are explicit that the mechanisms are not yet fully understood, and that results vary with dose, route, duration, target organ and animal model.

Separately, low ozone concentrations have been shown to stimulate mitochondrial activity in laboratory conditions.

The closest thing to direct human evidence is a small study measuring mitochondrial performance in blood cells from six patients after two high-dose sessions. It reported a rise in a laboratory index of mitochondrial health. It also had no control group, no randomisation, six participants, one week of follow-up, and the journal has since attached an editorial note recording concerns about informed consent and an undeclared conflict of interest. It is worth reading precisely because it is the strongest human data available here, and it is still early, mechanistic and contested.

In short: there is reasonable preclinical evidence that ozone influences mitochondrial function at the right dose. There is not yet clinical evidence that this translates into slower ageing in people.

Inflammation, immunity and circulation

Chronic inflammation is closely tied to cellular senescence. In laboratory and animal work, ozone has been observed to suppress pro-inflammatory NF-kB signalling, reduce cytokines such as TNF-alpha and IL-1beta, and influence immune cell activity. It has also been associated with improved microcirculation through increased nitric oxide and prostacyclin. See this review of ozone's cellular mechanisms for the detail.

Skin, collagen and tissue repair

Skin is where ageing is most visible, and where topical ozone has the most direct rationale. Ozone has been associated with upregulation of growth factors including VEGF, TGF-beta and PDGF, supporting angiogenesis and fibroblast activity, which in turn drive collagen and elastin synthesis.

The most frequently cited clinical example is a case report of a single 55-year-old patient across six sessions, reporting reduced expression lines and stimulated collagen synthesis. A case report describes one person's experience with no comparison group, so it is a starting point for research rather than evidence of a general effect.

What this does and does not tell us

Taken together, the picture is a plausible and internally consistent mechanism with encouraging preclinical support, and thin clinical support. Animal work in aged rats has reported reduced lipid and protein oxidation and restored glutathione levels. Human work on ozone and wound healing in diabetic patients is more developed than human work on ozone and ageing, which is largely absent.

Anyone telling you ozone therapy is a proven anti-ageing treatment is ahead of the evidence. What can fairly be said is that the mechanisms are real areas of active research, and that the studies linked above are worth reading in full, limitations included.

Where ozone therapy sits internationally and in New Zealand

Ozone therapy is not a fringe practice everywhere. A 2023 evidence and gap map published in Frontiers in Public Health records ozone treatment as available and recognised as a medical procedure in a number of countries, including Germany, Italy, Russia, Portugal, Spain, Turkey, Greece, Egypt, China, Cuba, Mexico and Honduras, as well as several Eastern European countries. In Brazil it was introduced into the public health system as a complementary integrative practice in 2018.

In New Zealand, ozone therapy occupies the same ground as much of complementary health: no legislation prohibits it, and no registration scheme formally approves it. It sits outside the registered-medicine framework rather than against it, and it is practised here by trained practitioners and used at home throughout the country. The professional body for the field is the Ozone Therapy Association of New Zealand (OTANZ) - a member of the International Medical Ozone Federation since 2018, adhering to the Madrid Declaration on Ozone Therapy - and Natural Ozone is a member of OTANZ.

Safety

Ozone is a respiratory irritant and should never be inhaled directly. Reported side effects from therapeutic administration are generally mild, such as temporary fatigue or vein irritation, but dose and technique matter, which is why protocols and equipment quality are not incidental details.

Always consult a healthcare provider before starting, particularly if you have a respiratory condition, are pregnant, or are managing an existing health problem.

Getting started with ozone therapy at Natural Ozone

We help our customers set themselves up for home ozone therapy, under the guidance of their own healthcare professional. If you are weighing it up and want a straight answer about whether it suits your situation, get in touch - we would rather talk it through than have you guess.