Ozone Therapy in Dermatology: Mechanisms and Clinical Applications
Overview
This comprehensive review examines the mechanisms of action and clinical applications of ozone therapy in dermatology. Ozone demonstrates multiple therapeutic properties including antimicrobial activity, immune system modulation, and antioxidant effects, making it valuable for treating various skin conditions.
Key Mechanisms of Action
1. Antimicrobial Properties
Ozone exhibits broad-spectrum antimicrobial activity through multiple mechanisms:
- Direct oxidation: Ozone disrupts bacterial cell walls, fungal cell membranes, and viral capsids through oxidative damage
- Lipid peroxidation: Attacks unsaturated fatty acids in microbial membranes, leading to cell death
- Enzyme inactivation: Oxidises essential enzymes required for microbial metabolism and replication
- DNA/RNA damage: Interferes with genetic material, preventing microbial reproduction
2. Immune System Activation
Ozone therapy stimulates both cellular and humoral immune responses:
- Cytokine modulation: Increases production of interferons, interleukins, and tumour necrosis factor
- Phagocyte activation: Enhances the activity of neutrophils and macrophages
- Immunoglobulin production: Stimulates antibody formation for enhanced immune defence
- T-cell activation: Promotes cellular immunity and immune surveillance
3. Antioxidant Defence Enhancement
Paradoxically, controlled ozone exposure activates endogenous antioxidant systems:
- Nrf2 pathway activation: Upregulates antioxidant enzyme production
- Superoxide dismutase (SOD): Increased activity neutralises free radicals
- Glutathione peroxidase: Enhanced protection against oxidative stress
- Catalase production: Improved cellular defence mechanisms
4. Circulation and Oxygenation
Ozone therapy improves tissue oxygenation and blood flow:
- Erythrocyte flexibility: Enhances red blood cell deformability for better microcirculation
- Oxygen release: Shifts the oxygen-haemoglobin dissociation curve, improving tissue oxygen delivery
- Vasodilation: Promotes blood vessel relaxation and improved perfusion
- Angiogenesis: Stimulates new blood vessel formation in damaged tissue
Clinical Applications in Dermatology
Wound Healing
Ozonated oils demonstrate significant efficacy in wound management through:
- Antimicrobial action preventing infection
- Enhanced granulation tissue formation
- Accelerated epithelialisation
- Reduced inflammation and pain
- Improved collagen synthesis
Inflammatory Skin Conditions
Effective for conditions including:
- Atopic dermatitis: Reduces inflammation and microbial colonisation
- Psoriasis: Modulates immune response and reduces scaling
- Acne vulgaris: Antimicrobial action against P. acnes and sebum regulation
- Eczema: Anti-inflammatory and barrier repair properties
Infectious Skin Diseases
Demonstrated effectiveness against:
- Bacterial infections: Including MRSA and other resistant organisms
- Fungal infections: Dermatophytes, Candida species
- Viral infections: Herpes simplex, herpes zoster
- Mixed infections: Polymicrobial wound infections
Diabetic Foot Ulcers
Particularly valuable for diabetic complications:
- Improved wound healing rates
- Reduced amputation risk
- Enhanced tissue oxygenation in ischaemic areas
- Infection control in compromised immune states
Ozonated Olive Oil: Mechanism and Stability
Formation Process
Ozonated olive oil is produced by bubbling ozone through high-quality olive oil, creating stable ozonides and peroxides. The process:
- Converts unsaturated fatty acids into ozonides
- Creates a gel-like consistency as ozonation progresses
- Produces stable compounds with prolonged therapeutic activity
- Maintains antimicrobial and healing properties over time
Therapeutic Advantages
Ozonated olive oil offers unique benefits:
- Sustained release: Gradual ozone delivery to tissues
- Stability: Long shelf life compared to gaseous ozone
- Ease of application: Topical use without specialised equipment
- Safety profile: Minimal adverse effects when properly formulated
- Dual action: Combines ozone therapy with olive oil's inherent skin benefits
Safety and Tolerability
The review confirms ozone therapy's favourable safety profile when properly administered:
- Minimal systemic absorption from topical application
- Low incidence of adverse reactions
- Well-tolerated across diverse patient populations
- No significant drug interactions reported
- Suitable for long-term use in chronic conditions
Clinical Evidence Summary
The literature demonstrates:
- Efficacy: Consistent positive outcomes across multiple skin conditions
- Versatility: Applicable to acute and chronic dermatological issues
- Complementary therapy: Can enhance conventional treatment outcomes
- Cost-effectiveness: Reduces healing time and healthcare costs
- Patient satisfaction: High acceptance and compliance rates
Conclusion
Ozone therapy, particularly through ozonated olive oil, represents a scientifically validated approach to treating various skin conditions. Its multi-faceted mechanisms—antimicrobial action, immune modulation, antioxidant enhancement, and improved tissue oxygenation—provide a comprehensive therapeutic strategy. The evidence supports its use as both a primary treatment and adjunctive therapy in dermatological practice.
Reference
Zeng J, Lu J. Mechanisms of action involved in ozone-therapy in skin diseases. Int Immunopharmacol. 2018;56:235-241. doi:10.1016/j.intimp.2018.01.040. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298518/