Ozone and Ozonated Oils in Skin Diseases: A Review

Background

By 2010, clinicians and researchers were facing two persistent skin-related problems: a rise in venereal (sexually transmitted) infections, particularly among younger people, and chronic wounds and ulcers in older adults that often failed to heal with standard care. Conventional antimicrobial and wound-care options were not resolving either problem consistently, and interest had been building in ozone gas and ozonated vegetable oils as topical alternatives, thanks to their antimicrobial and oxidative properties. This review set out to bring together what was known at the time about how ozone and ozonated oils behave on skin, and whether the existing evidence supported their use in dermatology.

Study design

This is a narrative literature review, not a clinical trial or laboratory study. The authors - based at the University of Siena and the University of Ferrara in Italy - drew together previously published mechanistic, preclinical and clinical literature on ozone chemistry and its effects on skin. No new patients, samples or experiments were involved; instead, the paper synthesises existing research on how ozone reacts with the lipids in vegetable oils to form ozonides, how these compounds are thought to act on microbes and tissue, and what had been reported in the literature about topical use in infections, wounds and ulcers.

Findings

The review describes how ozone reacts with unsaturated fatty acids in oils such as olive or sunflower oil to form ozonides, which release active oxygen species slowly and steadily once applied to the skin, rather than all at once. This slow-release action was reported in the literature as broadly antibacterial, antifungal and antiviral, which the authors link to reports of improved healing in chronic leg ulcers and other slow-healing wounds in elderly patients. The paper also discusses reports of ozonated oils being used against venereal infections, an area the authors flag as increasingly relevant given rising rates in younger people. The authors are clear that most of this supporting evidence came from smaller studies, case series and mechanistic work rather than large, well-controlled clinical trials.

What the authors concluded

The authors conclude that ozone and ozonated oils show enough promise as low-cost topical treatments for skin infections and chronic wounds to warrant serious clinical investigation. Rather than presenting the evidence as conclusive, they frame the review as a call to action - encouraging the design of proper, evidence-based clinical trials so that ozone therapy's efficacy in dermatology could be established (or ruled out) to the standard required by mainstream medicine.

Limitations of this study

As a narrative review rather than a systematic review, the paper does not describe a formal search protocol, and there is no way to confirm how comprehensively or consistently the underlying studies were selected. The evidence it draws on is a mixed bag - preclinical chemistry, mechanistic reasoning, and small or uncontrolled clinical reports - with few, if any, large randomised controlled trials available at the time to lean on. No new data was generated, so the paper's value lies in summarising and interpreting existing work rather than testing a hypothesis directly. Readers should treat its conclusions as a rationale for further research rather than as settled proof that ozonated oils are effective for any specific skin condition.