Psoriasis affects over 125 million people worldwide, and despite a growing arsenal of treatments, many patients still struggle with incomplete responses, side effects, and the relentless cycle of flares. Ozone therapy is gaining attention as a complementary approach that targets the inflammatory pathways driving psoriasis at a cellular level.
Key Takeaways
- Ozone therapy reduces psoriasis severity (PASI scores) by suppressing the NF-kB/Th17 inflammatory pathway, a central driver of psoriasis
- Topical ozonated oil and ozone baths show efficacy comparable to topical corticosteroids in mild-to-moderate psoriasis
- Major autohemotherapy (MAH) reduces serum inflammatory markers in psoriasis patients
- Ozone promotes normal keratinocyte differentiation through the Tp63/KRT10 pathway, addressing the abnormal skin cell turnover that causes plaques
- Evidence is promising but limited to small studies. Ozone is best positioned as a complement to conventional treatment, not a replacement
How Psoriasis Works
Psoriasis is an immune-mediated inflammatory disease characterized by hyperproliferation of keratinocytes (skin cells). Normal skin cells mature and shed in about 28 days. In psoriasis, this cycle accelerates to 3 to 4 days, causing the thick, scaly plaques that define the condition.
The key inflammatory players are:
- Th17 cells: These immune cells produce IL-17 and IL-22, the primary cytokines that drive keratinocyte proliferation
- NF-kB pathway: This master regulator of inflammation is chronically activated in psoriatic skin
- TNF-alpha: A pro-inflammatory cytokine that amplifies the inflammatory cascade
- Dendritic cells: These antigen-presenting cells sustain the inflammatory loop in psoriatic lesions
Current treatments range from topical steroids and vitamin D analogs for mild disease to biologics (TNF inhibitors, IL-17 inhibitors, IL-23 inhibitors) for moderate-to-severe cases. While biologics have transformed psoriasis treatment, they are expensive (often exceeding $50,000 per year), require injections, and carry risks of immunosuppression.
How Ozone Therapy Targets Psoriasis
Research has identified several specific mechanisms through which ozone may benefit psoriasis:
NF-kB suppression. A study published in the journal Aging found that ozone therapy attenuates NF-kB-mediated local inflammatory response and activation of Th17 cells in psoriasis treatment. The authors demonstrated that topical ozone treatment suppressed the TLR2/NF-kB pathway, reduced pro-inflammatory cytokines (IL-17, IL-22, TNF-alpha), and inhibited Th17 cell activation (Zeng et al., 2020. DOI: 10.18632/aging.103195).
Keratinocyte normalization. A separate study found that ozone therapy promotes the differentiation of basal keratinocytes via increasing Tp63-mediated transcription of KRT10. In simpler terms, ozone helps skin cells mature normally instead of overproliferating into psoriatic plaques (Xiao et al., 2020. DOI: 10.1111/jdv.16338).
Free radical scavenging. Ozone activates the body’s antioxidant enzyme system, producing free radical scavenging agents that remove inflammatory free radicals generated during psoriatic flares.
“Topical ozone treatment significantly decreased patients’ PASI scores and the expression of psoriasis-associated cytokines in their peripheral blood CD4+ T cells. In preclinical models, topical ozone significantly inhibited the formation of psoriasis-like lesions.”
Clinical Evidence
Several studies have examined ozone therapy for psoriasis:
Topical ozone for plaque psoriasis. Clinical trials demonstrate that topical ozonated oil and autohemotherapy reduce Psoriasis Area and Severity Index (PASI) scores and alleviate symptoms like erythema and pruritus, with efficacy comparable to topical corticosteroids in mild-to-moderate psoriasis.
MAH for psoriasis. A 2025 study published in the Journal of Clinical Medicine evaluated major autohemotherapy in psoriasis patients using serum inflammatory markers. The results showed significant decreases in inflammatory markers after a course of MAH treatment (Evaluation of MAH in Psoriasis Patients, J Clin Med, 2025. DOI: 10.3390/jcm15020485).
Preclinical evidence. In an imiquimod-induced psoriasis mouse model, topical ozone treatment significantly inhibited the formation of psoriasis-like lesions and reduced the expression of psoriasis-associated inflammatory factors (Zeng et al., 2020).
Forms of Ozone Therapy for Psoriasis
| Method | Best For | How It Works | Evidence |
|---|---|---|---|
| Ozonated oil | Localized plaques | Apply directly to plaques 2-3x daily | Moderate (clinical studies) |
| Ozone baths | Widespread psoriasis | Ozonated water soak, 20-30 min | Limited (case reports) |
| MAH | Moderate-severe psoriasis | IV autohemotherapy, 1-2x/week | Moderate (clinical studies) |
| Rectal insufflation | Systemic inflammation | Ozone gas via rectum | Limited (clinical reports) |
| Ozone sauna | Full-body treatment | Transdermal ozone absorption | Very limited |
Ozone vs. Conventional Psoriasis Treatments
Where does ozone fit in the psoriasis treatment landscape?
Mild psoriasis: Ozonated oil could serve as a steroid-sparing alternative for localized plaques. The evidence suggests comparable efficacy to topical corticosteroids without the risks of skin thinning, tachyphylaxis, or rebound flares.
Moderate psoriasis: MAH could potentially supplement phototherapy (NB-UVB) or systemic treatments like methotrexate. The anti-inflammatory and immune-modulating effects of ozone may enhance the response to these treatments.
Severe psoriasis: Ozone is not a replacement for biologics in severe cases. Biologics (secukinumab, ixekizumab, guselkumab) target the IL-17 and IL-23 pathways with proven efficacy and achieve PASI 75/90 responses in 70 to 90% of patients. Ozone has not demonstrated this level of efficacy.
The most realistic role for ozone in psoriasis is as a complementary therapy: reducing inflammation, managing mild-to-moderate disease without steroids, and potentially improving response to conventional treatments.
Typical Treatment Protocol
For psoriasis patients exploring ozone therapy, a practical approach might look like this:
Phase 1 (Weeks 1-4): Topical ozonated oil applied to plaques 2 to 3 times daily. Assess response. If plaques are improving, continue topical therapy.
Phase 2 (Weeks 4-12): If topical treatment alone is insufficient, add MAH or rectal insufflation 1 to 2 times per week. Continue topical ozone oil.
Phase 3 (Ongoing): Maintenance with topical ozone oil and periodic systemic sessions (every 2 to 4 weeks) to prevent flares.
Most practitioners recommend a minimum of 10 to 15 systemic sessions before evaluating efficacy.
What the Systematic Reviews Say
A 2022 systematic review in the Journal of Clinical and Aesthetic Dermatology evaluated ozone therapy across dermatological conditions. For psoriasis specifically, the reviewers noted that while the mechanistic evidence is compelling (NF-kB suppression, keratinocyte normalization), the clinical evidence has methodological limitations including small sample sizes, lack of control groups, and insufficient long-term follow-up (Mohtasham Amiri et al., 2022. DOI: 10.36849/JDD.6843).
A separate review focused specifically on ozone therapy’s mechanistic action and comparative effectiveness in psoriasis concluded that ozone demonstrates promising immunomodulatory and anti-inflammatory mechanisms, but the breadth and quality of comparative evidence with standard therapies remain limited.
Safety Profile
Ozone therapy for psoriasis has a good safety profile:
- Topical ozone (oil, baths) is well-tolerated with minimal side effects
- MAH may cause temporary fatigue, mild headache, or vein irritation
- No reports of worsening psoriasis from ozone therapy
- No steroid-type side effects (skin thinning, rebound flares)
- G6PD deficiency must be ruled out before systemic ozone
Patients currently on biologics or systemic immunosuppressants should discuss ozone therapy with their prescribing dermatologist, as the immune-modulating effects could theoretically interact with these medications.
The Bottom Line
Ozone therapy for psoriasis sits at an interesting intersection. The mechanistic evidence is solid: ozone clearly suppresses the NF-kB/Th17 pathway, normalizes keratinocyte differentiation, and reduces inflammatory markers. These are the exact pathways that drive psoriasis.
But the clinical evidence has not caught up with the science. We need larger, well-designed trials comparing ozone to standard treatments before it can be recommended as a first-line approach.
For now, ozone therapy is most appropriate for psoriasis patients who want to reduce steroid dependence, who have mild-to-moderate disease, or who are looking for a complementary approach to enhance their current treatment.
References
- Mohtasham Amiri, Z. et al. (2022). Ozone Therapy for Dermatological Conditions: A Systematic Review. Journal of Clinical and Aesthetic Dermatology, 15(5), 34-42. DOI: 10.36849/JDD.6843
- Xiao, T. et al. (2020). Ozone therapy promotes the differentiation of basal keratinocytes via increasing Tp63-mediated transcription of KRT10 to improve psoriasis. Journal of the European Academy of Dermatology and Venereology, 34(6), 1394-1401. DOI: 10.1111/jdv.16338
- Zeng, J. et al. (2020). Ozone Therapy Attenuates NF-kB-Mediated Local Inflammatory Response and Activation of Th17 Cells in Treatment for Psoriasis. Aging, 12(1), 394-406. DOI: 10.18632/aging.103195
- Evaluation of Major Autohemotherapy (MAH) in Psoriasis Patients Using Serum Inflammatory Markers. Journal of Clinical Medicine, 2025, 15(2), 485. DOI: 10.3390/jcm15020485
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Author
Seph Fontane Pennock is the founder of BaricBoost.com and Regenerated.com, a clinic directory for regenerative medicine serving 10,000+ providers across the United States. He previously built and sold PositivePsychology.com, which grew to 19 million users and became the largest evidence-based positive psychology resource on the web. Seph brings direct experience as an HBOT patient, having completed protocols at clinics across three continents while navigating mold illness, systemic inflammation, and autoimmune conditions. His treatment journey includes hyperbaric oxygen therapy, peptide protocols, NAD+ therapy, and consultations with specialists from Dubai to Cape Town to Mexico. This combination of entrepreneurial track record and lived patient experience shapes everything published on BaricBoost.com. Every article is grounded in peer-reviewed research, informed by real clinical encounters, and written for patients making high-stakes treatment decisions. Seph's focus is on bringing transparency, scientific rigor, and practical guidance to the hyperbaric oxygen therapy space.
