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Practitioner protocol
Topical Ozonated Oil and Cream for Skin Protocol
Strength, how often to apply, and precautions for ozonated oil and cream used on the skin.
Quick answer: Ozonated oil and cream are applied to the skin in a thin layer, up to 2–3 times a day. Strength is measured by peroxide value (PV), and the sheet lists 200–1,200. It is a practitioner protocol.
Home method. Best done as recommended by a licensed provider who knows your health history.
What are the basics of ozonated oil and cream on the skin?
- Ozonated oil is a vegetable oil, such as olive or sunflower, that has been treated with ozone. Its strength is measured by peroxide value (PV, in mEqO2/kg), not in µg/mL. Madrid's levels are low 200 to 400, medium 400 to 600, and high 800 to 1,200.
- Madrid lists ozone water sprays, lotions, creams and oils as topical preparations, used for milder skin concerns as part of a larger plan.
- Madrid gives no strength or schedule for creams. Follow the maker's directions.
- Madrid gives no schedule for everyday skin care. Our ozone oil article describes a thin layer, up to 2 to 3 times a day on a problem area, or nightly as part of a skin routine.
- This sheet covers skin-care use. It does not claim that ozonated oil treats or cures any skin condition.
Source: Madrid Declaration on Ozone Therapy, 4th edition (ISCO3, 2025), sections 5 and 13.2 and Table 4B. Paraphrased.
What dose and schedule are used for ozonated oil and cream on the skin?
| Strength | Peroxide value (mEqO2/kg) | Madrid lists it for |
|---|---|---|
| Low | About 400 (200–400) | Facial revitalization and general skin care |
| Medium | About 600 (400–600) | Scalp and skin care |
| High | 800–1,200 | Clinician-directed use on lesions |
Madrid's table also names specific skin conditions and wounds at each strength. Those uses are clinician-directed and are not claims made on this page. Frequency for skin care: a thin layer, up to 2 to 3 times a day.
What are the best tips when using ozonated oil and cream on the skin?
- Clean the area first and apply a thin layer. A little goes a long way.
- Store in amber glass at about 4 °C (refrigerated). Our oil article gives a shelf life of 6 to 12 months refrigerated.
- Choose an oil from a maker that states the peroxide value. Madrid notes that poor quality control of PV has biased the studies.
- Some products add a skin-penetration enhancer. Madrid describes these as suitable for intact, unbroken skin.
What are the precautions for ozonated oil and cream on the skin, and who should avoid it?
- Keep it away from the eyes. Madrid notes ozonated oil on the eye surface causes a burning sensation, and it is only used there by clinicians with topical anesthesia.
- Do not make ozonated oil with a medical ozone generator. Madrid says this must never be done: toxic by-products cannot be ruled out and there is a risk of explosion. Buy oil made and tested by a maker.
- Temporary redness, stinging or itching can occur. Use it less often or at a lower strength, and stop if it persists.
- Patch test first: try a small area of skin before wider use.
- Do not use on deep or infected wounds without a practitioner.
- Pregnancy: check with your healthcare provider before starting.
More detail
Oil, cream and glycerin
Oil stays on the skin and is the form Madrid gives strengths for. Ozonated glycerin mixes with water and lotion: see the ozonated glycerin protocol. For wounds and skin areas that a bag can cover, see the limb bag and cupping protocol.
What the studies used
Studies are in adults with wounds and foot skin problems, not cosmetic outcomes. No acne or psoriasis trial of topical oil is in our study set. Study doses are listed as printed and are not Madrid dosing.
- In 123 adults with diabetic foot ulcers, ozonated olive oil, 5 mL daily for 4 weeks on top of standard care, improved wound scores more than standard care alone (Vahedi 2025).
- In 300 adults with athlete's foot, ozonated oil twice daily for 6 weeks worked about as well as 2% ketoconazole or 1% terbinafine, with minor adverse events in 4 of 100 on the oil (Travieso 2025).
- In 86 adults with venous leg ulcers, ozonated oil dressings healed fewer ulcers than platelet-rich fibrin gel (30% vs 84%), with stinging in 5 (Cui 2026).
Learn more
Background, benefits and research: Ozonated olive oil, full article. Skin: Ozone cream, oil and treatments for skin. Comparing routes: Comparing home ozone therapies.
Related protocols: Ozone Oil Pulling Protocol, Ozone Oil Suppositories Protocol, Ozone Oil Capsules Protocol.
Other protocols
For licensed practitioners. Educational reference only, not medical advice. Follow your scope of practice and local regulations.
