{"entity":{"id":"rejuv-frontier-hyperbaric-oxygen-claims","kind":"technology","name":"Hyperbaric oxygen sold as rejuvenation","aka":[],"tldr":"Hyperbaric oxygen has real randomised evidence for a short list of late radiation injuries, and none at all for the general claims made for it in wellness clinics. The distinction is worth holding, because the clinics use the real indications to sell the invented ones.","summary":"Where it works: the Cochrane review of hyperbaric oxygen for late radiation tissue injury pooled 14 randomised trials in 753 participants. There was moderate-quality evidence that it achieved mucosal coverage in osteoradionecrosis (risk ratio 1.3, 95% CI 1.1 to 1.6, P = 0.003, five people treated for one extra benefit) and reduced wound breakdown after operative treatment for osteoradionecrosis (risk ratio 4.2 for breakdown without it, 95% CI 1.1 to 16.8). Single trials showed improvement or cure in radiation proctitis (risk ratio 1.72, 95% CI 1.0 to 2.9) and better healing of irradiated tooth sockets after extraction (risk ratio 1.4, 95% CI 1.1 to 1.7). There was no evidence of benefit for radiation injury to neural tissue. OnCo's record for that use is linked below.\n\nWhere it does not: the HOPON randomised trial tested hyperbaric oxygen to prevent osteoradionecrosis after dental extraction or implant placement in a mandible that had received more than 50 Gy. In 144 people randomised and 100 analysed, osteoradionecrosis at six months occurred in 6.4 per cent with hyperbaric oxygen and 5.7 per cent without (odds ratio 1.13, 95% CI 0.14 to 8.92, P = 1). Dropout was higher in the hyperbaric arm. So even inside the indication, prevention is not the same as treatment, and the trial that tested prevention was negative.\n\nThere is no randomised evidence that hyperbaric oxygen reverses biological ageing, improves fatigue in survivors generally, lengthens telomeres to any benefit, or treats anything outside a defined list of indications. Sessions are sold privately in courses of twenty to forty, and the courses are not funded by the NHS outside the approved indications, which is itself the clearest statement of what the evidence supports.","status":"emerging","asOf":"2026-10-02","wikipedia":"https://en.wikipedia.org/wiki/Hyperbaric_medicine","links":[{"label":"Bennett et al., Hyperbaric oxygen therapy for late radiation tissue injury (Cochrane Database Syst Rev 2016)","url":"https://doi.org/10.1002/14651858.CD005005.pub4"},{"label":"Shaw et al., HOPON: a randomized controlled trial of hyperbaric oxygen to prevent osteoradionecrosis of the irradiated mandible after dentoalveolar surgery (Int J Radiat Oncol Biol Phys 2019)","url":"https://doi.org/10.1016/j.ijrobp.2019.02.044"}],"tags":["rejuvenation","survivorship","evidence:insufficient","radiation-injury"],"related":[],"cancers":[],"sections":["rejuvenation","supportive-care"],"technologies":["hyperbaric-oxygen-radiation-injury","survivorship-care-plan"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["late-effects"],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Breathing 100 per cent oxygen at two to two and a half atmospheres raises dissolved plasma oxygen far above what haemoglobin can carry, which supports angiogenesis and fibroblast function in hypoxic, poorly vascularised irradiated tissue. That mechanism is specific to hypoxic injured tissue and does not generalise to healthy tissue.","strengths":["Moderate-quality randomised evidence for osteoradionecrosis, radiation proctitis and healing of irradiated tooth sockets","A defined physiological mechanism in hypoxic irradiated tissue","Delivered in regulated units for its approved indications"],"limitations":["The randomised trial of prevention after dental extraction was negative","No evidence of benefit for radiation injury to neural tissue","No randomised evidence for any general rejuvenation, fatigue or anti-ageing claim","Barotrauma to the ears and sinuses, and oxygen toxicity at depth, are real risks","Sold privately in long courses on claims the trials do not support"]},"route":"/technologies/rejuv-frontier-hyperbaric-oxygen-claims/","neighbours":{"section":[{"id":"rejuvenation","kind":"section","name":"Recovery & Rejuvenation","route":"/fronts/rejuvenation/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"hyperbaric-oxygen-radiation-injury","kind":"technology","name":"Hyperbaric oxygen for late radiation injury","route":"/technologies/hyperbaric-oxygen-radiation-injury/"},{"id":"survivorship-care-plan","kind":"technology","name":"Survivorship care and late-effects surveillance","route":"/technologies/survivorship-care-plan/"},{"id":"rejuv-frontier-what-works","kind":"technology","name":"What actually works after treatment","route":"/technologies/rejuv-frontier-what-works/"}],"term":[{"id":"late-effects","kind":"term","name":"Late effects and survivorship toxicity","route":"/terms/late-effects/"}],"bottleneck":[{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}]}}