Transcutaneous Ozone Therapy: What Cupping and Bagging Offer Skin, Wounds and Circulation

Ozone Therapy Series • Article 3 of 5

Not every ozone therapy method is about reaching the whole body at once. Sometimes what is needed is targeted: a way to bring ozone's healing potential directly to a specific wound, a problem area of skin, or a limb that is not healing the way it should. That is exactly what transcutaneous ozone therapy offers.

Through two closely related techniques, ozone cupping and ozone bagging, an ozone-oxygen mixture is delivered directly to the surface of the body, flooding a localised area with ozone in a way that promotes healing, clears infection, and improves circulation at the site. It is one of the oldest applications in ozone therapy's history, and the science behind it has only grown stronger with time.

A Brief History Worth Knowing

Ozone's use as a wound treatment goes back further than most people realise. During the First World War, field physicians who had access to ozone generators applied it topically to infected wounds and gangrenous tissue. What they observed was not just infection clearance; it was improved circulation, accelerated tissue repair, and reduced inflammation at the wound site. These early clinicians were documenting, in real-world conditions, what the biochemistry would later explain.

The International Scientific Committee of Ozone Therapy (ISCO3) formally recognises both ozone bagging and cupping as established application methods within its Madrid Declaration, the internationally accepted framework for ozone therapy practice. This is a therapy with a long track record and a well-understood mechanism.

How It Works: The Biology of Topical Ozone

When ozone comes into contact with skin tissue, it initiates several biological responses that are both protective and regenerative:

• It activates the body's antioxidant enzyme systems, including glutathione peroxidase, catalase, and superoxide dismutase, which protect healthy cells while dismantling pathogens.

• It stimulates the release of growth factors such as TGF-beta, which are central to tissue repair and regeneration.

• It triggers the production of prostacyclin, a natural vasodilator, which improves local blood flow to the treated area; a critical factor in wound healing.

• It directly disrupts bacterial cell walls, damages viral capsids, and inhibits fungal growth on contact.

A peer-reviewed study in biomedical research found that ozone bagging produced the most significant contribution to wound healing of all tested protocols, outperforming even topical ozonated oil in terms of wound contraction, inflammatory control, and the quality of new tissue organisation. The combination of the two was more powerful still, and many of our clients use them together as part of a structured wound care approach.

The Ohen Model 5 is used in exactly this kind of protocol by practitioners working with chronic wound patients, particularly because of its affordability in long term use and high ozone concentrations.

Cupping vs Bagging: Knowing the Difference

The two methods are closely related but suited to different anatomical areas. Ozone cupping uses a cup placed directly against the skin, creating a sealed localised ozone environment. It is best suited for wounds or conditions on the torso, upper body, or specific patches of skin where targeted application is needed.

Ozone bagging encloses a limb, most often the foot, ankle, or lower leg, inside an ozone-resistant bag which is then filled with the ozone-oxygen mixture. It is the method of choice for conditions affecting the extremities: diabetic foot complications, peripheral vascular disease, fungal nail infections, and poor circulation in the lower limbs.

Both function as closed systems. The ozone-oxygen mixture is contained entirely within the cup or bag, in full contact with the skin, without escaping into the surrounding air. This both maximises therapeutic exposure and means there is no risk of ambient ozone reaching the respiratory tract during a session.

Where the Evidence Is Strongest

Transcutaneous ozone therapy has one of the strongest evidence bases in ozone medicine for wound care, particularly for conditions where conventional treatments have fallen short:

• Diabetic foot ulcers: multiple clinical studies have documented meaningful improvements in wound closure rates compared to conventional care alone. For people managing the slow, difficult healing journey of a diabetic foot, this is significant.

• Fungal nail infections: ozone has outperformed standard antifungal treatments in some nail infection studies, a finding worth knowing for anyone who has tried topical antifungals with limited success.

• Non-healing post-surgical or post-traumatic wounds.

• Eczema, psoriasis, and other inflammatory skin conditions.

• Burns and abrasions, where ozone's antimicrobial and regenerative properties support healing without contributing to antibiotic resistance.

• Peripheral circulatory insufficiency, where ozone's ability to improve local blood flow makes it particularly valuable.

Enhancing Results with Ozonated Oil

Combining bagging or cupping sessions with the application of ozonated olive oil to the skin before or after treatment. The oil creates additional localised ozonide activity in the outermost skin layers, while the session allows ozone to penetrate deeper into the tissue below. Together, they work at different depths; a surface-and-depth approach that many users find more effective than either alone.

Whether you are working with a chronic wound, a skin condition, or simply supporting circulation in ageing or compromised tissue, transcutaneous ozone therapy is one of those approaches that seems straightforward on the surface but carries a depth of evidence behind it that rewards a closer look. With the right device producing the right concentration, it becomes a remarkably accessible and effective tool, and it is exactly the kind of therapy the Ohen Model 5 was built to support.

© Ohen Group • Ozone Therapy Series • Article 3 of 5