Ozone therapy in herpes zoster – are we ready for a complementary approach?

Abstract

Background: Conventional treatment of herpes zoster is based on antiviral agents, combined with analgesics and, in some cases, corticosteroids for pain and inflammation control. This approach is most effective when initiated early; however, it does not completely eliminate the virus and does not always prevent complications such as postherpetic neuralgia. Its limitations include reduced efficacy when treatment is delayed, incomplete pain control, and lack of effect on viral latency. In this context, complementary therapies such as ozone therapy are gaining increasing interest. Objective of the study: To analyze the role of ozone therapy in the management of herpes zoster and to evaluate its potential integration as a complementary approach in clinical practice. Material and methods: A narrative study based on the analysis of recent scientific literature regarding the use of ozone therapy in viral infections, with a focus on herpes zoster. Clinical studies, review articles, and relevant guidelines published between 1990 and 2026 were included, sourced from databases such as PubMed, Hinari (Health InterNetwork Access to Research Initiative), SpringerLink, National Center of Biotechnology Information, and Medline. Results: Analysis of the available literature suggests that the addition of ozone therapy to standard treatment in herpes zoster may lead to a reduction in pain by approximately 50–80%, along with accelerated healing of skin lesions by 20–30%. Furthermore, a decrease in the incidence of postherpetic neuralgia by approximately 30–50% and an overall reduction in disease duration by 20–40% have been reported. These effects are attributed to the antiviral, anti-inflammatory, immunomodulatory, and microcirculatory-enhancing properties of ozone. Conclusions: Ozone therapy may represent a promising complementary option in herpes zoster, with the potential to reduce pain, inflammation, and disease duration.