The effect of hyperbaric oxygen therapy on the pathophysiology of skin aging: a prospective clinical trial.
Level 3 - non-randomized controlled study
Prospective non-randomized self-controlled trial with a sequential pre-intervention control period
PubMed 34784294 · doi:10.18632/aging.203701
What was done
Thirteen healthy older men (mean age 68.07 ± 2.5 years, sub-selected from a cohort of 70 participants) completed a prospective study consisting of a 3-month non-intervention control period followed by 3 months of daily hyperbaric oxygen therapy (HBOT) sessions. Skin biopsies were collected at baseline, after the 3-month control period, and 1–2 weeks after completing HBOT. Tissue samples were evaluated via trichrome, orcein, lipofuscin, and CD31 staining to measure collagen fibers, elastic fibers, senescent cells, and blood vessels, respectively.
What was found
Following HBOT, there was a significant increase in collagen density (p < 0.001, effect size = 1.10), elastic fiber length (p < 0.0001, effect size = 2.71), and blood vessel count (p = 0.02, effect size = 1.00). There was a significant decrease in elastic fiber fragmentation (p = 0.012) and tissue senescent cells (p = 0.03, effect size = 0.84). No significant changes were detected in elastic fiber density or thickness.
Why it matters
This study provides preliminary human histological evidence that HBOT can modulate cellular and structural markers of skin aging, including promoting angiogenesis and reducing senescent cell burden.
Limits
The study is limited by a very small sample size (n = 13) consisting exclusively of older men, limiting generalizability. It employed a sequential self-controlled design rather than a randomized, sham-controlled parallel group, and did not evaluate clinical cosmetic outcomes or the long-term durability of the histological changes.
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