17811 Hyperbaric Oxygen Therapy

Overview

Hyperbaric oxygen therapy (HBOT) is a treatment that lets you breathe pure oxygen inside a sealed chamber. The air in the chamber is at a higher pressure than normal air around you. That extra pressure means your blood can carry much more oxygen than usual, so oxygen reaches parts of the body that may be short of it, such as slow-healing wounds or damaged tissue. It is only done in specialist centres by trained teams, and it is usually one part of a wider treatment plan rather than a treatment on its own.

No. Hyperbaric oxygen therapy is not a common treatment. Only a small number of hospitals and specialist centres have chambers, and only certain people are referred to them.

HBOT can be offered to people of any age, from children to older adults, but only when there is a clear medical reason. The people most often referred have wounds that are not healing (especially people with diabetes), tissue damage after radiotherapy for cancer, serious skin or bone infections, severe burns, or decompression sickness after diving. Some people take part in research studies looking at other uses.

Symptoms

Common symptoms

• A wound, ulcer or surgical wound that has not healed after weeks of good care
• Skin or bone damage in an area that was treated with radiotherapy, sometimes many months or years later
• A serious infection of the skin, muscle or bone that is not improving with standard treatment
• A burn or skin graft that is healing very slowly
• Carbon monoxide poisoning — this is an emergency
• Decompression sickness after diving — this is also an emergency

Causes

Main causes

• HBOT is a treatment, not a disease, so it does not have 'causes'. These are the main problems it is used for.
• Wounds and ulcers that are not healing, including foot ulcers in people with diabetes
• Damage to skin, bone or other tissue after radiotherapy
• Serious infections of the skin, muscle or bone, including some rapidly spreading infections
• Severe burns, and skin grafts that are healing slowly
• Carbon monoxide poisoning
• Decompression sickness in divers, and gas bubbles in the bloodstream
• Some centres also offer it for selected cases such as sudden hearing loss

Risk factors

• Having diabetes, especially with blood sugar that is hard to control, which raises the risk of foot ulcers
• Previous radiotherapy, particularly to the head, neck, chest or pelvis
• Poor circulation or narrowed arteries in the legs
• Smoking, which slows healing and narrows blood vessels
• Diving as a hobby or as part of your job
• Using a fuel-burning stove, heater or generator indoors without good ventilation (a carbon monoxide risk)

When to see a doctor

See a doctor urgently if:

• You have a wound that is not healing, or is getting worse
• You have diabetes and notice a new foot sore, blister, redness or swelling
• You have a fever, spreading redness or bad-smelling discharge from a wound
• You have ear pain that does not settle, or new trouble hearing
• You feel unwell, dizzy or breathless during or after a session

Book a routine appointment if:

• Your care team has mentioned HBOT and you would like to know more
• You are due to start a course of sessions and want to plan around work, travel or caring duties
• You feel anxious about being in a closed space
• You want to ask whether HBOT could help your particular condition

Diagnosis

HBOT is not a diagnosis — it is a treatment your doctor may suggest. Before it is offered, a specialist team will ask about your medical history, examine you, and check whether the treatment is likely to help and safe for you. This is sometimes called an assessment or pre-treatment review.

Tests that may be done

• A physical examination, including your ears, nose, lungs, heart and eyes
• Checking your wound or affected area, often with photos or measurements to track healing
• Blood tests to check your general health and your blood sugar control
• A chest X-ray or breathing tests if you have lung problems
• An eye check, because pressure changes can affect vision in some people
• A scan such as an X-ray, CT or MRI if a deep or bone infection is suspected
• A heart tracing (electrocardiogram) if you have heart problems

What to expect at your appointment

At the assessment you will meet the team, see the chamber, and have time to ask questions. They will explain how many sessions you are likely to need, how long each one takes, and what you should do before and after. You can usually bring a relative or friend with you. If small spaces make you nervous, say so — the team can show you how the chamber works and help you feel more at ease.

Treatment

HBOT is given in sessions. You sit or lie in a chamber — some are see-through tubes for one person, others are larger rooms that hold several people. The pressure is raised slowly, and you breathe oxygen through a mask or a light hood. You may feel fullness in your ears, like during a flight, and swallowing or yawning usually eases it. At the end, the pressure is lowered slowly. Trained staff watch you the whole time and you can talk to them.

Self-care at home

• Follow the team's instructions about what to wear and what to leave off your skin on the day of a session
• Do not smoke — smoking narrows blood vessels and works against the treatment
• Eat a normal meal before your session and drink enough water
• Avoid alcohol before sessions
• Keep taking your usual medicines, and tell the team about any changes or new medicines
• Tell the team if you have a cold, ear infection or blocked sinuses — you may need to wait
• Keep up your usual wound care between sessions
• Plan for travel time and some rest afterwards, as some people feel tired

Medical treatments

HBOT is one part of a wider plan. Other care may include cleaning and dressing wounds, removing dead tissue, treating infection, improving blood flow, and managing underlying conditions such as diabetes. Sessions are often given once or twice a day on weekdays, and the total number depends on the problem — some people need only a few sessions, others need several weeks. The team reviews your progress regularly and will stop if it is not helping. Mild side effects are common and usually settle: ears feeling full or sore, tiredness, and temporary blurring of vision. Serious problems are rare because the team checks you carefully first.

When is surgery considered?

HBOT is sometimes used around the time of an operation — for example, before a skin graft or to help a wound heal after surgery. Your surgical team and the HBOT team will decide the timing together.

Living with this condition

Most people manage HBOT alongside normal life, but the time commitment is real. A session can take two to three hours including preparation and travel, and you may need them most weekdays for several weeks. Some people ask a friend or family member to drive them, at least at first, and it helps to plan work or caring duties in advance. Many people read, listen to music or simply rest during the session.

Lifestyle tips

• Keep up gentle movement, such as short walks, unless your team advises otherwise
• Keep taking your usual medicines as agreed with your doctor, and do not stop anything without asking
• Protect your wound or treated skin from rubbing and pressure
• Ask for practical help with lifts and errands during an intensive course of sessions
• Check with your team before flying or diving after treatment

Diet and exercise

Eating well helps your body heal. Aim for regular meals with plenty of vegetables, fruit, whole grains and protein, and drink enough water. If you have diabetes, keeping your blood sugar steady is especially important for wound healing — ask your team for advice. Gentle exercise, like walking, supports your circulation. The team will tell you if you need to avoid anything.

Mental health and emotional wellbeing

Feeling anxious about a closed space is very common, and many people find the first session the hardest. Others feel tired or emotional during a long course of treatment, especially if they are also coping with a wound, cancer treatment or a hospital stay. These feelings are normal, and talking to the team, a friend or your doctor helps. If low mood or worry is affecting your sleep, appetite or daily life, tell your doctor — support is available. If you ever have thoughts of harming yourself, contact your local emergency number or a crisis line in your country straight away.

Prevention

HBOT itself is not something you can prevent — it is a treatment. But many of the problems it treats can be prevented or caught early. Look after your feet if you have diabetes, keep your blood sugar as steady as you can, avoid smoking, get wounds checked early, make sure fuel-burning appliances are well ventilated, and follow safe diving practice.

Screening programmes

Regular checks help catch problems early — for example, annual foot checks if you have diabetes, and dental and mouth checks if you have had radiotherapy to the head or neck.

Complications

If left untreated

• Wounds may become infected or fail to heal, and in serious cases this can lead to losing part of a limb
• Damage after radiotherapy can cause ongoing pain, stiffness, bleeding or scarring
• Serious infections can spread quickly through the body
• Carbon monoxide poisoning and decompression sickness are emergencies — without quick treatment they can cause lasting harm to the brain, heart or lungs

Long-term outlook

Most people cope well with HBOT, and many notice improvement, though results vary and it does not work for everyone. Your team will review your progress and be honest with you about whether it is helping. Even when HBOT is not the right treatment for you, there are usually other options, and having a clear plan can help you feel more in control.

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