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The Practical Use of Topical Oxygen

By: Peter T. Pugliese, MD
Posted: August 22, 2008, from the September 2008 issue of Skin Inc. magazine.

This article is written to provide the esthetician with a working knowledge of oxygen as a therapeutic modality. It is important to understand that oxygen is not a miracle remedy; it is, however, a very effective agent to treat many skin conditions that the esthetician sees almost daily. Although this article won’t go into great detail about the science of oxygen or free radical theory, it will touch on these topics lightly, as well as what skin conditions respond best to oxygen and why. The conditions to be covered include oxygen use in the treatment of acne, rosacea and aging skin.

Oxygen in the atmosphere

About two billion years ago, oxygen first appeared in the atmosphere as a by-product of single-cell metabolism. These creatures ran out of the initial food stuff in the oceans and had to synthesize their own food. Three raw materials were available to them: water, air (carbon dioxide) and sunlight, and from these, they synthesized sugars, or carbohydrate compounds. Water was split into hydrogen and molecular oxygen; carbon dioxide was split into carbon and oxygen; and the sun, in the form of photons, supplied the energy necessary to do all this work. Although the details are a fascinating read, this is not the place to go into depth with them. One important fact that you need to know is that this process produced a lot of molecular oxygen in the form of O2. Now keep in mind that all the organisms on Earth this time lived with oxygen (anaerobic), so oxygen became toxic to them and many hundreds of thousands of species died because of the toxicity of atmospheric molecular oxygen.

Some species obviously adapted to the presence of oxygen and survived, otherwise people would not be on the planet today. These species had mitochondria, which enabled them to make maximum use of oxygen as an energy source along with the sugars. The take-home lesson here is that oxygen is essential for life, and it became involved in the development of humans during the course of many millions of years in many ways. Even today, not every biological function of oxygen is known.

Oxygen and energy

With the advent of oxygen in the atmosphere, cells that were able to adapt to the presence of oxygen made great use of it as part of their energy systems. All energy on Earth is derived from the sun, in one form or the other, but humans’ biological energy comes indirectly from plants. Plants synthesize sugars via photosynthesis, people then eat the plants and break down the sugars to release biological energy in the form of adenosine triphosphate (ATP). Don’t worry about all the steps involved, just remember that oxygen is essential for that process to occur.

A large amount of the oxygen used by the skin passes into the skin from the atmosphere. A critical point to remember is that oxygen must diffuse into the skin and then down to the basal layer of the epidermis. Although a certain amount is used by the upper layers of the epidermis, the basal layer consumes most of the epidermal oxygen. Why is this important? Without the ability to get the oxygen into the skin first and then down to the basal layer next, it would not make any sense for oxygen to be used as a therapeutic modality. Diffusion laws are complex and the physics are a bit stiff, but you really do not need to know all of that to be able to use oxygen effectively. There are three conditions that respond to oxygen therapy: acne, rosacea and aging skin. For each of these biological disorders, the underlying pathology must be examined in order to appreciate and understand the role of oxygen in the treatment process.

Acne vulgaris