Look for the Doctor, Not the Chamber
Hyperbaric oxygen therapy has quietly become one of wellness's most fashionable treatments, a pressurised pod promising everything from faster recovery to reversed ageing. Dr Nur Ozyilmaz, a UK-trained physician with nearly three decades in medicine and founder of NUMA, has spent much of the last year watching that promise get ahead of the practice. Here, in her own words, she explains what's happening inside the chamber, why the equipment matters as much as the oxygen, and why the first question you should ask isn't about the pod at all.
Hyperbaric oxygen therapy is not new. What's new is where you can now find it spas, wellness studios, even living rooms, alongside claims about anti-ageing and “cellular optimisation” that would raise an eyebrow in any other branch of medicine. We asked Dr Nur Ozyilmaz, a former NHS consultant who trained in emergency medicine, paediatrics and nephrology before founding the hyperbaric clinic NUMA, to explain the medicine behind the marketing and what separates a genuine treatment from a well-lit pod.
WHY I BUILT A CLINIC AROUND THIS
I've been a doctor for nearly three decades. Throughout my career, my priority has always been the same: safe, evidence-based medical care. I trained at some of the UK's foremost university teaching hospitals, and those years shaped how I still practise today, thinking critically, working collaboratively, and putting patient safety at the centre of every decision.
My interest in hyperbaric oxygen therapy came from both sides of the stethoscope. Experiencing healthcare as a patient myself pushed me to look at emerging areas of medicine, but I wanted to stay firmly grounded in evidence. That search led me to postgraduate studies in regenerative and integrative medicine in the United States, where I first encountered hyperbaric oxygen therapy properly, not as a novelty, but as an established part of mainstream medical care. What struck me wasn't that HBOT was new. It was the rigour around it: careful patient assessment, individualised protocols, direct physician oversight, strict technical and safety standards.
Back in the UK, I noticed a gap. HBOT is available on the NHS for a defined set of commissioned indications. Outside that, it's increasingly sold as a wellness service. Between those two worlds, there was almost nowhere for a patient who wanted medically supervised, evidence-based hyperbaric care in a properly regulated clinical setting. That's the gap NUMA was built to close, rigorous assessment, physician oversight, multidisciplinary collaboration, and a standard of care I wasn't willing to compromise on.
Medicine has taught me that having access to a treatment was never the hard part. Knowing when to use it, when not to, how to adapt it to the individual in front of you, and how to deliver it safely - that's the job. It's what guides everything we do at NUMA.
“Medicine is never simply about having access to a treatment. It is about knowing when to use it, when not to, and how to deliver it safely.”
WHAT'S ACTUALLY HAPPENING INSIDE THE CHAMBER
Pressure changes how oxygen behaves in the body. Under it, far more oxygen dissolves directly into the bloodstream and reaches tissue that needs it. That increased availability helps modulate inflammation, supports the body's natural repair processes, promotes angiogenesis (new blood vessel growth), enhances immune function, and has been shown to stimulate stem cell mobilization.
None of that happens by accident, and none of it happens with any old set-up. These effects depend on patients breathing close to pure oxygen through approved delivery systems, at the correct pressure, for the correct duration. This is where I'd ask people to look closer at what they're actually being offered. Standard nasal cannulas and conventional hospital oxygen masks were never designed for use inside a hyperbaric chamber. Under pressure, they deliver oxygen less efficiently and in an oxygen-enriched environment, they can present a genuine fire risk. Medical-grade facilities use something called a Built-In Breathing System, or BIBS: a mask engineered specifically for hyperbaric use, allowing patients to breathe high concentrations of oxygen safely while managing exhaled gases appropriately. The chamber itself needs sophisticated pressure control technology to hold a stable treatment pressure throughout the session. If a facility is using standard nasal cannulas or ordinary oxygen masks inside the chamber, that should raise a question mark over both safety and clinical standard.
OXYGEN IS A DRUG
The rise of “oxygen chambers” in spas, wellness centres and for home use has created the impression that this is simply a wellness treatment. It isn't. Oxygen is a drug. Like any drug, it has indications, contraindications, dosing considerations and potential adverse effects. Hyperbaric oxygen therapy uses oxygen as a drug, delivered under pressure for a specific therapeutic effect. No responsible clinician would tell a patient to self-prescribe a potent medication at home, or to take it from someone unqualified to administer it. HBOT deserves the same standard. Safety depends on the clinical setting, a proper patient assessment, an accurate diagnosis, trained personnel, the right protocol, and medical oversight - every time. Every patient needs an individual assessment before treatment. Some have absolute or relative contraindications. Others need the protocol modified because of medical history, medication, age or an underlying condition. There is no single HBOT protocol that's appropriate, or safe, for everyone.
The technical side matters just as much. Medical HBOT uses delivery systems built specifically for hyperbaric medicine, within recognised clinical safety standards. Stepping into an “oxygen chamber” outside that environment shouldn't be expected to produce the same treatment, the same physiological effect, or the same outcome described in the research. It comes down to the technical integrity of the chamber, how it's built, how oxygen is delivered and monitored, how well it's calibrated and to the clinic enforcing protocol, including what patients are and aren't allowed to bring in with them. Medical oversight and technical standards go hand in hand. Neither can substitute for the other. A treatment is only as safe as its weakest link, so the equipment has to be built to the same standard as the medical care around it.
If you think HBOT might be right for you, the first step should always be a consultation with a physician trained in hyperbaric medicine, to work out whether it's indicated, and how it can be delivered safely. I'd strongly discourage anyone from seeking pressurised oxygen therapy at home, in a spa, or in a wellness centre as a substitute for that.
WHY THE “MINOR” SHORTCUTS AREN'T MINOR
I've written before about zip-style chambers, nasal cannula or basic mask delivery, and electronics being brought into chambers, and I want to be clear these are not minor technicalities. They are fundamental safety standards. Oxygen-enriched environments demand meticulous fire safety, because oxygen dramatically increases how quickly materials burn. That's why hyperbaric medicine has spent decades developing strict engineering and operational standards, covering everything from delivery systems and chamber design to clothing, materials and what's permitted inside.
Approved delivery systems aren't just about getting therapeutic oxygen concentrations to the patient — they're designed to limit unnecessary oxygen accumulation inside the chamber. Electronic and battery-powered devices are tightly controlled for the same reason: they're potential ignition sources. When I see people taking phones or laptops into oxygen-enriched chambers, or posting selfies from inside one, it concerns me deeply. These aren't arbitrary rules. They exist to protect patients.
The rise in serious incidents reported internationally doesn't mean HBOT itself is unsafe, quite the opposite. It has an excellent safety record when practised to recognised medical standards. What concerns me is what happens when those standards are ignored, misunderstood, or simply not regulated.
What goes wrong without them, practically speaking, starts with patients simply not receiving the treatment they believe they're getting. If oxygen isn't delivered at therapeutic concentration, or the protocol departs from what's used in clinical research, you shouldn't expect the same physiological effects or outcomes. The bigger issue is that HBOT was never one-size-fits-all. Before treatment, every patient should be screened for contraindications, medications, lung disease, cardiovascular conditions and anything else that could affect safety or protocol. Some patients shouldn't have HBOT at all. Others need the compression rate, oxygen exposure or monitoring adjusted. Without that assessment, complications can follow, ear or sinus barotrauma, oxygen toxicity, and in susceptible individuals, more serious events like seizure or pneumothorax (a collapsed lung).
I want to keep that in perspective: HBOT is an exceptionally safe treatment within recognised medical standards. The entire point of careful assessment, physician oversight and individualised protocols is to identify and minimise those risks before anyone enters the chamber.
WHAT GOOD GOVERNANCE ACTUALLY LOOKS LIKE
Proper medical governance starts before anyone enters the chamber. Every patient should be medically assessed to establish whether HBOT is appropriate, whether there are contraindications, and whether the protocol needs tailoring to them specifically. Treatment should be prescribed by a qualified physician, delivered by appropriately trained clinical staff, and carried out in a regulated clinical environment following recognised medical, engineering and safety standards. HBOT's excellent safety record exists because these standards have been developed and refined over decades. Followed properly, this is an exceptionally safe medical treatment.
WHAT TO ACTUALLY LOOK FOR - AND WHAT TO ASK
My advice is simple: don't start by looking at the chamber. Start by looking for the doctor.
Ask who is medically responsible for your treatment. Have you had a consultation with a qualified physician experienced in hyperbaric medicine? Have you been medically assessed before anyone suggests putting you in a chamber? If the answer is no, that's a significant red flag. If you're simply handed a waiver to sign before getting into a chamber, with no proper assessment, I'd walk away, as I would if patients are allowed to bring phones or laptops in, or if there's little visible attention to safety procedure.
Before booking, I'd ask directly: who is medically responsible for my treatment? Will I have a consultation with a doctor who has appropriate expertise before I'm treated? Will my medical history and medications be reviewed? Will the protocol be tailored to me, rather than identical for every patient? Is the clinic regulated, who supervises treatment, what training do the clinical staff have, and what are the emergency procedures? A reputable medical provider should answer all of that confidently and without hesitation.
And once you're in front of the chamber, someone should be actively monitoring you throughout, not pressing start and leaving the room. This is a medical treatment, never a self-service wellness experience. Patients should be continuously monitored by trained clinical staff, with immediate access to medical support if needed, and every session should follow established operating procedures. Before any of that, the consent process matters. Every patient should have a thorough medical assessment covering history, medications, previous surgeries, respiratory and cardiovascular health, and any contraindications — alongside an honest conversation about the evidence, the expected benefits, the risks, and whether treatment is right for that individual. If you're invited into a chamber without any meaningful assessment, that's a red flag. Good medicine starts with understanding the patient, not simply delivering the treatment.
I'd also pay attention to how a clinic markets itself. I get cautious whenever HBOT is presented as a universal solution, claims that it cures dozens of unrelated conditions, reverses ageing, detoxifies the body, or guarantees dramatic results. Medicine rarely deals in guarantees. Walk-in availability with no assessment is another flag. If a clinic spends more time talking about miracles than medicine, my advice is stay away.
“Don’t start by looking at the chamber. Start by looking for the doctor.”
THE REGULATORY GAP MOST PATIENTS DON'T KNOW ABOUT
This tends to surprise people: in the UK, hyperbaric oxygen therapy at up to 2.0 ATA isn't regulated as a distinct medical service. In practice, almost anyone can buy a chamber and start offering HBOT, without medical qualifications or specialist expertise. I think that's a significant gap in patient protection.
One of the biggest misconceptions I encounter is that “mild” hyperbaric oxygen therapy is inherently safer because it runs at a lower pressure. It isn't that simple. Safety comes from appropriate medical assessment, physician oversight, recognised safety standards and safe oxygen delivery - not from the number on the pressure gauge. What actually protects patients isn't a logo or a marketing claim. It's treatment delivered by qualified medical professionals, in a regulated clinical environment, using the right equipment, to recognised medical and safety standards.
I think patients deserve better and more consistent protection here. HBOT changes human physiology and has recognised indications and contraindications - it should sit within a physician-led clinical environment, following recognised clinical, regulatory and safety standards. Part of the problem is simply pace: the popularity of HBOT has outrun the regulatory framework around it. The technology became accessible faster than the standards governing who can provide it evolved. This isn't about restricting innovation or patient choice. It's about patients getting honest information so they can make an informed decision.
WHO THIS IS ACTUALLY FOR
HBOT has a number of well-established medical indications, recognised internationally by bodies including the Undersea and Hyperbaric Medical Society and the European Underwater and Baromedical Society, conditions with strong clinical evidence and established protocols behind them.
Beyond that, there's an expanding body of research looking at HBOT in traumatic brain injury, inflammatory bowel disease, neurological rehabilitation, post-surgical recovery, Long COVID and other conditions where inflammation, tissue repair or impaired healing play a role. Some of it is genuinely promising. It also remains evolving evidence, and I'm careful to say so.
My approach has always been that HBOT should complement standard medical care, not replace it. Where the evidence and physiological rationale support it, we use it as an adjunct alongside a patient's treating specialists, as part of a multidisciplinary approach. That's how we practise at NUMA.
Biologically, HBOT influences a number of processes involved in healing and regeneration: reducing inflammation, promoting angiogenesis, supporting stem cell mobilisation, enhancing neuroplasticity through increased brain-derived neurotrophic factor, and supporting tissue repair. Those effects are biologically plausible and increasingly supported by research. They should never be exaggerated or sold as a cure-all.
The same goes for healthy ageing. Ageing is complex, shaped by genetics, lifestyle, nutrition, exercise, sleep, mental wellbeing and much more. There is no single treatment that reverses it. If you want to optimise your long-term health, the foundations don't change: eat well, exercise regularly, maintain a healthy weight, don't smoke, limit alcohol, sleep well, look after your mental health. HBOT may have a role in supporting healthy ageing and regenerative processes for the right patient, but it's one part of a much bigger picture, not a replacement for a healthy lifestyle, and not a magic solution. To me, that honesty about what we know, what we don't yet know, and where HBOT genuinely adds value is what evidence-based regenerative medicine actually looks like.
WHY I'M SPEAKING OUT
The simple answer is patient safety. As a doctor, I feel a responsibility to say something whenever I see a medical treatment being misunderstood, or delivered outside the standards developed to keep patients safe. When I see people posting selfies inside oxygen-enriched chambers, using phones or other electronics inside them, or being treated with no medical supervision in an environment that seems to overlook basic safety principles, I genuinely worry.
I'm not speaking out because I think HBOT is the answer to everything. It's the opposite. I think it's an important medical treatment that deserves to be practised responsibly. My aim isn't to put patients off exploring it, it's to encourage them to seek it in the right clinical environment, where safety, medical expertise and evidence come first.
Beyond the physical risk, what concerns me most is something quieter: the erosion of trust. Trust is one of the foundations of medicine. Patients come to us often at their most vulnerable, living with chronic illness, recovering from injury, or out of options after conventional treatment. They deserve honest information to make an informed decision.
One of the most important parts of my job isn't deciding who should have hyperbaric oxygen therapy. It's deciding who shouldn't. At NUMA, we have difficult conversations every week with patients who are hoping HBOT will help them, where the evidence doesn't support it or it's unlikely to change their outcome. We have a responsibility to be honest, even when it isn't the answer someone was hoping for. Equally, some patients come to us believing they need HBOT when what they actually need is further investigation, standard care, or referral elsewhere and I regularly refer patients on to colleagues, because that's what good medical care demands. For others, HBOT may genuinely help, but only alongside conventional treatment, never in place of it.
If someone believes they're receiving evidence-based medical care when they're not, they can spend real time, money and emotional energy on treatment that's unlikely to help and, more importantly, delay the investigations or therapies that might. Even when nothing acutely goes wrong, that experience erodes confidence, not just in hyperbaric medicine but in healthcare more broadly. Patients should never have to guess whether they're receiving a medical treatment or a wellness service. That distinction should always be clear.
If HBOT is appropriate for your condition and delivered safely, to recognised standards, it can be an excellent adjunct to conventional care. If it isn't or those standards can't be met, I wouldn't compromise on safety. Go back to the foundations: exercise, nutrition, sleep, not smoking, limiting alcohol, and working closely with your healthcare team. Hyperbaric oxygen therapy has an important place in medicine. It should never be treated as a shortcut to health, or a replacement for good medical care.
THE WELL EDIT VIEW
What's striking about talking to Dr Ozyilmaz isn't the case against hyperbaric oxygen therapy - she isn't making one. It's the case for asking better questions before you get in the pod. In a landscape where wellness treatments are so often sold on the strength of the claim rather than the rigour behind it, “who is medically responsible for my care?” might be the most useful sentence in this entire piece.
Words by Dr Nur Ozyilmaz The Well Edit.
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