Who should not do HBOT: contraindications explained
Hyperbaric oxygen therapy is well tolerated by most people, but not by everyone. That's why every session should start with a health screening. Here are the main reasons a provider might ask you to wait or to get medical clearance first.
The one absolute "no"
An untreated collapsed lung (pneumothorax). Air trapped in the chest can expand dangerously when the chamber depressurizes. HBOT should not be done until it has been treated.
Medications that need a doctor's input
Some drugs interact with high-oxygen environments. They include certain chemotherapy drugs (such as bleomycin, doxorubicin and cisplatin), disulfiram (used for alcohol dependence) and mafenide acetate (a burn cream). If you take any of these, now or recently, your doctor needs to weigh in.
Always give your provider a full list of your medications.
Conditions that need caution or clearance
Your provider may ask for a note from your doctor, or advise against HBOT, if you have:
- Lung disease, such as COPD with air trapping or a history of collapsed lung, or lung cysts or bullae
- A cold, sinus infection or congestion (wait until it clears)
- Ear problems, including recent ear surgery or trouble equalizing
- A seizure disorder, since high oxygen levels can, rarely, trigger seizures
- High fever, which can raise seizure risk
- Uncontrolled high blood pressure or certain heart conditions
- Pregnancy
- Implanted devices such as pacemakers, neurostimulators or pumps, which must be rated for pressure
- Significant claustrophobia
- Recent eye surgery, or certain eye conditions
- Recent scuba diving or flying, depending on timing
Why this matters
Most of these aren't about the oxygen being harmful in itself. They're about how pressure changes affect air spaces in the body (ears, sinuses, lungs) and how high oxygen levels interact with certain conditions and drugs.
What a good screening looks like
You should be asked about your health history, current illnesses, medications and devices before your first session, and asked to update it if anything changes. If a provider doesn't ask, treat that as a warning sign.
When in doubt, talk to your doctor before you book. See also HBOT side effects and safety.