2026 Aesthetic Plastic Surgery RCT Human H₂ therapy Drinking (HRW)

2026 · Kuang — Exploratory Evaluation of Hydrogen-Rich Water Therapy for Keloid Management: A Double-Blinded Randomized Pilot Trial

Original title: Exploratory Evaluation of Hydrogen-Rich Water Therapy for Keloid Management: A Double-Blinded Randomized Pilot Trial

Super-Abstract

Hydrogen-rich drinking water relieved pain and itching in keloid patients and dampened inflammatory and scar-forming messengers. In a double-blind pilot RCT with 21 patients, VSS scar score and pigmentation fell significantly, the anti-inflammatory messenger IL-10 rose, while VEGF and TGF-β fell. (Aesthetic Plastic Surgery, 2026 — first clinical signals, exploratory.)

Classified as a RCT study using Drinking (HRW). See Methodology for how we grade evidence.

Commentary

Keloids are overgrown, often itchy and painful raised scars — hard to treat and strongly inflammation-driven. This Chinese group tested hydrogen-rich water (HRW) for them for the first time. Design: double-blind randomized pilot trial with 21 patients who were having a two-stage operation anyway; one group drank hydrogen-rich water, the other hydrogen-free water. Before and after the intervention, inflammatory and scar messengers were measured by Western blot, qPCR and ELISA. The results: significantly less frequent pain and itching, significantly lowered VSS (Vancouver Scar Scale) and pigmentation scores. At the molecular level the itch messenger TRPV1 and the keloid driver HIF-1α fell, the anti-inflammatory messenger IL-10 rose, while the inflammatory and vessel-forming factors VEGF and TGF-β fell. This fits cleanly into the anti-inflammatory profile of H₂. Honestly: exploratory pilot with only 21 patients — the authors themselves call it early clinical signals that justify larger studies, not proof of efficacy.

Key quotes

„Patients reported a significantly lower frequency of pain and pruritus after hydrogen-rich water therapy. The VSS and pigmentation domain scores significantly decreased after hydrogen-rich water therapy.“ — tangible and visible improvement of the scar
„Anti-inflammatory cytokine IL-10 levels significantly increased after hydrogen-rich water therapy, while inflammation-related cytokines VEGF and TGF-β levels significantly decreased.“ — the messenger shift toward less inflammation
„These findings represent an exploratory, double-blinded randomized pilot trial that provides early clinical signals supporting further large-scale investigation.“ — the authors' honest framing: early signal, not proof

Our assessment

Interesting for the skin/scar and anti-aging segment, because an unusual but clinically hard endpoint picture (scar score, messengers) is shown here. Mechanistically consistent with the anti-inflammatory H₂ effect. Limitation, stated honestly: very small sample (n = 21), exploratory pilot — the authors themselves classify it as early signals. Evidence level 2. No basis for treatment promises; but valuable as a scientifically exciting data point for an unusual indication.

Study design

Type: double-blind randomized pilot RCT · n: 21 (keloid patients with two-stage surgery) · Duration: before/after intervention between the surgical stages · H₂ delivery: hydrogen-rich drinking water (HRW) vs. hydrogen-free water
Result figures: significantly less pain/itching; VSS and pigmentation score significantly ↓; TRPV1 and HIF-1α ↓; IL-10 ↑; VEGF and TGF-β ↓ (all reported as significant)

Abstract

BACKGROUND: Clinical or experimental trials have shown that hydrogen-rich water has anti-inflammatory properties, but its use for keloids has not been studied. This research explores HRW's therapeutic potential and mechanism for keloid treatment. METHODS: 21 keloid patients scheduled for two-stage operations were randomly divided into the HRW treatment group (HRW group) and the control group (Con group). The HRW group received hydrogen in their drinking water, while the Con group drank hydrogen-free water. Clinical information was collected. Cytokines related to inflammation, keloid formation, and symptoms were measured using western blotting (WB), qPCR, and ELISA before and after the interventions. RESULTS: Patients reported a significantly lower frequency of pain and pruritus after hydrogen-rich water therapy. The VSS and pigmentation domain scores significantly decreased after hydrogen-rich water therapy. WB and qPCR results showed a significant decrease in the expression of pruritus-related cytokine TRPV1 and keloid-related cytokine HIF-1α after hydrogen-rich water therapy. Anti-inflammatory cytokine IL-10 levels significantly increased after hydrogen-rich water therapy, while inflammation-related cytokines VEGF and TGF-β levels significantly decreased. CONCLUSIONS: Hydrogen-rich water therapy appears to be a safe and promising approach for symptom relief and inflammation modulation in keloid patients. These findings represent an exploratory, double-blinded randomized pilot trial that provides early clinical signals supporting further large-scale investigation. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Source & links

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