The body is not a collection of isolated systems. Inflammation affects circulation. Poor circulation affects hormone delivery. Chronic stress affects recovery. Recovery affects everything else. Which is why the most effective approach to supporting the body often is not one therapy at a time but several working in the same direction simultaneously.
HOCATT was designed around that idea. It stands for Hyperthermic Ozone and Carbonic Acid Transdermal Technology, and it delivers multiple therapeutic modalities in a single, approximately 30-minute session. At Valley Vital Medicine in Fargo, ND, it has become one of the tools we reach for most often when we are working with patients on inflammation, recovery, nervous system support, and whole-body optimization.
Here is what it is, how the science behind it works, and who it may be the right fit for.
What Happens Inside a HOCATT Session
The HOCATT is an enclosed pod that the patient sits inside from the neck down, with the head remaining outside throughout the session. Over approximately 30 minutes, the system moves through a carefully sequenced combination of therapies that can be adjusted to each patient’s protocol.
A session begins with carbonic acid. Carbon dioxide introduced into the chamber reacts with steam to form carbonic acid, which has a vasodilatory effect on blood vessels near the skin’s surface. The result is improved circulation, a warming of the skin, and increased permeability of the skin barrier, which prepares the body for optimal absorption of what follows.
Transdermal ozone is then delivered into the chamber. Because the head remains outside, ozone is absorbed through the skin rather than inhaled, allowing for systemic exposure without respiratory irritation. This is a meaningful distinction. Ozone absorbed transdermally activates the body’s antioxidant defense systems, modulates inflammatory signaling pathways, and has been shown in multiple studies to reduce key inflammatory markers including CRP and IL-1B.
Far infrared heat and whole-body hyperthermia maintain sustained warmth throughout the session. This form of heat stress activates heat shock proteins, supports circulation, and promotes sweating as part of the body’s natural detoxification processes through the skin.
Pulsed electromagnetic field therapy (PEMF), photon light, and microcurrent technology round out the session. PEMF uses low-frequency electromagnetic pulses to support cellular energy production and tissue recovery. Photon light supports mitochondrial function and skin health. Microcurrent therapy has documented effects on pain modulation and cellular repair.
Each of these modalities has its own evidence base. What makes HOCATT distinct is the sequencing. The carbonic acid and heat phase opens the skin and supports circulation before ozone is introduced, which means the ozone is being delivered into a body that is already primed to receive it. The therapies are not simply stacked; they build on each other. This is sometimes called bio-stacking, and it is the core design principle of the system.
What the Research Shows
The most rigorous peer-reviewed study specifically examining the HOCATT machine was published in the American Journal of Reproductive Immunology in 2023 by Merhi and colleagues. The study looked at women with endometriosis, a chronic pelvic inflammatory condition in which standard treatments leave a significant percentage of patients still symptomatic.
In the first part of the study, eight women with endometriosis received transdermal ozone sauna therapy combined with PEMF via the HOCATT machine twice a week for three weeks, for a total of six sessions. Pain scores improved significantly beginning after the fourth session.
In the second part, ten women received the same protocol to measure changes in serum inflammatory markers. After the three-week course, CRP declined significantly (p = .0438) and IL-1B declined significantly as well (p = .0031).
The study’s authors concluded that the combination of ozone sauna therapy and PEMF via the HOCATT machine may represent a meaningful complementary therapeutic option for women with inflammatory conditions, while calling for larger randomized controlled trials. The sample size is small and the study is a pilot, which means findings should be interpreted with appropriate caution. But the results are consistent with the broader evidence on ozone’s anti-inflammatory mechanisms, and this is one of the only published studies to use the HOCATT device specifically, rather than ozone or PEMF in isolation.
That evidence base for the individual components is meaningful in its own right. The January 2026 psoriasis study in the Journal of Clinical Medicine found that major ozone autohemotherapy, another form of systemic ozone delivery we also use at the clinic, produced significant reductions in both CRP and Siglec-14 after eight to ten sessions in psoriasis patients. Far infrared sauna research has documented effects on cardiovascular function, cortisol, and muscle recovery. PEMF research spans bone healing, pain management, and cellular energy. The HOCATT brings these together in one session with a sequencing approach designed to maximize their combined effect.
Who HOCATT May Help
At Valley Vital Medicine, HOCATT sessions are used as a complementary tool within personalized care plans. Patients who have seen the most benefit include those working on chronic inflammation or inflammatory conditions, recovery from illness or injury, immune dysfunction, fatigue and low energy, nervous system dysregulation, skin conditions including psoriasis and eczema, hormonal transitions including perimenopause and menopause, cardiovascular wellness as part of a broader prevention strategy, and athletic performance and recovery.
It is also used alongside hormone optimization, ozone IV therapy, peptide therapy, procaine IV therapy, and other integrative interventions at the clinic. These therapies tend to work in the same direction, and the synergies are real. Patients who are doing the foundational work often find that consistent HOCATT sessions amplify their results.
HOCATT is not a treatment for any specific condition. It is not a replacement for medical evaluation or conventional care. At Valley Vital Medicine it is always part of a larger, individualized plan.
What to Expect
The session itself is straightforward. You sit inside the pod from the neck down while your head remains free and comfortable outside the chamber. The warmth builds gradually. Most patients describe the experience as deeply relaxing, with the combination of heat, ozone, and steam producing a calm that often extends well into the hours after the session ends.
Sessions are monitored by our trained clinical staff throughout. The modality combination and intensity can be adjusted based on your goals and how you are responding over time. For most patients, the recommendation is a series of consistent sessions rather than a single visit, because the cumulative effects of repeated therapeutic stimulation are where the most meaningful outcomes tend to develop.
Getting Started
If you are a current Valley Vital Medicine patient and are curious whether HOCATT belongs in your care plan, reach out to Trevor or Kali Boyer, FNP-C, through the patient portal. If you are new to the clinic, a free discovery call with our certified health coach Lori is the right first step.
Call 701-532-1926 or visit
www.valleyvitalmedicine.com/contact-us to schedule your discovery call and learn whether HOCATT is a fit for what you are working on.
Medical Disclaimer: The information in this article is for educational purposes only and does not constitute medical advice. HOCATT is not FDA-approved as a treatment for any specific condition and should be used as a complementary therapy under professional guidance. Always consult a qualified healthcare provider before beginning any new therapy.
References:
- Merhi Z, Emdin D, Bosman L, Incledon T, Smith AH. Ozone Sauna Therapy (OST) and Pulsed Electromagnetic Field Therapy (PEMF) delivered via the HOCATT machine could improve endometriosis pain along with lowering serum inflammatory markers. Am J Reprod Immunol. 2023 Apr;89(4):e13690. doi:10.1111/aji.13690.
- Soylu S, Sensoy N, Dogan N, Koca HB, Koken T. Evaluation of major autohemotherapy (MAH) in psoriasis patients using serum inflammatory markers. J Clin Med. 2026;15(2):485. doi:10.3390/jcm15020485.
- Viebahn-Haensler R, Leon Fernandez OS. Ozone in medicine: The low-dose ozone concept and its basic biochemical mechanisms of action in chronic inflammatory diseases. Int J Mol Sci. 2021;22(15):7890.
- Liu L, Zeng L, Gao L, Zeng J, Lu J. Ozone therapy for skin diseases: Cellular and molecular mechanisms. Int Wound J. 2023;20(6):2376-2385.
