Cold atmospheric plasma is a real, fast-growing research field — and almost none of it has been tested in people. Here is the whole literature, sorted by what the evidence actually supports.
CAP research has grown roughly seventy-fold since 2005. But growth in papers is not growth in proof. When you filter the corpus down to studies that put a plasma device on an actual human being and compared it against something, the field collapses to a few dozen studies — and they cluster almost entirely in one application.
Under 50 papers a year until 2014. Over 750 in 2025. The inflection is real — but it is an inflection in laboratory output, not in clinical validation. Published human trials have run at a steady 2–4 per year throughout the boom.
If you picture CAP as a skin-and-wellness technology, the literature will surprise you. The two largest blocks by far are killing microbes and treating food and crops. Human-facing therapeutic areas — wounds, skin, dentistry, pain — are a minority of the field combined.
The bulk of the CAP literature is not about the human body at all. It is about sterilising equipment, extending the shelf life of food, and modifying the surfaces of implants and polymers. Citing "over 4,000 studies" without saying which slice you mean is technically true and practically misleading — most of those studies treated a petri dish, a strawberry, or a titanium disc.
Not all CAP claims sit at the same level of proof, and the gap between the strongest and the weakest is enormous. These four tiers are the honest sorting.
This is the one application where CAP has crossed from promising to demonstrated. Multiple independent randomised controlled trials, pooled by more than one team, agree on direction and magnitude — and the safety record is consistently clean across sixteen years.
Corroborated by a 2025 meta-analysis in Clinical Laboratory (12 studies, 448 patients, 43% greater relative wound-area reduction) and a 2025 International Wound Journal systematic review of 4 RCTs in diabetic foot ulcers, which reported no adverse effects or safety concerns in any included trial.
The honest caveat the authors themselves insist on: significant heterogeneity between studies, small trials, short follow-up, and no standardised protocol. Every one of these reviews ends by asking for larger trials with agreed parameters.
Huge and consistent laboratory evidence, thin but growing clinical evidence. A 2026 systematic review of MRSA biofilms found every one of 17 in-vitro studies reported a reduction, ranging from 1 to over 6 log₁₀ CFU, with near-complete eradication within minutes in several — but all of it in vitro, none in patients.
Dentistry has systematic reviews on root-canal disinfection, implant decontamination and dentin bonding, mostly pooling laboratory work. The clinical question is being tested right now: two 220-patient trials are recruiting for acne vulgaris and tinea pedis, and a 26-patient peri-implantitis trial began in February 2026.
Treat this tier as plausible and being tested — not as settled.
747 papers on CAP and cancer. Zero completed randomised human efficacy trials. The mechanistic work is genuinely interesting — a 2026 study in Free Radical Biology and Medicine traced plasma-activated medium killing lung-cancer cells through a lysosome-to-mitochondria calcium pathway — but this is cell and mouse work, and the mechanism it describes is mitochondrial collapse and cell death. Two early human studies exist: five patients with peritoneal tumours, and a thirty-patient intra-operative breast-cancer study, both recruiting.
A 2026 systematic review asked directly whether CAP is selective for breast tumour cells and concluded there is a tendency toward partial selectivity — but that protocol heterogeneity was so severe that the planned meta-analysis could not be performed at all.
Protein and anti-ageing effects sit here too. A September 2026 RSC Advances paper showed argon plasma restructuring elastin and fragmenting glycation products — in a test tube, on purified protein, with the authors noting their material "may not fully represent the native elastin modification" found in real tissue.
These phrases appear in consumer marketing around plasma devices. They do not appear in the peer-reviewed CAP literature, and nothing in these 4,846 papers supports them.
All 37 controlled human and veterinary trials indexed in Europe PMC, 2010 to September 2026. This is the complete clinical record — you can read the whole thing in an afternoon, and roughly half of it is free.
| Year | Study | Journal | Access |
|---|---|---|---|
| 2026 | Cold plasma surface activation on early dental implant stability — randomised | BMC Oral Health | Paywall |
| 2026 | Plasma-activated water as a wound rinse in diabetes-related foot ulcers, two Australian hospitals | BMJ Open | Free |
| 2026 | Single CAP therapy for canine otitis externa with secondary infection | Veterinary Dermatology | Free Vet |
| 2025 | CAP in pyoderma gangrenosum — pilot study | Journal of Wound Care | Paywall |
| 2025 | Chronic wounds treated with cold plasma — randomised, single-blind, placebo-controlled | Journal of Wound Care | Paywall |
| 2025 | Direct CAP once or twice weekly on chronic wounds — RCT | Advances in Wound Care | Free |
| 2025 | Soft-tissue response to titanium healing abutments, Er:YAG laser vs plasma spray — RCT | Clin Implant Dent Relat Res | Paywall |
| 2024 | CAP for Malassezia folliculitis — lab work plus randomised clinical trial | Skin Research & Technology | Free |
| 2024 | Nebulised plasma-activated water in moderate COVID-19 after antiviral failure | BMC Infectious Diseases | Free |
| 2023 | CAP for actinic keratosis — prospective randomised controlled pilot | Skin Pharmacol Physiol | Free |
| 2022 | Cold atmospheric-pressure plasma for striae distensae | J Cosmetic Dermatology | Paywall |
| 2022 | Cold atmospheric-pressure plasma for keloid — randomised | J Cosmetic Dermatology | Paywall |
| 2022 | Growth-factor expression in chronic diabetic wounds treated by CAP | Diabetic Medicine | Paywall |
| 2022 | Plasma-activated water spray for vaginal cleaning in bacterial vaginosis — human trial | Medical Sciences (Basel) | Free |
| 2022 | Non-thermal nitrogen plasma vs long-pulsed Nd:YAG laser for hand rejuvenation | Lasers in Medical Science | Paywall |
| 2021 | CAP device in atopic dermatitis — prospective comparative clinical pilot | Scientific Reports | Free |
| 2021 | CAP wound dressing for split-skin-graft donor sites | Skin Pharmacol Physiol | Paywall |
| 2021 | Antibacterial and safety tests of a flexible CAP device for wound healing | Appl Microbiol Biotechnol | Free |
| 2021 | Atmospheric-pressure plasma in diabetic ulcer healing — randomised clinical trial | Dermatologic Therapy | Paywall |
| 2020 | CAP effect on bacterial contamination and healing tendency of chronic wounds — pilot | J Dtsch Dermatol Ges | Paywall |
| 2020 | CAP as an effective method to treat diabetic foot ulcers — randomised clinical trial | Scientific Reports | Free |
| 2020 | CAP therapy vs standard therapy placebo on wound healing in diabetic foot ulcers | JAMA Network Open | Free |
| 2020 | CAP vs diclofenac 3% gel in actinic keratoses — prospective randomised | JEADV | Paywall |
| 2020 | Tolerability of six months indirect cold physical plasma on the scalp for hair loss | J Drugs in Dermatology | Paywall |
| 2019 | Polyhexanide vs CAP vs saline in canine bite wounds | J Small Animal Practice | Paywall Vet |
| 2017 | CAP for wound-healing disorders of radial forearm free-flap donor sites — proof of concept | J Oral Maxillofac Surg | Paywall |
| 2017 | Direct CAP on microcirculation of intact skin in a controlled mechanical environment | Microcirculation | Free |
| 2016 | Improvement of cutaneous microcirculation by CAP — controlled prospective cohort | Microvascular Research | Paywall |
| 2016 | Repetitive non-thermal dielectric barrier discharge plasma boosts cutaneous microcirculation | Microvascular Research | Paywall |
| 2015 | Chronic venous leg ulcers with a hand-held DBD plasma generator (PlasmaDerm) | JEADV | Paywall |
| 2015 | Cold atmospheric-pressure argon plasma in chronic leg ulcers — pilot | Journal of Wound Care | Paywall |
| 2013 | Cold atmospheric argon plasma on skin-graft donor sites — randomised placebo-controlled pilot | Wound Repair & Regeneration | Paywall |
| 2013 | Atmospheric non-thermal argon plasma — randomised two-sided placebo-controlled study | JEADV | Paywall |
| 2012 | Electron spectroscopic analysis of the human lipid skin barrier after CAP | Experimental Dermatology | Paywall |
| 2012 | Cold plasma is well tolerated and does not disturb skin barrier or reduce skin moisture | J Dtsch Dermatol Ges | Paywall |
| 2012 | Two-minute cold atmospheric argon plasma in chronic wounds — RCT | British J Dermatology | Paywall |
| 2010 | First prospective RCT to decrease bacterial load using cold atmospheric argon plasma on chronic wounds | British J Dermatology | Paywall |
Four papers landed in the first week of September 2026. None of them is a clinical breakthrough. One of them is quietly the most useful paper the field has produced this year.
Native soluble elastin formed long fibrils under argon CAP; glycated elastin fragmented, especially at seven minutes. Carbonyl content more than doubled in the glycated samples, confirming oxidation.
Our read: real and interesting, but purified protein in a tube — no cells, no skin, no people. The authors say their material may not represent elastin in living tissue. This is not evidence that plasma reverses skin ageing.
A wide review linking plasma parameters to biological outcomes, which concludes that the absence of standardised parameters and dosimetry is "the single most significant research gap" and "the principal barrier" to clinical translation.
Our read: the most useful paper of the four. It gives the field a checklist — discharge power, voltage, frequency, gas, duration, distance, reactor configuration — and it also warns that uncontrolled reactive species may cause oxidative stress and genotoxicity in healthy tissue.
A review of 2015–2026 work on permittivity, conductivity, membrane capacitance, polarisability and surface charge as label-free markers of cell state.
Our read: this is what real bioelectricity looks like — measurable, instrumented, specific. It supports none of the consumer claims about restoring a body's electrical field. Abstract only; we have not read the full text.
Plasma-activated medium coupled lysosomal TRPML1 to mitochondrial VDAC1, causing calcium overload, membrane depolarisation, cytochrome-c release and death in lung-cancer cells and animal models.
Our read: the clearest available correction to "plasma charges your mitochondria." Here plasma chemistry collapsed mitochondrial membrane potential — deliberately, as an anti-cancer strategy. Abstract only; we have not read the full text.
A separate 2026 meta-analysis in Redox Biology analysed 400+ studies and mapped five control parameters — frequency, flow rate, voltage, processing time and gas composition — against biological outcome. Its central finding is that CAP is hormetic and biphasic: low-to-moderate doses activate antioxidant defences and protect cells, while moderate-to-high doses cause oxidative cytotoxicity and kill them. Same device, opposite effect, dose decides. It is free to read, and it is the single most important idea in the field right now.
52 CAP trials are registered on ClinicalTrials.gov; 23 are active. For the first time the field is attempting studies large enough to settle something — including two with combined enrolment of 1,800 patients.
| Start | Trial | Indication | N | Status |
|---|---|---|---|---|
| 2026-11 | Intraoperative CAP to prevent postoperative wound complications | Peripheral occlusive disease | 214 | Not yet recruiting |
| 2026-05 | Plasma Therapy for Diverse Wounds | Wound care | 1,000 | Not yet recruiting |
| 2026-05 | Plasma Therapy for Scar Management | Wound healing | 800 | Not yet recruiting |
| 2026-04 | PAW-Hydrogel for Chronic Wound Healing | Diabetic foot & pressure ulcers | 50 | Recruiting |
| 2026-03 | Non-thermal plasma to reduce recurrence in chronic subdural haematoma | Subdural haematoma | 40 | Recruiting |
| 2026-02 | AmbiJet system for peri-implantitis | Peri-implant mucositis | 26 | Recruiting |
| 2025-11 | CAP vs standard wound care in diabetic foot and venous leg ulcers | DFU & venous leg ulcer | 494 | Not yet recruiting |
| 2025-07 | CAP for moderate-to-severe acne vulgaris | Acne vulgaris | 220 | Recruiting |
| 2025-07 | Atmospheric-pressure cold plasma for moderate-to-severe tinea pedis | Tinea pedis | 220 | Recruiting |
| 2025-04 | Breast Cancer Plasma Adjuvant Intra-operative Treatment (PAINT) | Breast cancer | 30 | Recruiting |
| 2025-12 | Bladder perfusion of plasma-activated saline | Bladder cancer | 5 | Not yet recruiting |
| 2024-07 | Long-term consumption of plasma-activated water in fibromyalgia | Fibromyalgia | 80 | Recruiting |
Cold Plasma Research Library. An independent survey of the published literature on cold atmospheric plasma, compiled from Europe PMC and ClinicalTrials.gov in September 2026. Every figure is sourced and checkable.
These pages describe published research on a technology. They do not describe or endorse any product, they are not medical advice, and nothing in them should be used to make a decision about treating a health condition. Speak to a qualified clinician about anything that matters.