Derived from the Latin word balneum meaning bath, balneotherapy (sometimes referred to as water therapy or spa therapy) involves the immersion of patients in thermal or mineral waters for the treatment of various illnesses (psoriasis being one of the major illnesses). This form of therapy goes back to early civilisation and has rapidly evolved into the use of mud packs, saunas and steam baths, physical exercises, inhalation of water vapour, and drinking mineral water; all these come under the general name of balneotherapy [1].

The process involves particular types of water, which have healing properties; these include, sulphur springs and concentrated salty water, such as found at the Dead Sea. Hot springs, which are high in Radon (a radioactive substance) are also said to possess particular healing properties.

Mineral waters
Mineral waters are natural solutions, which are formed under specific geologic conditions and characterised by what is known as chemico-physical dynamism. Originating in springs, they are bacteriologically pure and have a therapeutic potential. In recent times, thousands of health resort areas have developed around hot springs, and each spa resort is differentiated according to location (sea side or mountain area) and the chemical composition of their mineralised water. Mineral waters may be classified in many ways according to their distinctive chemical and physical elements, such as temperature, molecular concentration, chemical composition, and mechanism of therapeutic action. Spa waters can be said to be salty, sulphurous, carbonic, arsenical, bicarbonated, sulphated, and ferruginous based on their chemical content. Water temperature is described as being cold (<20°C), hypothermal (20°C-30°C), thermal (>30°C-40°C), or hyperthermal (>40°C). According to Matz et al (2003) the waters used to treat dermatologic disorders have varying chemical and physical properties, but are generally rich in sulphur, hydrogen sulphide, and sulphates [2].

Dead Sea salts
The waters of the Dead Sea have been renowned for their therapeutic effects since ancient times. They are unique in that they contain 27% of various salts as compared to 3% in normal sea water. In addition, while sodium accounts for approximately 80% of the salt content of normal sea water, it comprises much less of the salt total in water from the Dead Sea. The balance of the salts in Dead Sea water is magnesium, potassium, calcium chloride and bromides [3].

The main question therefore is: Why are these types of salts beneficial? Here’s why…
1. Magnesium is important for combating stress and fluid retention, slowing skin aging and calming the nervous system.
2. Calcium is effective at preventing water retention, increasing circulation and strengthening bones and nails.
3. Potassium energises the body, helps to balance skin moisture and is a crucial mineral to replenish following intense exercise.
4. Bromides act to ease muscle stiffness and relax muscles.
5. Sodium is important for the lymphatic fluid balance (this in turn is important for immune system function).
All of these help indicate that bathing in high quality sea salt could replenish the minerals which are critical to our skin metabolism [3]. `
Since ancient times the beneficial effects of the Dead Sea Salts on the skin and their unique therapeutic and beautifying powers have been recognised. This recognition was such that Cleopatra, who was considered the most beautiful woman in the world, went to great expense to obtain exclusive rights over the Dead Sea area, and at her command, pharmaceutical and cosmetic factories were built near the Dead Sea. Their remains can still be seen at Ein Bokek and Ein Gedi till date. Based on the beneficial effects of Dead Sea salts, a number of spa resorts the world over make use of Dead Sea bath salts for balneotherapeutic treatments [4].

How does balneotherapy heal?
SaltWorks lists eight ways in which balneotherapy heals,
1. Bathing in hot springs gradually increases the temperature of the body, thus killing harmful germs and viruses.
2. Thermal bathing increases hydrostatic pressure on the body, thus increasing blood circulation and cell oxygenation. The increase in blood flow also helps dissolve and eliminate toxins from the body.
3. Hot springs bathing increases the flow of oxygen-rich blood throughout the body, bringing improved nourishment to vital organs and tissues.
4. Bathing in thermal water increases body metabolism, including stimulating the secretions of the intestinal tract and the liver, aiding digestion.
5. Repeated hot springs bathing (especially over 3- to 4- week period) can help normalize the functions of the endocrine glands as well as the functioning of the body's autonomic nervous system.
6. Trace amounts of minerals such as carbon dioxide, sulphur, calcium, magnesium, and lithium are absorbed by the body and provide healing effects to various body organs and system. These healing effects can include stimulation of the immune system, leading to enhanced immunity; physical and mental relaxation; the production of endorphins; and normalized gland function.
7. Mineral springs contain high amounts of negative ions, which can help promote feelings of physical and psychological well-being.
8. The direct application of mineralised thermal waters (especially those containing sulphur) can have a therapeutic effect on diseases of the skin, including psoriasis, dermatitis, and fungal infections. Some mineral waters are also used to help the healing of wounds and other skin injuries.
(Taken from http://www.saltworks.us/salt_info/si_Balneotherapy.asp)

Medical conditions exempt from balneotherapy
Individuals suffering from certain conditions may be exempt from balneotherapy. These include acute alcoholic states, epilepsy, psychiatric conditions, severe varicose veins, hypersensitivity to mineral water, open wounds, inadequate balance, and cardiac dysrhythmias [1]. Such patients need to consult their physician before attempting to go ahead with balneotherapy. Hot baths can also be dangerous for pregnant women and young children, and as such proper advice needs to be sought.

Balneophototherapy
Balneophototherapy uses a combination of balneotherapy and light therapy to recreate elements of the Dead Sea therapy (See the article on Climatotherapy). At the Dead Sea, patients are typically exposed to natural sunlight after a deep in the magnesium-rich waters. With balneophototherapy, Dead Sea salts or highly concentrated salt water are used to prepare baths for patients, after which they are exposed to Narrowband Ultraviolet B (UVB) [5].

Many patients generally receive between 15 and 25 treatments of balneophototherapy in order to achieve 80 to 85% clearance of skin lesions. Remission may vary based on factors such as environmental conditions, stress levels and the severity of the disease. A number of patients choose to maintain their remissions by visiting their chosen spas once or twice a week [5].

Mavena Derma Center in the United States offers balneophototherapy by combining a magnesium-rich Dead Sea salt whirlpool soak followed by a narrow-band UVB phototherapy. Other Mavena Centers exist in Switzerland and Germany.

Balneophototherapy helps eliminate the need for costly medications that require extensive monitoring or pose a long-term risk to patients. As such, potential side effects resulting from current therapies may be avoided, thereby improving quality of life for patients.

Useful links
SaltWorks (Salt information)
http://www.saltworks.us/salt_info/si_Balneotherapy.asp

References
1. Nasermoaddeli A, Kagamimori S. Balneotherapy in Medicine: A Review. Environ Health Prev Med 2005; 10: 171-179.
2. Matz H, Orion E, Wolf R. Balneotherapy in dermatology. Dermatol Therapy 2003; 16: 132-140
3. Salt information. The benefit of Dead Sea salts. Available via: http://www.saltworks.us/salt_info/si_DeadSeaSalt_Benefits.asp. Accessed on: 26 July 2007.
4. Salt information. Dead Sea Salt Bathing. Available via: http://www.saltworks.us/salt_info/si_DeadSeaSaltBathing.asp. Accessed on: 26 July 2007.
5. Mikula C. Balneo-phototherapy: A New Holistic Approach To Treating Psoriasis. J Am Acad Nurse Prac 2003; 15 (6): 253-259.

Disclaimer

This article is only for informative purposes. It is not intended to be a medical advice and is not a substitute for professional medical advice. Please consult your doctor for all your medical concerns. Kindly follow any information given in this article only after consulting your doctor or qualified medical professional. The author is not liable for any outcome or damage resulting from any information obtained from this article.

Author's Bio: 

BSc (Hons) Pharmacology MSc. Pharmaceutical Science with Management Studies