Key Takeaway
Systematic review finds balneotherapy with thermal mineral waters improves symptoms of psoriasis, atopic dermatitis, and chronic eczema, with sulfurous and bicarbonate-rich waters showing the most consistent dermatological benefits.
Summary
This systematic review examined the evidence for balneotherapy using thermal mineral water baths in the management of dermatological diseases. The authors conducted a comprehensive literature search and included studies evaluating the effects of immersion in natural mineral waters on various skin conditions.
The review found favorable evidence for balneotherapy in psoriasis, atopic dermatitis, and chronic eczema. Sulfurous waters demonstrated the strongest evidence for psoriasis, with studies reporting reductions in PASI scores and improvements in skin lesion severity. Bicarbonate-sulfate waters showed benefits for atopic dermatitis, with improvements in itch intensity, skin hydration, and disease severity indices. The mineral composition of the water appeared to be a key factor, with different water types showing preferential effects on different skin conditions.
The authors noted that proposed mechanisms include anti-inflammatory effects of sulfur compounds, modulation of skin microbiome, improvement of skin barrier function, and immunomodulatory properties of trace minerals. While the evidence is promising, the review highlighted limitations including small sample sizes, heterogeneous protocols, and the difficulty of blinding in balneotherapy studies. Overall, the findings support balneotherapy as a complementary treatment option for chronic inflammatory skin diseases.