Soaking up the sun’s rays and listening to the waves wash upon the shore. Not so bad for treatment, right? But, does it work? It sure does! For most psoriasis sufferers a destination including salt or thermal waters and sun offers much needed relief.
Balneophototherapy is the combination of salt or spring water soaks and ultraviolet light exposure. Some hospitals and dermatologic clinics offer balneotherapy (salt water soaks) during or prior to receiving UV therapy.
Despite evidence that balneophototherapy is beneficial and often results in complete clearing and remission of psoriasis we still do not fully understand the mechanism by which this therapy works. Likely a combination of immunologic, neurologic, mechanical, chemical and thermal effects synergistically act to induce therapeutic benefit.
One interesting avenue of research to tune into is that of the skin’s microbiome. Medical scientists are beginning to unveil the importance of the skin’s microbiome for the maintenance of healthy skin as well as in understanding skin diseases.
A study published in 2015 showed that patients with psoriasis have poor bacterial diversity on their skin, essentially an unhealthy microbiome. This same study showed that after 3 weeks of soaking in selenium-rich water patients had a significant reduction in psoriasis severity while 8% of patients were completely clear. The patients also had an increase in a particular bacterial species that is found on healthy skin and known to cause the death of keratinocytes. (Keratinocytes are the cells responsible for the psoriatic lesion and divide up to 1000 times the normal rate— cell death in this case is good!). Balneotherapy improved the skin’s microbiome in patients with psoriasis and as a result diminished disease severity.
Further evidence points to enhanced UV transmission and sensitivity following balneotherapy likely as a result of desquamation (the loss of scale and thickness of the lesions). Another hypothesis is that bathing in salt water results in the loss of a specific enzyme that perpetuates the disease process and with this reduction improvement follows. Balneotherapy has also been shown to effect the amount of various signaling proteins that play a role in the disease process of psoriasis.
One study that I find to be of significant value showed that patients with psoriasis who underwent balneophototherapy or balneotherapy alone had improved measurements in quality of life (emotional status, symptoms and functioning). If feeling better is your goal then balneotherapy may be something to consider!
Psoriasis sufferers have been making pilgrimages to healing waters for millennia. Hot springs, ocean water, the dead sea and high percentage salt baths each have different compositions with varying types and percentages of salts and minerals. Yet, they each are used to help clear psoriasis.
Some of the more well-known destinations for spa therapy include the Blue Lagoon in Iceland, the Dead Sea in Israel, Soap Lake in central Washington and Kangal Hot Springs in Turkey.
However, healing waters exist almost everywhere and expensive destinations are not always necessary. The San Francisco Bay Area, my home, has several hot spring destinations that I have frequented over the years. One of my fondest memories of childhood is soaking in the spas in Calistoga. Not only did the soaks have a significant healing effect on my skin but they also provided a meaningful time for reflection and peace.
Ask around if you’re not already familiar with your area and I suspect there is a perfect destination close to your own home.
It’s important to remember that although the sun can be healing for your skin too much sun can be dangerous. Be careful and know your limit. A sunburn can actually cause your psoriasis to flare as well as increase your risk for the development of skin cancer. The most effective and safe way to use the sun as a healing tool is in small, regular doses. Check with your doctor, determine your skin type and get a prescription for the length of time that you should expose your skin.
Bathing in salt or mineral waters is safe, however, you may loose track of time and not realize that you are also getting a significant amount of sun exposure. Be mindful such that you achieve the results you want— a therapeutic experience for you and for your skin.
Sources & references:
National Psoriasis Foundation. https://www.psoriasis.org/advance/bathing-for-healing-natural-hot-springs-and-sun
Environmental Working Group. http://www.ewg.org/sunsafety/tips-sunlight-and-aging.php
Quality of Life of Psoriasis Patients before and after Balneo – or Balneophototherapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2678696/
Balneotherapy in dermatology. https://www.ncbi.nlm.nih.gov/pubmed/12919115
Cyclooxygenase 2 expression and apoptosis in normal and psoriatic epidermis models exposed to salt water soaks and narrowband ultraviolet B radiation. https://www.ncbi.nlm.nih.gov/pubmed/24341417/
Skin Microbiome in Patients With Psoriasis Before and After Balneotherapy at the Thermal Care Center of La Roche-Posay. https://www.ncbi.nlm.nih.gov/pubmed/26659932
The impact of salt water soaks on biophysical and molecular parameters in psoriatic epidermis equivalents. https://www.ncbi.nlm.nih.gov/pubmed/22056695
TGFβ/Smad signalling in psoriatic epidermis models exposed to salt water soaks and narrowband ultraviolet B radiation. https://www.ncbi.nlm.nih.gov/pubmed/23838545