Miscellaneous
Scientific Evidence of the Therapeutic Effects of Dead Sea Treatments: A Systematic Review

https://doi.org/10.1016/j.semarthrit.2012.02.006Get rights and content

Objectives

The Dead Sea, the deepest and most saline lake on earth, has been known from biblical times for its healing properties. The aim of this systematic review was to present critically the level of evidence for the claims of therapeutic effects of Dead Sea treatments in several rheumatologic diseases and psoriasis as well as to review these treatments' safety.

Methods

All articles cited in MEDLINE under the query, “Dead Sea,” were reviewed.

Results

We found bona fide evidence that Dead Sea treatments are especially effective in psoriasis due to both the special characteristics of solar ultraviolet radiation in the Dead Sea and the Dead Sea water balneotherapy. Dead Sea mud and Dead Sea balneotherapy have been found to be beneficial in rheumatologic diseases, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and knee osteoarthritis. In the safety analysis, we found no evidence for an increase in skin neoplasia, although skin actinic damage seems to be increased in patients treated in the Dead Sea. Dead Sea treatments do not lead to worsening of blood pressure. Substantial ingestion of Dead Sea water (generally in unusual near-drowning cases) is toxic and can result in cardiac rhythm disturbances because of electrolyte concentration abnormalities. Laboratory analysis of Dead Sea mud did not reveal mineral concentrations that could represent a health concern for their intended use.

Conclusions

Dead Sea treatments are beneficial in several rheumatologic diseases and psoriasis and have a good safety profile.

Section snippets

Materials and Methods

Abstracts of articles cited in MEDLINE under the query “Dead Sea” were initially retrieved (360 articles). All the abstracts were reviewed and clinical articles in which Dead Sea balneotherapy, phototherapy, or mud therapy were investigated for rheumatologic diseases (31 articles), psoriasis (50 articles), or safety assessment (25 articles) were retrieved and included. Individual case reports or opinions were excluded (42 articles). The available evidence and strength of recommendation was

Psoriasis—Dermatologic Manifestations

Dead Sea water balneotherapy and phototherapy have been used to treat dermatologic and rheumatologic involvement in psoriasis. Although several new therapeutic approaches have emerged in the last decade for psoriasis, resistant forms of the disease, cases in which only partial remission is achieved with medications and cases in which medications have unacceptable toxicity, may benefit from complementary treatments like Dead Sea water balneotherapy and phototherapy (11, 12).

In a large

Discussion

Several investigations have been published on the benefits of the Dead Sea treatments in a large host of rheumatologic diseases and psoriasis.

In psoriasis, topical therapy of skin manifestations is based on glucocorticoid preparations and calcineurin inhibitors (82). UV light and psoralens are also used to treat psoriasis (4, 83). Systemic therapies with methotrexate and retinoids combined with UV light are used for more extensive disease (84). Biologic agents like alefacept, efalizumab,

Acknowledgments

Many thanks to Dr. Miriam Vered for the English proofreading.

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