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Dead Sea Minerals AUGUST 2009 • WWW.SKINANDALLERGYNEWS.COM AESTHETIC DERMATOLOGY 27 COSMECEUTICAL CRITIQUE Dead Sea Minerals he palliative effects of immersing in baths or 4-week period. Only the psoriasis patients had significant sisted of 30 conventionally treated patients. The ra- pools of thermomineral water, known as bal- increases in serum levels of bromine, calcium, and zinc diochemotherapy patients were directed to use two Tneotherapy, have been known for centuries, (Pharmacol. Res. Commun. 1985;17:501-12). products containing Dead Sea minerals—a mouth- with modern practices dating back to the 1800s and nat- wash (Lenom, made by Clinica Lenom Ltd.) and a ural health spas dating back more than 3,000 years Antiproliferative Action moisturizing cream (Solaris)—three times daily for 1 (Dermatol. Ther. 2003;16:132-40; Clin. Dermatol. Two years later, Shani et al. tested diluted Dead Sea week before, during, and up to 2 weeks following the 1996;14:659-64). brine and salt solutions, and found that they reversibly conclusion of radiotherapy. Places such as the Kangal hot spring in Turkey, the suppressed cell proliferation in vitro. They noted that The investigators observed grade 1-2 mucositis in 13 Blue Lagoon in Iceland, and the Dead Sea bromides were more potent inhibitors than patients treated with Dead Sea minerals (54%), with between Israel and Jordan are particularly chlorides, and that potassium salts exhibit- none exhibiting grade 3-4 mucositis. In the control popular “hot spots” for such therapy. ed greater effectiveness than sodium or group, 17 subjects (57%) had grade 1-2 mucositis, while The Dead Sea is the lowest saline lake— magnesium salts. The authors speculated grade 3-4 mucositis was noted in 4 (13%). In addition, and the lowest accessible point—on earth that the penetration of minerals through the grade 1-2 dermatitis was seen in 13 patients treated with (400 meters, or about 1,300 feet, below sea skin, along with antiproliferative effects, Dead Sea minerals (54%), with none displaying grade level). Its therapeutic benefits have been may help explain the effectiveness of Dead 3-4 dermatitis, whereas grade 1-2 dermatitis was ob- well known for 1,500 years, with the mod- Sea spa treatments for psoriasis (Pharma- served in 11 control patients (37%) and grade 3-4, in 5 ern era for such treatments beginning in cology 1987;35:339-47). (17%) (Isr. Med. Assoc. J. 2007;9:439-42). 1959 (Clin. Dermatol. 1998;16:695-8). Over Interestingly, in 1996, investigators sought the past half century, the Dead Sea has be- to identify the antiproliferative effects of cer- On the Market come well recognized for its balneologic ac- BY LESLIE S. tain Dead Sea minerals that play a role in Several companies offer product lines that feature Dead tivity, allowing climatotherapy to be used for BAUMANN, M.D. ameliorating psoriasis, by comparing the in Sea minerals, including Adovia Inc., Ahava, Health & dermatologic and rheumatologic conditions. vitro proliferation of fibroblasts grown from Beauty Dead Sea Minerals, Kawar, La Cure, and Obey In particular, Dead Sea climatotherapy is considered biopsy specimens of healthy and psoriatic skin. They Your Body. to be very effective in the treatment of psoriasis and, found that magnesium bromide and magnesium chlo- The array of such products includes hand and body to a lesser extent, atopic dermatitis (J. Am. Acad. Der- ride exhibited significantly more potent inhibitory effects lotions, bath salts, body butter, eye cream, cleansing matol. 2005;52:445-50; Arch. Dermatol. 1998;134:1416- on cell growth than did their corresponding potassium mud masks, mineral mud soaps, mineral peeling soaps, 20). Other conditions successfully treated with bal- salts and sodium chloride, and that these effects were body exfoliants, collagen firming creams with SPF, neotherapy include acne, alopecia areata, chronic manifested in healthy as well as psoriatic fibroblasts acne lotions, lightening cream with SPF, firming night ulcers, contact dermatitis, dyshidrotic dermatitis, gran- (Pharmacology 1996;52:321-8). uloma annulare, ichthyosis, lichen planus, lichen scle- rosus and atrophicus, mycosis fungoides, palmoplantar Moisturizing Action keratosis, pityriasis rubra pilaris, pruritus, rosacea, scle- In 1997, Ma’or et al. compared the cutaneous smooth- roderma, seborrheic dermatitis, urticaria pigmentosa, ing effects of three different liquid gels, one of which vitiligo, and xerosis (Dermatol. Ther. 2003;16:132-40). contained Dead Sea minerals. The formulations were Products that contain Dead Sea minerals are currently applied to 20 mature women twice daily over 4 weeks, used to treat several of these cutaneous conditions. with computer-aided laser profilometry used to eval- uate skin roughness before and after the treatment pe- COM . Dissolved Minerals riod. At the conclusion of treatment, the gel contain- The Dead Sea, which contains exceedingly high salt con- ing 1% Dead Sea mineral solution was associated with OTOLIA centrations, acts as a reservoir of minerals with distinct a 41% reduction in skin roughness. A 28% reduction /F evaporation properties. Dead Sea salts are the source of was achieved with the use of the gel devoid of miner- HTERN numerous chemical and health products. Specifically, al additives, and a 10% reduction was seen with a con- S various skin conditions and allergies, as well as arthri- trol gel absent any antiwrinkle ingredients (Int. J. Cos- DWARD tis and respiratory disorders, have been treated with met. Sci. 1997;19:105-10). ©E Dead Sea–derived magnesium salts and sulfur-contain- The therapeutic effects of immersion in the water of ing mud (Rev. Environ. Health 1999;14:257-67). Mag- Photodamage and Skin Cancer the Dead Sea have been well known for 1,500 years. nesium salts, which are known to have anti-inflamma- In 2005, in a multicenter controlled cross-sectional tory activity, are the prevailing minerals in Dead Sea study, investigators determined the prevalence of pho- creams, antidandruff and numerous other shampoos, water (Int. J. Dermatol. 2005;44:151-7). Compared with todamage and skin cancer in a cohort of psoriasis pa- scalp masks, and sunscreens. the world’s oceans, the Dead Sea is more abundant in tients undergoing climatotherapy by the Dead Sea. The calcium, magnesium, potassium, and bromide, and cohort consisted of 1,198 patients (460 psoriasis patients Conclusions lower in sodium, sulfate, and carbonate (Dermatol. and 738 controls) between 20 and 70 years of age who The therapeutic effects of mineral waters at various Ther. 2003;16:132-40; Int. J. Dermatol. 1989;28:1-9). received treatment at the Dead Sea Solarium Clinic and spas, and at the Dead Sea in particular, have been well participating outpatient clinics. established. Such results help explain the popularity of Enzyme Stimulation Results indicated that psoriasis patients were much makeup and other skin products that contain mineral In 1985, Shani et al. found that glutathione peroxidase more likely to manifest elastosis, poikiloderma, solar ingredients. Vichy Thermal Spa Water (Vichy Labora- activity was significantly increased in 35 psoriatic Danes lentigines, and facial wrinkles than controls, with a dose tories Inc.) and La Roche-Posay Spa Water (La Roche- who received 4-week therapy at the Ein Bokek Inter- response associated with increased exposure time to the Posay) contain the anti-inflammatory minerals sulfur national Psoriasis Treatment Center along the Dead Sea Dead Sea. Control patients self-reported more previous and selenium, respectively, and mineral-laden Dead Sea in Israel. The drinking water at the center was found skin cancers than psoriasis patients, but examinations water is known to exert a lenitive influence on psoria- to be rich in selenium. The researchers assayed the ac- revealed no differences in the prevalence of non- sis, eczema, and other cutaneous conditions. tivity of erythrocyte glutathione peroxidase, the most melanoma skin cancer. Neither group included cases of It remains unclear, however, how effective several reliable marker for increases in selenium bioavailabili- malignant melanoma. The researchers concluded that products touted for harnessing the curative powers of ty, in the psoriasis patients, in 25 long-time local hotel Dead Sea climatotherapy poses no increased risk for de- the Dead Sea are in conferring similar benefits. Al- workers, and in healthy volunteers who consumed low- veloping skin cancer among psoriasis patients, but the though these products likely do no harm and, given the selenium water. Enzymatic activity in the hotel work- prolonged solar exposure inherent in this therapeutic host of other ingredients, probably at least contribute ers was found to be 50% higher than in the low-sele- modality may increase the risk of inducing photo- to moisturizing the skin, more research is necessary to nium drinkers. The investigators concluded that damage (J. Am. Acad. Dermatol. 2005;52:445-50). establish these products as adjuvants for any of various selenium might play a beneficial role in psoriasis treat- skin disorders. ■ ment (Pharmacol. Res. Commun. 1985;17:479-88). Easing Chemotherapy’s Side Effects That same year, several of the same researchers com- In another recent study, researchers assessed the effec- DR. BAUMANN is director of cosmetic dermatology at the pared the penetration of electrolytes through the skin tiveness of Dead Sea products in mitigating the side ef- University of Miami. To respond to this column, or to of healthy volunteers and psoriasis patients who bathed fects of radiochemotherapy in 24 patients suffering suggest topics for future columns, write to Dr. Baumann at in the Dead Sea or comparable bath-salt solutions for a from head and neck cancer. The control group con- our editorial offices via e-mail at [email protected]..
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