NATURAL THERAPY AT THE DEAD SEA

Sponsored by Dead Sea Mor Clinic

Dead Sea Mor Dermatology & Rheumatology Clinic, Israel 
V.Kipnis, M.D.

Treatment of different skin diseases at the Dead Sea: a natural selective ultraviolet phototherapy.
V.Kipnis, Mor Dermatology & Rheumatology clinic at the Dead Sea, Israel, 1995.

The Dead Sea area is the world's lowest place with a rare combination of unique therapeutic qualities, which have been well-known for ages.
The Dead Sea has been the focus of interest and amazement since ancient times. ARISTOTLE (304 - 322 B.C.) was the first to tell the world about the wonderful qualities of the Dead Sea: "very bitter and salty water in which no fish can live and where neither man nor animal can sink". JOSEFUS FLAVIUS (37 - c.100), GALEN (122 - c.220), PLINY THE ELDER (23 - 79), have reported the therapeutic characteristics of the Dead Sea water, mud and mineral hot springs. JULIUS AFRICANUS (the Third century) said: "Bathing in the Dead Sea is therapeutic for everyone".

The Dead Sea is located 400 meters below sea level, it is 80 km long and 17 km wide. The Sea has two basins: one in the north, 350 meters deep, and the other in the south, a shallow pool just a few meters deep. The Dead Sea is situated in a deep hollow between the mountains, which rise 1200 meters high above it.

The temperatures are high all year round (Table 1):

jan feb mar apr may jun jul aug sep oct nov d ec 
average 
max t, C		 20 22 25 29 34 37 39 38 36  32 27 22 
average 
min t, C		 11 13 16 20 24 27 28 29 27  24 18 13 
average 
moisture		 50 46 42 37 34 34 34 36 40  41 45 49 
average 
precipitation (mm)		 11 9 7 2 0 0 0 0 0  1 8 8 
Table 1
The average maximum temperature is about 22° - 29° C from November to April, 32° - 37° C during the intermediate months (September - October) and 38° - 39° C in June - July. The temperature is almost never below +10° C. There are more than 330 sunny days all year round. The average pressure is about 1050 - 1066 millibars, oxygen content in the air is 10% higher than at the sea level.

The Dead Sea is also called the Salt Sea, due to it's extremely high contents of salts and minerals (Table 2):

NaCl MgCl2 CaCl2 KCl MgBr2  CaSo4 MgSo4 Total
Dead Sea 86 (29%) 132 (41%) 35 (12%) 11 (4%) 9 (3%)  7 (2%) ----- 300 g/l
Mediterranean 
Sea		 27 (77%) 4 (11%) 0.3% 0.3% 0.3%  2 (3%) 2 (6%) 35 g/l
Table 2
Recent studies indicate that the salt concentration in the Dead Sea is about 33% in comparison to 3% in the Mediterranean. These qualities, in combination with unique photo biological characteristics, are present only at the Dead Sea area. Due to extremely high evaporation, which is about 2 billion m3 a year , there is a heavy haze over the Dead Sea at all times. The haze and additional 400 meters of atmosphere help to filter out more UVB rays (which can cause sunburn), and create the ideal correlation of UVA and UVB rays, so the duration of exposure to the sun can be increased.

Sea and sun (NSUP - Natural selective ultraviolet photo therapy) are the basis of treatment for different skin diseases and joint diseases, especially psoriasis, though patients with atopic dermatitis, vitiligo, ichtiosis and acne also respond well to the treatment.

Treatment of psoriasis

Dead Sea Mor Clinic, 
Dead Sea, Israel 
Complete clearing (variable pigmentation may remain) 56.4% 
Excellent improvement (almost complete flattening of all plaques, minimal erythema or scaling) 29.1% 
Considerable improvement (considerable flattening of all plaques; minimal erythema and scaling). 13.6% 
Definite improvement (moderate flattening of plaques, less scaling and erythema) 0.9% 
No change 0 
Psoriasis deterioration 0 
Table 3
Most of the patients (99.1%) showed excellent improvement, or complete clearing (the results depend on diagnosis and skin involvement (Table 4):
Percent of involvement 
prior to treatment		 Number (percentage) 
of patients		 Number (percentage) of 
patients with complete clearing 
or excellent improvement 
0 - 9 11.8 100 
10-19 21.8 75 
20-29 27.3 93.3 
30-100 39.1 81.4 
Table 4
The treatment is based on a continuous increase of exposure to the sun up to a maximum of 6 hours, in combination with bathing in the Dead Sea. Depending on skin involvement range, the treatment is adjusted as required.

Different natural oils are used in the clinic (baby oil, avocado oil, olive oil, indifferent creams and ointments and bath oils). Various concentrations of sulfur-salicylic ointments are sometimes used in treatment of psoriasis. At no time is any topical or systemic medication used in the treatment. No topical or systemic steroids are utilized. Patients with atopic dermatitis are also treated by sun exposure and various creams and ointments.

The first signs of improvement (less itching, for example) appear after 3-4 days, and improvement is continuous. 92.7% patients with atopic dermatitis feel major improvement or complete skin clearing. 7.3% of patients feel definite improvement (no itching, erythema and excoriations disappear, less papuls and lichenification). Studies, which were carried out at the Mor Clinic, showed that bathing in the Dead Sea and sun's ultraviolet rays have beneficial effects on patients with ichthyosis. Patients feel considerable improvement after a 4-weeks course of treatment. Patients with vitiligo notice the repigmentation which lasts for 3- 4 months after the treatment. Mor Clinic also has much experience in treatment of such diseases as parapsoriasis, seborrheic dermatitis, lichen planus, prurigo and others.

Climatotherapy, in combination with natural factors and specific geographic conditions of the Dead Sea area, have been used for the treatment of skin and joint diseases for more than 20 years. Many thousands of patients are treated every year with excellent results. The number of patients coming to the Dead Sea, Israel - one of nature's marvelous pearls - increases every year.

REFERENCES

  1. D.J.Abels, M.D., Theodore, Ph.D., Jacob E.Bearman, Ph.D. Treatment of psoriasis at a Dead Sea Mor Dermatology clinic. International Journal of Dermatology, vol.34, no.2, February, 1995.
  2. Abels, Kattan-Byron J. Psoriasis treatment at the Dead Sea. J.Am.Acad.Dermatol 1985; 12:639-643.
  3. Even-paz, R.Gumon, V.Kipnis, D.Abels, D.Efron. Dead Sea Sun Versus Dead Sea Water in the treatment of psoriasis. Mediterranean conference center, MALTA, nov.1994.
  4. A.P.Kushelevsky. A Review of some important Biometeorological factors at the Dead Sea. Department of Nuclear Engineering Ben Gurion University, Israel, J Med Sci, 1988.
  5. Guidelines of care for phototherapy and photo chemotherapy. Committee on Guidelines of care, Task force on phototherapy and photo chemotherapy. J Am Acad Dermatol 1994; 31;643-8.
  6. Gold, B., Sukenic, S., Gavza, Z. Radioactivity and chemical composition of the therapeutic mud and hot spring baths in the Moriah Spa, Dead Sea, Israel. In Frontiers in radiation Biology. Editor:Riklis, E., Balabak 1990, 625-30.
  7. S.Sukenic, Hani Giryes, Sima Halevy, Lily Newmann, Dan Flusser and Dan Buscila. Treatment of Psoriatic Arthritis at the Dead Sea. J.Rhevmatol.1994; 21:1305-9.
  8. Sukenik S., Buscila D., Newmann L., Kleiner-Baumgarten A., Zimlichman RS.Horovitz J:Sulfur bath and mud pack treatment for rhevmatoid arthritis at the Dead Sea area. Ann.Rheum Dis. 1990; 49:99-102.
  9. D.J.Abels, M.D. Treatment at the Dead Sea (Dead Sea Mor dermatology clinic, Israel). International psoriasis Symposium. April, 1991.
  10. E.D. Maryasis. Treatment of health diseases at health resorts. "Medicina", 1981; UDK 616.5-0.85.838.
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