Thermal Spring Water

Although there is little data on how thermal spring waters permeate the skin to exert their effects, they do seem to be effective in photoprotecting the skin, and can also soothe and heal the skin after dermatology procedures.

Effects


Grade Level of Evidence
A Multiple double-blind, controlled clinical trials.
B 1 double-blind, controlled clinical trial.
C At least 1 controlled or comparative clinical trial.
D Uncontrolled, observational, animal or in-vitro studies only.
Grade Effect Size of Effect Comments

C

Healing

Mild

Alleviates pain, inflammation and dryness after peels, laser treatment or photodynamic therapy. Promotes skin regeneration and healing.

C

Dermatitis treatment

Mild

Repairs dry skin and reduces the severity of atopic dermatitis.

D

Psoriasis treatment

Strong

Completely cleared psoriasis or improved psoriasis by more than 50% in the majority of patients after 3 weeks of treatment.

D

Photoprotection

Moderate

Reduces sunburn cell formation and protects against UV-induced damange to DNA, proteins and cell membranes.

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Scientific Research


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Table of contents:

1. Sources

Thermal spring waters are mineral waters that originate in springs. The composition and physicochemical properties of thermal spring waters is related to the nature of the geologic materials through which the water has flowed.[1] Common soluble minerals include calcium, magnesium, bicarbonate, silicates, iron compounds, sulphur compounds and trace elements such as selenium.[1][2]

2. Bioavailability

Absorption of the mineral salts found in thermal spring waters seems to be limited, but there is no precise data on this subject.[3] The penetration of salts from the Dead Sea, another mineral-rich water source, has been scientifically demonstrated and quantified, however.[4] It is possible, therefore, that the therapeutic effects of thermal spring water lies not only in the local interaction between the mineral water and the structure of the skin surface, but also the absorption through the skin of its minerals and trace elements.[3]

3. Effects on the skin

3.1 Photoprotection

Thermal spring waters confer resistance to oxidative stress induced by exposure to UV light.[1][5] Human skin fibroblasts and human keratinocytes cultured in a medium reconstituted with La Roche-Posay Thermal Spring Water had better resistance and higher cell survival after exposure to UVB,[6][7] perhaps due to increases in the activities of glutathione peroxidase and superoxidase dismutase.[6] Selenium, an important trace element found in La Roche-Posay Thermal Spring Water, has been shown to have beneficial effects on lipid peroxidation, reducing lipid peroxide content after UVA exposure, and increasing glutathione peroxidase activity and cell viability.[8][9]

Furthermore, prior application with a cream containing La Roche-Posay Thermal Spring Water before exposure to UVB dramatically reduced the formation of skin tumours and sunburn cells.[10][11]

Similarly, Avène Thermal Spring Water is capable of protecting cell membranes, genomic DNA and proteins from UV-induced oxidative stress.[2] Avène Thermal Spring Water significantly reduced UVA-induced lipid peroxidation, oxidative genomic lesions and oxidative damage to proteins in an in-vitro study on human keratinocytes.[12]

Thermal water from Uriage-les-Bains in France has also been demonstrated to protect against UVB-induced DNA damage, through restoring the activity of catalase, an intracellular antioxidant enzyme, and the expression of claudin-6, a putative tumour suppressor.[5]

3.2 Post-procedure healing

Various dermatology procedures such as chemical peels, laser treatment or photodynamic therapy often cause skin discomfort and safety problems, reducing patient adherence to therapy.[2]

Avène Thermal Spring Water has been shown to help counteract the symptoms of erythema, itching, stinging and tightening of facial skin after laser resurfacing, alleviate discomfort and inflammation after photodynamic therapy, and reduce pain, dryness and redness after fractional photothermolysis.[13][14][15]

These effects are believed to be partly associated with the low mineral content of Avène Thermal Spring Water, as a sensory analysis has indicated that skin comfort, softness and suppleness is better with thermal spring water having a lower mineral concentration.[16]

Thermal spring water also has also been shown to improve skin regeneration and healing by promoting keratinocyte proliferation and by modulating collagen and elastic fibers in the dermis,[17] as well as increase the expression of filaggrin, aquaporin-3, claudin-4 and claudin-6, proteins implicated in skin barrier repair and skin moisturization.[18]

3.3 Atopic dermatitis treatment

Atopic dermatitis is a common chronic inflammatory skin disease in which epidermal barrier defects leads to dry skin.[19]

Several studies have demonstrated the efficacy of hydrotherapy with Avène Thermal Spring Water in improving atopic dermatitis.[20][21] 3 weeks of treatment positively impacted the activities of β-glucocerebrosidase, phospholipase A2, proteases and cholesterol sulphatase, enzymes that play an important role in the formation and maintenance of the epidermal barrier function.[22][23]

Avène Thermal Spring Water also significantly reduced the secretion of IL-4, a T helper cell cytokine associated with acute atopic dermatitis.[24][25]

Moreover, a comparative clinical study has revealed that spraying Avène Thermal Spring Water in addition to emollient application helps optimize the effectiveness of the emollient in repairing dry skin and reducing the severity of atopic dermatitis.[26]

3.4 Acne treatment

Topical application of tretinoin in combination with Avène Thermal Spring Water sprays significantly decreased desquamation in an open-label, comparative study, suggesting that Avène Thermal Spring Water may increase treatment adherence by improving the local skin tolerability of topical retinoids in acne treatment.[27]

3.5 Psoriasis treatment

In one clinical study on 92 patients with moderate psoriatic plaques, balneotherapy with and drinking of La Roche-Posay Thermal Spring Water daily for 3 weeks completely cleared psoriasis in 8% of patients and improved psoriasis by more than 50% in 48% of patients.[28]

3.6 Rosacea treatment

La Roche-Posay Rosaliac AR, a commercial product containing Ambophenol, Neurosensine and La Roche-Posay Thermal Spring Water, appears to help prolong the efficacy of metronidazole treatment when used as an adjunctive treatment, and also significantly improved the clinical signs and symptoms of rosacea when used as monotherapy.[29]

4. Side Effects

There have not been any published reports on the safety and long-term effects of using thermal spring water, to our knowledge. However, several studies have shown that thermal spring water has soothing and anti-irritant properties in various skin conditions, including dermatitis caused by topical retinoic acid and specific procedures such as chemical peels, laser therapy and photodynamic therapy.[15][27] There have also not been any adverse events reported in clinical studies investigating the efficacy of topical thermal spring water.

Scientific References


  1. Seite S. Thermal waters as cosmeceuticals: La Roche-Posay thermal spring water example. Clin Cosmet Investig Dermatol. (2013)
  2. Merial-Kieny C, et. al. Avène Thermal Spring Water: an active component with specific properties. J Eur Acad Dermatol Venereol. (2011)
  3. Matz H, Orion E, Wolf R. Balneotherapy in dermatology. Dermatol Ther. (2003)
  4. Shani J, et. al. Skin penetration of minerals in psoriatics and guinea-pigs bathing in hypertonic salt solutions. Pharmacol Res Commun. (1985)
  5. Joly F, Branka JE, Lefeuvre L. Thermal Water from Uriage-les-Bains Exerts DNA Protection, Induction of Catalase Activity and Claudin-6 Expression on UV Irradiated Human Skin in Addition to Its Own Antioxidant Properties. JCDSA. (2014)
  6. Richard MJ, et. al. Antioxidizing power of a selenious mineral water upon cutaneous diploid human fibroblasts. Nouv Dermatol. (1990)
  7. Rougier A, et. al. Preventative effect of a selenium-rich thermal water against cell damage induced by UV light. Presented at the Congress of the International Federation Societies of Cosmetic Chemists, Montreux, Switzerland. (1995)
  8. Moysan A, et. al. Ultraviolet A-induced lipid peroxidation and antioxidant defense systems in cultured human skin fibroblasts. J Invest Dermatol. (1993)
  9. Moysan A, et. al. Effects of selenium on UVA-induced lipid peroxidation in cultured human skin fibroblasts. Skin Pharmacol. (1995)
  10. Cadi R, et. al. Protective effect of a selenium-rich thermal water on UVB induced skin carcinogenesis. Nouv Dermatol. (1991)
  11. Richard A, et. al. Protective effect of La Roche-Posay thermal water on UVB-induced photodamage in man. Presented at the Congrès Annuel de Recherche Dermatologique; Clermont-Ferrand, France. (1995)
  12. Chaveron M, et. al. In vitro evaluation of the Avène spring water effect on oxygen radical generations. Poster at World Congress of Dermatology, Paris. (2002)
  13. Sulimovic L, et. al. Efficacy and safety of a topically applied Avène spring water spray in the healing of facial skin after laser resurfacing. Dermatol Surg. (2002)
  14. Goldman MP, et. al. Comparative benefit of two thermal spring waters after photodynamic therapy procedure. J Cosmet Dermatol. (2007)
  15. Barolet D, et. al. Beneficial effects of spraying low mineral content thermal spring water after fractional photothermolysis in patients with dermal melasma. J Cosmet Dermatol. (2009)
  16. Bacle I, et. al. Sensory analysis of four medical spa spring waters containing various mineral concentrations. Int J Dermatol. (1999)
  17. Faga A, et. al. Effects of thermal water on skin regeneration. Int J Mol Med. (2012)
  18. Joly F, et. al. Beneficial Effect of a Thermal Spring Water on the Skin Barrier Recovery after Injury: Evidence for Claudin-6 Expression in Human Skin. JCDSA. (2012)
  19. Varothai S, Nitayavardhana S, Kulthanan K. Moisturizers for patients with atopic dermatitis. Asian Pac J Allergy Immunol. (2013)
  20. Pigatto P. The efficacy of Avène thermal spring water in light to moderate atopic dermatitis. Ann Dermatol Venereol. (2005)
  21. Giannetti A. The hydrotherapy centre in Avène-les-bains. A controlled study in atopic dermatitis. Ann Dermatol Venereol. (2005)
  22. Redoules D, et. al. Characterisation and assay of five enzymatic activities in the stratum corneum using tape-strippings. Skin Pharmacol Appl Skin Physiol. (1999)
  23. Tarroux R, et. al. Variability of enzyme markers during clinical regression of atopic dermatitis. Skin Pharmacol Appl Skin Physiol. (2002)
  24. Werfel T. The role of leukocytes, keratinocytes, and allergen-specific IgE in the development of atopic dermatitis. J Invest Dermatol. (2009)
  25. Portalès P, et. al. Immunomodulation induced by Avène spring water on Th1- and Th2-dependent cytokine production in healthy subjects and atopic dermatitis patients. Skin Pharmacol Appl Skin Physiol. (2001)
  26. Sachdev H, Chavda R, Mery S. Interest of associating Thermal Spring Water spray with emollient in the management of atopic dermatitis. Poster at European Academy and Dermatology and Venerology, Berlin. (2009)
  27. Alirezai M, et. al. A low-salt medical water reduces irritancy of retinoic acid in facial acne. Eur J Dermatol. (2000)
  28. Pinton J, et. al. Clinical and biological effects of balneotherapy with selenium-rich spa water in patients with psoriasis vulgaris. Br J Dermatol. (1995)
  29. Seite S, et. al. Management of rosacea-prone skin: evaluation of a skincare product containing Ambophenol, Neurosensine, and La Roche-Posay Thermal spring water as monotherapy or adjunctive therapy. J Drugs Dermatol. (2013)