PSORIASIS

The Dead Sea region is recognized worldwide for its efficacy in the treatment of dermatological diseases, particularly Psoriasis, Atopic Dermatitis, Vitiligo, and Mycosis Fungoides. In skin diseases, such as Psoriasis, it has been shown :

• To be at least as effective as other treatment modalities both in terms of disappearance of lesions and duration of remission.
• The overall UV radiation dose to which the patient is exposed is markedly smaller than in any artificial treatment modality.
• That the unique conditions present at the Dead Sea enable adequate sun exposure containing the specific healing range of UV radiation while the more damaging solar rays are strongly attenuated by natural filtration.
• That recurrences are usually less severe than the previous attack.
• That the relaxed environment facilitates social interaction and psychological encouragement
• No corticosteroids or cytotoxic medications are required
• To be more cost effective than many other treatments

Sun Exposure

The treatment protocol used at the different clinics consists essentially of the time of exposure to the sun, in a proportion and duration which depends on the skin type, season of the year, time of day, and the medical diagnosis.

The amount of radiation prescribed for each patient, for the length of the stay,is calculated for psoriatics patients,to reach in a 4-weeks treatment the amount of 3.1 Joule/cm² (unit of radiation) which is, strikingly less than the usual amount of artificial UV radiation hospitals and clinics (Table 5).

This regimen is prescribed by the physician and used by the patient after conversion of the amount of daily MED (minimal erythema dose) in a duration (in minutes) of sun exposure at a defined time of the day. For this purpose a personally tailored software has been developed, however preprinted tables are often used, even if they are less personally adjusted for each patient. These tables prescribe a progressively increased sun exposure, starting with a few minutes and reaching up to 4 hours a day.

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Table 5

Dead Sea Bathing

Bathing in the Dead Sea water for 20 minutes twice a day is usually recommended and has to be done gradually before sun exposure. The skin condition has to be taken into account, requiring a medical examination before the decision of Dead Sea water bathing can be taken.

Topical Treatment

Emollients such as Vaseline, baby oils and moisturizing creams are used freely by the patients in order to prevent or treat the drying effect of the atmosphere. For psoriasis patients, topical preparations containing salicylic acid, sulfur, tar or dithranol are sometimes prescribed and applied, but steroidal preparations are not recommended, even for other skin conditions. Further investigations are needed in order to define the place of new topical antipsoriatic preparations in combination with climatotherapy at the Dead Sea.

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Psychosocial Factor

At the Dead Sea, patients are in a natural health oriented environment which promotes relaxation and reduces psychological stress, a factor which is often associated with Psoriasis, and can aggravate its condition. Patients staying at the Dead Sea experience very different conditions from those experienced in hospitals or other conventional clinics around the world. The "Dead Sea Treatment" incorporates psychological features that can favorably influence the course of the disease. Patients are accommodated in all category hotels and participate willingly in social activities. In fact, they form an "International Club", strike up friendships and discuss common problems with each other.Thus the quality of life rises or, as one patient remarked: "...at the Dead Sea I am a welcome guest and not a patient".  

Before -After    

Results and Costs

Typical results reported in scientific literature for treating Psoriasis at the Dead Sea are shown in Table 6. These studies indicate that the mean percent of improvement ranges between 80 and 100 percent for 88% of the patients.   A recent study planned and carried out by the Swiss Psoriasis Association compared effectiveness and cost of Dead Sea therapy with a comparable course of conventional therapy performed in Switzerland. It turned out that therapeutic successes were similar in both groups (83% reduction of lesions at termination of therapy and close to 50% reduction of lesions after six months). However, the cost of treatment (all expenses included) were 31 to 55% less in the Dead Sea protocol than in the compared treatments in Switzerland. Thus, being a strikingly cost effective alternative for Swiss psoriasis patients, Dead Sea therapy is expected to be worthwhile for patients from other Western European countries as well.

Table 6

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ATOPIC DERMATITIS

This disease, more prevalent in children, and found in 3 to 5% of the population, often represents a challenge for the physicians, in moderate to severe cases. The Dead Sea treatment program (see above) has to be tailored individually for these very sensitive people. For these patients, the duration of treatment has to be between four and six weeks. The results are not less impressive than for Psoriasis: 97% of Dermatitis patients improve after Dead Sea therapy, while 70% show dramatic improvement.  

VITILIGO

The "Dead Sea therapy" is also effective in treating this disease in which small or large areas of skin lose their natural pigment. After the first 4-week course, and sometimes before the end of the treatment, the white patches start to show new pigments, beginning the healing process that continues several weeks after the patient returns home.

In most cases, climatotherapy has to be repeated for several years until the condition is eliminated. Occasionally, rapid and complete repigmentation can occur after a single visit at the Dead Sea. Bathing in the Dead Sea water for 20 minutes twice a day is usually recommended and has to be done before sun exposure. The skin condition has to be taken into account, requiring a medical examination before the decision of Dead Sea water bathing can be taken.