International Journal of Biometeorology

, Volume 62, Issue 8, pp 1345–1360 | Cite as

Salt water and skin interactions: new lines of evidence

  • Jose Manuel Carbajo
  • Francisco MaraverEmail author
Review Paper


In Health Resort Medicine, both balneotherapy and thalassotherapy, salt waters and their peloids, or mud products are mainly used to treat rheumatic and skin disorders. These therapeutic agents act jointly via numerous mechanical, thermal, and chemical mechanisms. In this review, we examine a new mechanism of action specific to saline waters. When topically administered, this water rich in sodium and chloride penetrates the skin where it is able to modify cellular osmotic pressure and stimulate nerve receptors in the skin via cell membrane ion channels known as “Piezo” proteins. We describe several models of cutaneous adsorption/desorption and penetration of dissolved ions in mineral waters through the skin (osmosis and cell volume mechanisms in keratinocytes) and examine the role of these resources in stimulating cutaneous nerve receptors. The actions of salt mineral waters are mediated by a mechanism conditioned by the concentration and quality of their salts involving cellular osmosis-mediated activation/inhibition of cell apoptotic or necrotic processes. In turn, this osmotic mechanism modulates the recently described mechanosensitive piezoelectric channels.


Health resort medicine Salt water Skin Spa therapy Mud therapy Review 



Apoptotic volume decrease


C-tetraethylammonium bromide


Adult human keratinocyte cell line


Human stratum corneum


Potassium chloride


Octanol/water partition coefficient






Sodium chloride




Natural moisturizing factor


Necrotic volume increase


Participation coefficient


Quantitative structure permeability relationships


Regulatory volume decrease


Regulatory volume increase




Transepidermal water loss


Ultraviolet radiation



This study was funded by grant UCM-911757 awarded to the research group of the Universidad Complutense de Madrid (Medical Hydrology).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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© ISB 2018

Authors and Affiliations

  1. 1.Department of Radiology, Rehabilitation and Physiotherapy, Faculty of MedicineUniversidad Complutense de MadridMadridSpain
  2. 2.Professional School of Medical Hydrology, Faculty of MedicineUniversidad Complutense de MadridMadridSpain

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