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    Natural forces?

    Benefits of thermal spring water get clinical inspection

    Water from the thermal springs in Avène, France, has been shown in some studies to be effective in treating psoriasis, inflammation, and atopic dermatitis, as shown in these before-and-after photos.
    Waikoloa, Hawaii - Controlled studies show water from thermal springs in Avene, France, reduces inflammation, pruritis, and erythema, according to a general practitioner whose employer markets the water. The water is effective in treating psoriasis, inflammation caused by laser treatments, and mild to moderate atopic dermatitis, said FranÇois Verriere, M.D., at the Hawaii Dermatology Seminar.

    Patients have flocked to the springs at Avene since they were discovered in 1736 to seek treatment for a variety of skin diseases. The water is also bottled as a medicine. In 1871, Avene water was sent to the burn victims of the Great Chicago Fire. Currently, the French national healthcare system pays for psoriasis and atopic dermatitis therapy at the baths if prescribed by a physician. Laboratoire Dermatologique Avene, which manages the baths, also sells the water in spray bottles.

    Although natural hot springs have been used for 6,000 years in medical treatments, they have not come under much scientific scrutiny until the past 20 years. "It is not easy to conduct studies," said Dr. Verriere, the medical director of Laboratoire Dermatologique Avene. Over the last 12 years, investigators have sought to document the water's benefits.

    In one study, 76 patients with mild atopic dermatitis were treated with a moisturizer, Pasti Base hydrocarbon gel, over their entire bodies including both arms, and with Avene water on only the right arm. At the end of three weeks, investigators found a 46 percent decrease in erythema on the patients' arms treated with the spring water, compared to a 27 percent decrease on the patients' other arms (p < 0.0001). The investigators noted similar results in dryness, exudation, induration, and pruritus.

    For another study, reported in the European Journal of Dermatology (2000;10:370-372), investigators divided 69 acne patients into a group of 34 treated with retinoic acid alone and 34 treated with the acid plus Avene. The acid caused inflammation and irritation in both groups, but after 28 days, investigators found that 37 percent of the water group had a "good" tolerance to the acid, compared to 12 percent of the control group (p = 0.04). The investigators found the spring water ameliorated the scaling caused by retinoic acid. However, this study found no significant effect on erythema, burning, or itching.

    A third experiment, published in Dermatologic Surgery (2002; 28: 415-418), tested how well the spring water could soothe the effects of laser resurfacing. It found that 40 patients adding the spring water to petrolatum experienced less erythema, itching, stinging, and tightness - but the same amount of pain -- as 34 patients who used the petrolatum alone.

    Just how might the water achieve its benefits? Dr. Verriere believes the answers lie in the water's unique chemical properties. The water takes 40 years to flow through the ground before it reaches the springs, where it emerges under pressure at a rate of 70 m3 per hour and a temperature of 25.6 °C (78.1 °F). It is colorless, odorless, tasteless and is used without any chemical treatment.

    The water is pH neutral and has a low mineral content; its dry residue at 180 °C is only 207 mg / L (compared to 4,500 mg/l for the famous waters of Vichy). Water high in mineral content - for example, sea water - can have an irritating effect.

    But the absence of minerals alone cannot explain Avene water's effects. Dr. Verriere attributes these to the silica, anions, cations, and trace elements present. In one in vitro experiment, the water was applied in cellulose patches to skin samples that had been inflamed by vasoactive intestinal peptides. The water reduced vasodilation, tumor necrosis factor, and edema. The reduction in edema with the Avene water was greater than with patches containing distilled water.

    Investigators have reported a variety of other interesting effects from in vitro experiments, including:

    • Inhibition of basophil degranulation in skin from 30 patients who had been sensitized to pollen and mite allergens.
    • Inhibition of the release of histamine and prostaglandin D2 from rat mast cells, with the effect increasing with the concentration of the water.
    • Protection against oxidation.
    • Immunoglobulin E regulation.

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