Thalassotherapy – A Healing Approach in a Growing Wellbeing-Industry
Prof. Dr. Kai Illing
1. Introduction
The term Thalassotherapy stems from the Greek word thálassa (θάλασσα) meaning sea or ocean and
comprises many seawater-based treatments. Treatments on the base of remedies taken from the sea
are quite common in Europe and used as well in wellness tourism as in medical tourism. The medical
capabilities of the Thalassotherapy have been extensively discussed in Illing 2018 whereas the article
in hand tries to focus on tourist aspects and the chances Thalassotherapy offers to the growing
wellness and wellbeing industry.
There are some European countries the social insurances of which pay for certain treatments offered
in the realm of Thalassotherapy. In other countries, the Thalassotherapy remained in a state of a
popular and somehow shamanistic state that does have much to do with evidence-based medicine.
2. The Thalasso-world of treatments
Thalassotherapy capitalizes on many natural remedies that are offered by the sea:
1 2 3 4 5 6 7
Light/Sun Air/Wind Sand Peloide Seawater Algae Salt A
Remedies
(non- (herbal)
herbal)
All relevant weather More solid substances Seawater and its ingredients B
conditions as part of the beach
Sunbath Peeling Peeling Shower (jet Cosmetics, Peeling C
shower) skin care
Sport and other outdoor Sand Wrapping Underwater massage Salty air D
Treatments
activities (gym) bath (pack) inhalation
Heliotherapy Salty air Drinking Food, pills Food E
inhalation cure
Wrapping F
Rubbing G
Massage H
Bath (Thalasso circuit) I
Table 1: The Thalasso-grid (source: Adapted from Illing 2018, p. 104.)
Basically, almost all Thalasso treatments can be offered in a more non-medical context or in a more
medical one. The latter one makes it necessary to hire medical therapists or even medical doctors.
Those treatments being under the double rule (grey colour) are more often part of medically
supervised treatments. Explanations:
1C: Sunbath is normally not recommended as a high exposure to sunshine may cause skin cancer.
But certain skin diseases can be relieved if the exposure to sunshine is medically guided.
1
If your establishment concentrates on 6C your location might be far away from the sea. Amongst
others you offer cosmetic treatments using those with algae and maybe salt for salt baths. To foster
the sustainable background of your products you may use salt that is harvested by a saltern directly
by the sea. A saltwater pool may be an appropriate diversification of your pool area that might
comprise mostly sweet water pools.
Salty air inhalation as mentioned in 2E and 7D are most often offered in medical institutions that
care of patients suffering from respiratory diseases. An inhalation of this kind offers a relief for the
respiratory tract since it has a secretolytic effect. Inhalation with salty air can be done directly by the
beach inhaling the maritime aerosols or in the medical spa with an inhaler. The best effect can be
reached if people are in the breaking wave zone. An even small distance of 15 metres can reduce the
effect by 50%.
3D is normally offered as thermal therapy aiming at relieving the locomotory system. But this kind
of thermal treatment can also be offered in a mere wellbeing context causing a cozy feeling of
warmth. A sand bath can be done in a sand bed in your spa, but it can also be offered at the beach
using sand that is taken from the beach directly.
3C, 4C and 7C underline that many different materials taken from the sea can be used for peelings
that are mostly booked for wellbeing and cosmetic purposes. Peelings can be made in a treatment
room but also in combination with a sauna ritual in a Razul bath. It helps not only to remove dirt but
also to peel off loose skin scales.
5I and 6I lead to a discussion of what character the pool that offers salt water should be. The pool
might be rather simple offering just saltwater or it may be quite sophisticated equipped with various
water jets providing an underwater massage. The water jets may eject the water with different
power, they may be directed to different body areas and they may eject water of different
temperature.
6E is normally offered in the hotel’s restaurant where the so-called Mediterranean Food
consisting of red wine, olive oils, and many different types of fish can be taken as one important
pillar in a healthy food concept. 6E also comprises all dietary supplements that are based on algae
and other ingredients that are taken from the seawater.
5G, 6G, and 7G normally use a massage sponge to get the salt water, the algae peeling, and the
salt spread and rubbed in the body part targeted. This procedure is often done by a therapist. If salt
water is used it can be done in the way the Vichy Shower does it taking the water from a little shower
from above which is part of the massage bench.
7E: Salt as food means that hotels with a major in cuisine and delicious food attach importance to
offer various types of salt such as seawater salt, mountain salt, herbal salt, iodised salt etc.
5I and 6I: A so-called Thalasso-circuit aims at offering a certain way through the saltwater pools to
be done in a predefined order with the purpose of improving the medical outcome and/or to deepen
the wellbeing experience. Such a Thalasso-circuit can be done at the beach including real seawater,
but it can also be done in the spa using different types of pools such as a counter current pool (work
out, toning the tissue, accelerating the pulse), a hydromassage in a jacuzzy-like smaller pool-type
(relaxation), another pool offering a swan jet (muscle relaxation, improving the circulation), whirlpool
beds (relaxation and simultaneously activating venous circulation), a drainage section (ascending jets
from the ground activating the blood circulation of the foot and the lower part of the legs, lymphatic
drainage), and last but not least a cooler salt water bath that is to get the blood circulation in balance
again so that the guests can leave the Thalasso-circuit refreshed without a breakdown because of a
2
low blood circulation. Those Thalasso-circuits can be planned in a more activating, healing or relaxing
way. It depends on the strategy of the company, of the type of the guests, and of the possibility to
get patients sent by health insurances.
A Thalasso-circuit does not have necessarily something to do with pools. A succession of Thalasso-
based treatments can start with a peeling (algae peeling), followed by a warm salt-bath in a hot tub,
and finalized with a massage using oil made of algae. Many European cosmetics manufacturers play
on Thalasso products successfully advertising with keywords such as “authenticity”, “clean ocean
water”, “the power of the sea”, and the like.
If a saltwater pool is planned attention should be paid to the many difficulties concerning the pool-
technology because saltwater has a tremendous eroding effect on water pipes, water treatments
plants, and other elements of the water technology.
3. A medical concept based on Thalassotherapy
The following chart is to show a medical concept that was made by the author of this article for a
medical hotel on the Mediterranean island of Cyprus (Europe). The ThalassaLIFE preventive concept
aims to achieve purification and relief: Purification stands for physical and mental cleansing. The
detoxifying process will relieve guests from harming body poisons. Purification is a prerequisite for
relief and healing. Relief aims to free guests from their burdens of lifestyle diseases. ThalassaLIFE
means that lifestyle diseases are going to be treated using as well conventional (western) as
alternative treatments in a preventive and non-invasive manner. In this sense healing, relief, and
wellbeing will be reached with aid of a holistic combination of conventional and alternative
treatments.
Table 2: A medical concept based on Thalassotherapy (source: Illing 2015)
The author of this article suggests differentiating between the means (instruments, “how”) on the
one hand and the results (aims, “what”) on the other hand. The way to design a spa concept in this
way is to present not only the instruments (“what do I have to do?”) but also the aims guests have
when they visit the spa (“what do I get after doing all the procedures?”).
3
4. Summary
Thalassotherapy is a quite comprising approach to tourist health care centers playing successfully on
authenticity, healing, wellbeing, and (medical) prevention. It can be integrated into medical
companies (medical hotel, specialized clinics offering natural remedies) as it can be integrated into
hotel spas focusing on relaxing and beauty services. It is recommended to have Thalassotherapy
realized in establishments by the sea, but some treatments can also be realized successfully far away
from it.
5. Literature
Abu-Shakra, M., Mayer, A., Friger, M., Harari, M. (2014). Dead Sea mud packs for chronic low back pain. The
Isreal Medical Association Journal 16/9, p. 574-577.
Adams, M. (2009). Superfood for optimal health: Chlorella and Spirulina. Truth Publishing. Download 11th Nov.
2016 von http://www.naturalnews.com/specialreports/superfoods.pdf.
Boulangé, M., Kanny, G. (2014). Thermalisme et climatisme, médecines environnementales. Hegel 4/2, p. 170-
172.
Chen, Y., Chang, G., Kuo, S., Huang, S., Hu, I., Lo, Y., Shih, S. (2016). Well-tolerated Spirulina extract inhibits
influenza virus replication and reduces virus-induced mortality. Scientific Reports, 12.
Crecente, J., Santé, I., Díaz, C., Crecente, R. (2012). A multicriteria approach to support the location of
thalassotherapy (seawater therapy) resorts: Application to Galicia region, NW Spain. Landscape and Urban
Planning 104, p. 135–147.
de Andrade, S., de Carvalho, R., Soares, A., de Abreu Freitas, R., de Medeiros Guerra, L., Vilar, M. (2008).
Thalassotherapy for fibromyalgia: a randomized controlled trial comparing aquatic exercises in seawater and
water pool. Rheumatology International, 29/2, p. 147-152.
Deutscher Heilbäderverband, Deutscher Tourismusverband (2005). Begriffsbestimmungen – Qualitätsstandards
für die Prädikatisierung von Kurorten, Erholungsorten und Heilbrunnen. Download 12th Nov. 2016 von
http://www.deutscher-heilbaederverband.de/Begriffsbestimmungen-12-Aufl-aktualisiert-2011-PDF-
685370.pdf
Fernandes, J., Fernandes, F. (2013). Thalassotherapy and Aesthetical Tourism. Medical Tourism Magazine 22,
Sept.-Oct, p. 89-91.
Gilot, Jean-Michel (o.J.). Il y a 150 ans : l’invention de la thalassothérapie, une idée qui miroite aux yeux des
gens du monde. Download 12th Nov. 2016 von
http://enenvor.fr/eeo_actu/bellepoque/il_y_a_150_ans_l_invention_de_la_thalassotherapie_une_idee_qui_m
iroite_aux_yeux_des_gens_du_monde.html
Glavaš, N., Mourelle, M., Gómez, C., Legido, J., Šmuc, N., Dolenec, M., Kovač, N. (2016). The mineralogical,
geochemical, and thermophysical characterization of healing saline mud for use in pelotherapy. Applied Clay
Science.
Glavaš, N., Kovac, N., Jurjec, J (2010). Thalasso medical centre in the saltpans of Secovlje (Portoroz, Slovenia).
In: Maraver, F., Karagülle, M. (eds). Medical Hydrology and Balneology: Environmental Aspects. Balnea 6, p.
110-111.
Gomes, C. (2013). Naturotherapies based on minerals. Geomaterials 3, p. 1-14.
Gomes, C., Silva, J., Sequeira, M., Gomes, J. (2009). Potentials for therapeutic purposes of the biogenic
carbonate sand occurring in some Island of the Macronesia Archipelago based on their unique chemical and
physical properties. Geochimica Brasiliensis, 23, p. 332-343.
4
Gomes, C., Silva, M., Gomes, J. (2001). Psammotherapy in Porto Santo Island (Madeira archipelago). Anales de
Hidrología Médica 4, p. 11-34.
Gutenbrunner, C., Bender, P., Cantista, P., Karagülle, Z. (2010). A proposal for a worldwide definition of health
resort medicine, balneology, medical hydrology and climatology. International Journal of Biometeorology 54, p.
495-507.
Harari, M. (2012). Beauty is not only skin deep: The Dead Sea features and cosmetics. Maraver, F., Karagülle, M.
(eds). Medical Hydrology and Balneology: Environmental Aspects. Balnea 6, p. 127.
Heering, S. (2010). Balneo-Phototherapie mit Solelösung des Toten Meeres und Schmalspektrum UV-B
Bestrahlung (311NM): Evaluation der optimalen Therapieparameter. Inaugural Dissertation der Medizinischen
Fakultät der Universität Regensburg.
Hinteregger, S. (2010). Medizinalbäder und wasserunterstützte Therapieformen im Bereich der physikalischen
Medizin. Wissenschaftliche Literaturstudie zur Wirkung gängig angewandter Therapieformen. Download 4th
Nov. 2016 from
http://www.hauptverband.at/cdscontent/load?contentid=10008.566558&version=1391184727
Hirahashi, T., Matsumoto, M., Hazeki, K., Saeki, Y., Ui, M., Seya, T. (2002). Activation of the human innate
immune system by Spirulina: augmentation of interferon production and NK cytotoxicity by oral administration
of hot water extract of Spirulina platensis. International Journal of Immunopharmacology 2/4, p. 423-434.
Illing, K. (2018). Thalassotherapie – Medizinischer und touristischer Nutzen. Tourismus Wissen Quarterly, p.
103-108.
Illing, K. (2017): Medical Hotels: An approach to sustainable health in the leisure industry. Smith, M. & Puczko,
L. (eds.). Routledge international handbooks, p. 246-260.
Illing, K. (2015). ThalassoLIFE – Business Plan for a Thalasso-hotel on Cyprus. TDC.
International Standard Organization (ISO) (2015). ISO 17680 - Tourism and related services, Thalassotherapy —
Service requirements.
Katz, U., Shoenfeld, Y., Zakin, V., Sherer, Y., Sukenik, S. (2012). Scientific evidence of the therapeutic effects of
dead sea treatments: A systematic review. Seminars in Arthrosis and Rheumatism 42/2, p. 186-200.
Kazandjieva, J., Grozdev, I., Darlenski, R., Tsankov, N. (2008). Climatotherapy of psoriasis. Clinics in Dermatology
26, p. 477–485.
La Bonnardière, J. (1865). Introduction à la Thalassothérapie, Thèse de médecine. Boehm & Fils: Montpellier.
Lacroix, P., Aboyans, V. (2005). Thermalisme et médecine vasculaire - Thermatology and vascular medicine.
EMC-Cardiologie Angéiologie 2, p. 344–350.
Maraver, F., Karagülle, M. (eds.) (2012). Medical Hydrology and Balneology: Environmental Aspects. Balnea 6.
Panahi Y., Darvishi, B., Jowzi, N., Beiraghdar, F., Sahebkar, A. (2016). Chlorella vulgaris: A Multifunctional
Dietary Supplement with Diverse Medicinal Properties. Current Pharmaceutical Design 22, p. 164-173.
Parinet, J., Tabaries, S., Coulomb, B., Vassalo, L., Boudenne, J. (2012). Exposure levels to brominated
compounds in seawater swimming pools treated with chlorine. Water Research 46, p. 828-836.
Pore, P. (1984). Detoxification of Chlordecone poisoned Rats with Chlorella and Chlorella derived
Sporopollenin. Drug and Chemical Toxicology 7, p. 57-71.
Revue du rhumatisme (2016). Place actuelle du thermalisme en rhumatologie. Éditoral. In press.
Rosenfeld, M., Ratjen, F., Brumback, L. (2012). Inhaled Hypertonic Saline in Infants and Children Younger Than
6 Years with Cystic Fibrosis. The ISIS Randomized Controlled Trial. Journal of the American Medical Association
307/21, p. 2227-2269.
5
Russel, R. (1749). Dissertatio de tabeglandular, sive de uso aquaemarinae in morbis glandularum.
Schuh, A. (2009). Die Evidenz der Klima- und Thalassotherapie - Ein Review. Schweizer Zeitschrift für
GanzheitsMedizin 21/2, p. 96–104.
Schuh, A. (2004). Klima- und Thalassotherapie. Grundlagen und Praxis. Stuttgart: Hippokrates.
Stier-Jarmer, M., Kus, S., Frisch, D., Sabariego, C., Schuh, A. (2015). Health resort medicine in non-
musculoskeletal disorders: Is there evidence of its effectiveness? International Journal of Biometeorology 59, p.
1523–1544.
Tomasovi, M., Borovac, J., Vrdoljak, D., Grazio, S., Tikvica, L., Tomek-Roksandić, P. (2015). When elders choose:
Which factors could influence the decision-making among elderly in the selection of health tourism services?
Medical Hypotheses 85, p. 898–904.
Verband Deutscher Thalassozentren (2002). Qualitätskriterien. Download 13th Nov. 2016 from
http://www.thalasso-verband.de/index.php?idcat=17&sid=01b6c7023130cee9b72c5f136c669ac1
Zijlstra, T., van de Laar, M., Bernelot Moens, H. (2005). Spa treatment for primary fibromyalgia syndrome: a
combination of Thalassotherapy, exercise and patient education improves symptoms and quality of life.
Rheumatology (Oxford) 44, p. 539–46.
The author of this article is a university teacher, consultant, and hotel developer focusing on medical
hotels. He is specialized in making business plans, strategy papers, feasibility studies for health
tourism companies. Another major of the author is quality management and business development
for tourist companies in general.
FHProf. Dr. Kai Illing
TourismDevelopmentHealthCare TDC
Austria: Floecking 194, 8200 Gleisdorf
Germany: Annastrasse 18, 12247 Berlin
Mobile: +43 6888198807
Mail:
[email protected]www.med-tourism.eu
www.regiosana.eu