Published on Discovery Channel health, 21 February 2003

There’s nothing more luxurious than relaxing in a hot spa or sauna after a hard day’s work. But as well as making you more relaxed, can these therapies actually boost your well-being?

The history of hydrotherapy

Water has been used for thousands of years to improve health and is now being rediscovered by doctors, sports players and stressed office workers as a terrific means of recuperation.

Healing with water, or hydrotherapy, has been around since records began. There’s evidence that people built water installations as early as 2400 BC. The Egyptians and Assyrians used mineral waters for their health. Most famously, the Romans were huge fans of water therapy, ranging from hot and cold water to steam rooms, but it was equally popular with the Japanese, Chinese and Greeks.

The decline of the Roman Empire saw the West turn its back on hydrotherapy. The Church branded any association with the use of the elements, like water or fire, pagan, and hence its use rapidly petered out.

Not that it died out completely. The German government, for example, remained so convinced of the recuperative effects of spas that until recently all its citizens were entitled to four weeks every three years at the famous spa town of Baden-Baden, all on the state. When the government decided to cut its expenditure on spas to balance the books, Germans were up in arms over what many saw as their birthright.

Feelings may not run so high in the UK, but spas and saunas are nevertheless becoming big business, now found in many hotels and several dedicated facilities around the country.

A new Bath spa

Dr John Harcup, medical advisor to the British Spas Federation, says Britain’s most famous spa town – Bath – will soon benefit from a brand new dedicated spa complex, which should be open in two or three months. Crucially, however, he says that about 20 per cent of the complex will be for specifically medical use.

“Spa treatments are getting more medically orientated,” he says. “There’s lots of research into things like arthritis and sports treatment.” He is hoping Bath rugby club will take advantage of the facilities. “It’s much easier to exercise in water, and so after injuries or operations or strokes it is very effective for rehabilitation.”

Water not only supports the body but is also excellent at distributing, applying and removing heat. “People have used water for 2,000 years but post-war they didn’t think they needed things like water. What they have forgotten is that it has very little side effects,” explains Dr Harcup.

Sarah Cox, chartered physiotherapist and member of a special interest group for hydrotherapy, agrees entirely. “There are many conditions that can be treated in a pool but not in a gym,” she says. “People with broken legs or knees for example. They can’t walk normally but they can exercise in the water.”

Pain relief is also a great advantage, according to Sarah, who says terminally ill patients often contact the group in order to gain some relief.

As well as aiding injuries, aching or stiff muscles and joint problems such as arthritis, the New England Journal of Medicine claimed in 1999 that soaking in a warm spa can help type 2 diabetes. The condition mainly affects older people; especially those who are overweight.

Dr Philip Hooper of the McKee Medical Centre in Colorado found that, over three weeks, patients who spent 30 minutes a day in a hot tub had an average drop in blood sugar levels of 13 per cent. In some cases, this meant they did not need to take their insulin injections.

Exercise while soaking

The significant drop was put down to a spa’s ability to act in a similar way to exercise. The heat of the water draws a lot of blood into the skin, which causes a drop in blood pressure. This drop then causes the heart to pump faster in order to maintain blood pressure.

It is this change that is behind many of the water therapy’s positive effects but also why people with high blood pressure, pregnant women and children should be wary of spas and saunas.

Only last week, doctors warned people with kidney problems and high blood pressure to avoid jacuzzis after a 36-year-old German man with cysts on his kidney suffered internal bleeding after using one.

Jacuzzis, named after Roy Jacuzzi who invented the artificial water-jet spa in 1970, are unusual in that a fast jet of air is fired into the tub. The man – who also had high blood pressure and took medication to thin his blood – was particularly susceptible to the blast.

Ask the Finns

Extensive research shows that saunas do have a physiological effect. Experts have carried out large numbers of medical experiments on the Finns who are famous for their love of them. Aside from facts and figures on cardiac output, studies have shown saunas to induce hormonal changes.

The Finnish Sauna Society says a sauna is a pleasant, relaxing and refreshing experience beneficial to both body and mind. It cleanses the skin, removes aches and pains, and helps people sleep more soundly. The society adds that a sauna has many physiological short-term effects, but no permanent effects on health.

Dr Harcup assures us that a bath in dense water, perhaps including creams or algae or peat, is so soothing that the intense feeling of relaxation lasts for hours or even days afterwards. Don’t expect miracles from your spa, but you might be surprised at just how many benefits a bit of water therapy can provide.

Further information:

• British Spas Federation
• Finnish Sauna Society

Published on Discovery Channel Health, 12 July 2002

The mention of scabies is likely to have most people recoiling in horror. An infestation of small mites that dig under your skin and leave eggs to hatch along the way is hardly attractive.

Unfortunately, it is precisely this stigma that stops many people getting help immediately. As well as prolonging a sufferer’s discomfort, this delay puts friends and family at a significantly higher risk of becoming infected too.

We are just past the peak of a 30-year cycle of scabies in the UK, but despite it being a common complaint, most of us remain hopelessly ignorant of what scabies is, how it is spread and how to treat it.

An unwelcome visitor

Scabies is a mite infestation. A female mite, about 4mm long, tunnels into the skin where she lays eggs and then moves on. Behind her she leaves burrows of up to a centimetre in length, noticeable on the skin, sometimes red, sometimes a grey/white colour. After the mite has been in the skin for around four weeks, sufferers experience intense itching especially at night or after a hot shower – which first alerts them that they have the condition.

In most cases, the mites, and therefore the itching, can be found on the fingers or wrists, and in children, on the face or the soles of the feet. It also tends to occur on the penis or scrotum in men and on the nipples in women.

Scabies is extremely infectious, and people who come into close contact with an infected person have a 40 per chance of contracting the condition. It is spread by one way only – skin-to-skin contact.

In most cases, this simply relates to holding hands, which explains why families and old folks’ homes are particularly susceptible to scabies. But close genital contact can also spread the condition, which explains why many wrongly see it as purely a sexually transmitted disease.

Mistaken identity

However, apart from the stigma of scabies and delay in symptoms, one of the major problems is that the disease is chronically misdiagnosed, says Philip Cox, an entomologist from the Medical Entomology Centre in Cambridge. “It can be put down to anything from heat rashes to insect bites.”

That problem is confirmed by GP Jim Lawrie, who works in east London. “It’s known as ‘the great mimic’ because it can look like 100 other things from eczema to all different types of rashes. Unless your suspicion is high, you may not notice it,” he says.

And the longer scabies goes unnoticed, the greater the infestation will become and the higher the risk of it spreading to others.

Fortunately, it is easy to test for the disease, says Philip. “You take a scraping and it takes five minutes to do the test. Simple.”

Once diagnosed, treating scabies is easy: sufferers use an over-the-counter body cream similar to the shampoo used to get rid of head lice – something every parent will be aware of.

A waiting game

But this can cause further problems. “You have to get the treatment right,” Dr Lawrie explains. “You have to cover your whole body with the cream and then leave it on for at least 12 hours. The problem is that people go to the toilet, wash their hands, and don’t reapply it.”

With just one of the mites’ favourite places free from the cream designed to kill them, the infestation will continue.

Coupled with this, even after a successful treatment, patients may continue itching for up to two weeks, making it even harder to know if the scabies has been wiped out. If one family member fails to rid themselves from the lice, the whole infestation could start all over again.

Scabies won’t disappear by itself, but with some attention it is no more difficult to get rid of than head lice. Plus, fortunately, the disease is in decline at the moment. After five years of increasing incidence in scabies, there was a reduction in 2001, Douglas Fleming, director of the Royal College of General Practitioners recently noted.

That reduction looks set to continue over the next few years until it eventually reaches the previous low of 1988. However, without a more widespread understanding of scabies among the general public, it is almost certain to rise again.

Even with wider understanding, it seems unlikely we will ever get rid of the pest, Dr Lawrie says.

“You see, the itching comes from an allergic reaction to the mite’s faeces. Some people get terrible itching while others feel nothing, so they happily wander around co-existing with their parasites,” he says.

A lovely image if ever there was one.

Further information:

• Public Health Laboratory Service