Comprehensive review of dermatological and cosmeceutical manifestations of thermal water and future insights

Abstract Balneotherapy is a widely accepted and well-practiced treatment modality for dermatological diseases in many countries worldwide. The use of balneotherapy approaches for skin disease management is continuously increasing, but the mechanism by which thermal water affects the treatment of different dermatological conditions has not been fully explored. This comprehensive review seeks to consolidate scientific findings regarding the effects of thermal water in the treatment of different skin diseases, such as psoriasis, atopic dermatitis, acne, ichthyosis, and lichen planus, as well as its cosmeceutical effects, drawing from both in vitro and in vivo research. This review analyzed both in vitro and in vivo studies to validate the anti-inflammatory, immunomodulatory, and antioxidant potential of thermal water in dermatology. Thermal water exhibits these properties, making it beneficial for treating various skin conditions and enhancing cosmeceutical effects." Many studies have strongly demonstrated the therapeutic benefits of different thermal waters for the successful treatment of many skin diseases, and these materials have been incorporated into cosmetics for skin hydration and anti-aging and anti-wrinkle effects. The physicochemical and microbial characteristics of thermal water contribute to its therapeutic properties, with sulfurous water being particularly effective due to their favorable mineral composition and antioxidative effects.Although the cosmetic properties of thermal water are well described, further research is needed to identify specific mineral and microbial profiles for incorporation into cosmetic products and to integrate advanced technologies and approaches to increase the effectiveness of formulated products. S hould aim to clarify the underlying mechanisms of action of thermal waters, investigate optimal treatment protocols, and assess their long-term efficacy. Longitudinal clinical trials are also needed to assess the long-term benefits and safety of these treatments, paving the way for standardized protocols in dermatological care. Graphical Abstract