What Is Hydrotherapy?

Learn what hydrotherapy is and how it is used in skin healing

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Hydrotherapy could be thought of as one of the most primitive methods of healing. Just as a wild, wounded animal will lick an injury or temporarily soak a wound, we can use water to assist with healing or for general skin health.

Water alone does not possess any innate healing powers. In fact, too much water is not good for the skin and can, for example, delay wound healing or compromise the skin barrier leading to worsening of eczema. However, water used in the correct manner can be therapeutic and have beneficial effects on the body, especially the skin. As an example, some believe tap water can increase the risk of infection if used to clean a wound, but there is some evidence in the medical literature suggesting that it may, in fact, reduce the rates of infection.[1]  

Hydrotherapy is a form of healing that involves the application of water in some way, but it is much more than simply water therapy. This technique regularly utilizes temperature variations of water to direct healing in a certain way or to a specific part of the body. Submerging a limb in hot or cold water will have a much more dramatic and rapid effect on muscle temperature than using hot or cold packs.[2] In addition, changing the composition of the water can have different effects. For example, adding colloidal oatmeal to a bath can have both antioxidant and anti-inflammatory effects that can be helpful for patients with atopic dermatitis (ecezma).[3]

Many forms of hydrotherapy are commonly used. Baths, saunas, hot towels, etc. are all ubiquitous but they aren’t necessarily thought of as hydrotherapy. Immersion hydrotherapy is common in burn units.[4] Other forms of hydrotherapy that are common, but may not be well recognized include wet wraps, warming socks, and sitz baths. There are also rare forms of hydrotherapy that may require special instruments, or they may have simply fallen out of favor.

The table below summarizes different types of hydrotherapy and its application in specific skin conditions:

Table 1. Uses of Hydrotherapy with Dermatology

Type of Hydrotherapy

Disease Studied


Salt water baths[5]

Epidermolysis Bullosa

1) Reduction in pain
2) Reduced medication use
3) Reduced skin odor
4) Reduced skin discharge

Oatmeal Baths[3]

Eczema (Atopic Dermatitis)

1) Antioxidant and anti-inflammatory effects

Bleach Baths[6]

(Atopic Dermatitis)

1) Reduction in Eczema Area and Severity Index (EASI)

Electrolyzed Reduced Water Bathing[7]

UVB radiation-induced skin injury in mice

1) Reduced UVB damage
2) Decreased inflammation
3) Epidermal thickening

Thermal Baths + Sun Exposure[8]


1) Improvement in scaling, erythema and plaque thickness

Dilute Bleach Baths[9]

Bacterial infections with atopic dermatitis

2) Decreased clinical severity of atopic dermatitis


For general wellbeing

1) Reduced blood pressure
2) Enhanced blood flow
3) Mobilization of heavy metals and xenobiotics

Balneotherapy (Bathing in mineral springs) [11]

Therapy after plastic surgery

1) Reduced inflammation, pruritus and pain
2) Enhanced scar maturation
3) Improved skin thickness

In-Patient Hydrotherapy (Treatment Facility)[12-14]

Psoriasis, Atopic Dermatitis

1) Improved quality of life
2) Reduction in severity of symptoms
3) Reduced inflammatory markers
4) Reduced S. Aureus infections

Thermal Water Incubated with Boron and Manganese[15]

Potential for wound repair

1) Induction of matrix proteins that help with tissue remodeling during wound healing

Rice-starch Bath[16]

Atopic Dermatitis, barrier damaged skin

1) 20% improvement of healing capacity of damaged skin
2) Improved barrier function

Wet Pajama Wraps[17]

Atopic Eczema

1) Reduced itch
2) Reduction of sleep loss
3) Reduced S. Aureus colonization

Wet Wraps[18]

Atopic Dermatitis

1) 70% reduction in SCORAD* scores

*SCORAD = Scoring Atopic Dermatitis


Are There Any Risks with Hydrotherapy?


The use of extreme temperatures (both hot and cold) can pose a risk of damaging skin. Freezing is more of a theoretical issue, not a practical issue, because very cold temperatures are rarely used with any form of hydrotherapy, but burns from heat can be a common problem. This is particularly concerning when using extreme temperatures on a person with altered sensation. For example, people with diabetes often have a diminished pain sensation in the extremities, called diabetic neuropathy. When a person is unable to adequately feel pain, they are not able to perceive the skin damage that might be occurring due to extreme temperatures. When having a hydrotherapy treatment, it is important that each person is capable of understanding and communicating any adverse effects that may be happening as a result. 


Contaminated equipment used in hydrotherapy treatment can lead to outbreaks of infections.[19]

The goal of hydrotherapy is to utilize water in some form, or with varying temperatures, to direct healing to some part of the skin or body. Temperature variations can affect blood circulation, and this can be controlled in a way that can direct the blood flow to or from a specific organ or organ system. Altering the composition of water by adding substances to it can also target the desired effect of the treatment. By harnessing the beneficial effects of a form of treatment that has been used for thousands of years, hydrotherapy can provide a useful addition to many skin treatment regimens.

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​1.    Fernandez R, Griffiths R. Water for wound cleansing. Cochrane Database Syst Rev.2012;2:CD003861; PMID: 22336796.

2.    Petrofsky JS, Laymon M. Heat transfer to deep tissue: the effect of body fat and heating modality. J Med Eng Technol.2009;33(5):337-348; PMID: 19440919.

3.    Fowler JF, Jr. Colloidal oatmeal formulations and the treatment of atopic dermatitis. J Drugs Dermatol.2014;13(10):1180-1183; quiz 1184-1185; PMID: 25607551.

4.    Staley M, Richard R. Management of the acute burn wound: an overview. Adv Wound Care.1997;10(2):39-44; PMID: 9204810.

5.    Petersen BW, Arbuckle HA, Berman S. Effectiveness of saltwater baths in the treatment of epidermolysis bullosa. Pediatr Dermatol.2015;32(1):60-63; PMID: 25644039.

6.    Wong SM, Ng TG, Baba R. Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia. J Dermatol.2013;40(11):874-880; PMID: 24111816.

7.    Yoon KS, Huang XZ, Yoon YS, et al. Histological study on the effect of electrolyzed reduced water-bathing on UVB radiation-induced skin injury in hairless mice. Biol Pharm Bull.2011;34(11):1671-1677; PMID: 22040878.

8.    Morelli V, Calmet E, Jhingade V. Alternative therapies for common dermatologic disorders, part 2. Prim Care.2010;37(2):285-296; PMID: 20493337.