Skin conditions: a modern-day problem that changes everyday life
Skin conditions are among the most common chronic complaints of our time. Psoriasis, atopic dermatitis and eczema can profoundly affect everyday life: from unpleasant physical symptoms such as itching, burning, pain and inflammation to psychological effects — stress, exhaustion or a loss of self-confidence.
Mariánské Lázně (Marienbad) — an official climatic spa since 2023 — is a spa resort listed in the Czech indication list for skin diseases. Treatment here combines traditional balneology, dermatological treatments and the climatic conditions of the region. Whether you are included in a treatment plan is decided by the spa physician after the initial examination; the stay complements the care of your dermatologist, it does not replace it.
Which diagnoses are treated here
The Czech indication list (Decree No. 2/2015 Coll.) places skin diseases in group X. In Marienbad the following are treated:
- X/1 — atopic eczema: basic stay of 21 days in both comprehensive and contributory care, repeat stay of 21 days (contributory care 21 or 14 days)
- X/2 — generalised and arthropathic psoriasis vulgaris: basic stay of 28 days in comprehensive care or 21 days in contributory care, repeat stay of 28 days (contributory care 21 or 14 days)
Details of the types of covered care can be found on the page Indications and contraindications. Treatment takes place in the stable phase of the disease, not during an acute flare; for other chronic skin complaints, the suitability of a self-paying stay is decided by the spa physician.
How the treatment works
The treatment programme for skin diseases at Ensana Mariánské Lázně combines five types of treatment. Their selection, number and order is determined by the spa physician according to the condition of the skin and general health.
1. Mineral baths
A bath in the local mineral water, with its high content of dissolved carbon dioxide, usually lasts 20 minutes in water at 34–36 °C. The skin is in contact with the water and the dissolved minerals throughout; the bath is followed by rest. What reviews of studies say about bathing in mineral water is summarised in the section below.
2. Dry CO₂ baths
In a dry CO₂ bath, the body is enclosed from the neck down in a bag filled with natural carbon dioxide from the Maria Spring. CO₂ penetrating the skin dilates the cutaneous vessels and increases blood flow in the skin; the treatment lasts 20 to 30 minutes and places no strain on the body from heat or the hydrostatic pressure of water. Read more about Marienbad's gas in the guide to gas injections.
3. Peloid (peat) wraps
Peat from the Slavkov Forest, heated to 38–42 °C, is applied to the affected areas and covered with a film and cloth; the wrap lasts 20 to 40 minutes. For skin diseases it is part of the traditional treatment programme; whether it is included, and at what temperature and length, is decided by the spa physician according to the condition of the skin. Details about peat can be found in the article on peat therapy.
4. Climate therapy
Since 2023, Marienbad has carried the designation of a climatic spa: the clean air here is a monitored natural healing resource. The local environment at 630 metres above sea level is characterised by a low content of particulate matter, a low concentration of allergens and temperatures without extreme swings. Climate therapy is part of the treatment programme for skin diseases: the spa physician prescribes time in the fresh air, terrain walks and rest in the parks as part of the daily regime. More on the page on climate therapy.
5. Phototherapy
The treatment programme is complemented by phototherapy with narrow-band UVB light at a wavelength of 311 nm, including a phototherapy comb for the scalp, and with red light. This is a standard dermatological method; the dose and number of sessions are determined by the physician according to skin type and diagnosis.
What research says
Balneotherapy for skin diseases has been the subject of a number of studies, although their quality varies. An overview of 49 systematic reviews from across balneology placed psoriasis, alongside selected musculoskeletal conditions and chronic venous insufficiency, among the areas with the best-documented benefit from spa treatment (Antonelli et al., 2021, Int J Biometeorol). A systematic review focused specifically on bathing in thermal mineral water for skin diseases included eight studies — seven in psoriasis and one in atopic dermatitis — and all consistently described an improvement in symptoms after a series of baths; the authors point out that the studies are few and often of low quality (Protano et al., 2024, Int J Biometeorol). A broader review of 22 studies of balneotherapy, spa treatment and hydrotherapy for psoriasis and atopic dermatitis reports that most of them describe an improvement in the PASI index (Moini Jazani et al., 2022, Int J Dermatol).
One limitation needs to be stated openly: the cited studies come from spas with a different water composition, often warm sulphurous or saline waters, whereas the Marienbad springs are cold carbonated waters. The results therefore describe balneotherapy as a method, not the specific Marienbad programme.
What the expert says
MUDr. Lucie Jarešová, vice-chair of the Association of Outpatient Dermatovenereologists of the Czech Republic, says of a stay at a climatic spa in a report from Marienbad:
"A stay at a climatic spa leads to an improvement in skin symptoms thanks to the combination of therapeutic treatments and clean air. The easing of itching leads to good-quality sleep, which in turn affects a person's mental state and calms skin problems."
This is an expert opinion from practice that complements the reviews cited above; it is not the result of a clinical study.
When spa treatment is not suitable
Spa care cannot be provided in the case of infectious diseases transmissible from person to person, in the acute stage of any disease — and so not during an acute flare of eczema or psoriasis either — with clinical signs of circulatory failure, recent deep vein thrombosis, in pregnancy and with the other general contraindications, the full list of which can be found on the page indications and contraindications. For phototherapy, the physician also considers skin type, any medications that increase sensitivity to light and a history of skin cancer. The final word rests with the treating dermatologist in the proposal and with the spa physician at the initial examination.
Insurance and the spa treatment voucher
For guests insured in the Czech Republic, spa treatment can be covered by public health insurance. Under comprehensive care, the insurer covers treatment, accommodation and meals at the standard level; the condition is a proposal from a dermatologist or GP and approval by the insurer's medical reviewer. Under contributory care, the insurer covers the treatment component and the patient pays for accommodation and meals. The step-by-step procedure is described in the guide to the spa treatment voucher. A self-paying stay is possible at any time without waiting.
Why Mariánské Lázně
Available here in one place are mineral springs, a natural source of CO₂, peat from the Slavkov Forest, the status of a climatic spa and a medical team that works with dermatology patients throughout the stay. Guests can also make use of wellness services, quality accommodation and a calm setting. An overview of the Ensana spa hotels can be found on the accommodation page.
Before you leave, ask for a copy of your dermatology records and a list of the medications you use, including ointments. On the day of arrival, you have an initial examination with the spa physician, who draws up the plan of treatments and adjusts it during the stay according to how your skin responds.
