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Background: Spa has been applied for the alleviation of atopic dermatitis (AD), but there have been few studies on the efficacy and safety of hot spring sea water therapy. Objective: This study aimed to clarify the conditions which have adequate efficacy and safety of hot spring sea water therapy for the treatment of AD. Method: Twenty-eight patients with AD who had mild to moderate symptoms were enrolled and divided into 14groups according to bathing frequencies, temperatures, durations,and kinds of water. Bathing frequency was 2, 3 or 7 times a week. Temperature was 37oC or 40oC, and duration was 15 or 30 minutes. Twelve groups took a bath in hot spring sea water obtained from an island in Korea,1 group took a bath in salt water and 1 took a bath in tap water. We assessed o-SCORAD index at baseline and every week for 4 weeks. In addition, colony counts of S. aureus were evaluated at baseline and at the last visit. Result: The 3 times-a-week/37o C/15 minute and twice-aweek/37oC/30 minute groups showed the largest and continuous decline in o-SCORAD index. The index was also slightly decreased in the salt and tap water groups. The colony counts of S. aureus did not show significant changes after bathing. Conclusion: This pilot study shows the possibility that hot spring sea water therapy might be an efficacious and safe treatment option for treating AD. However, the precise mechanism should be elucidated through further studies.

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