Sauna for psoriasis
Evidence review
Overview
In a German examination of 213 men with psoriasis, sauna bathing had no effect on skin lesions in 87.9%, improved them in 10.7% and worsened them in 1.4%. Sweating over untreated plaques was about 50% lower than normal skin and increased after scale removal. There is no controlled evidence that sauna treats psoriasis.
Key findings
- Sauna bathing: no change in lesions in 87.9%, improvement in 10.7%, deterioration in 1.4% (Ständer 1983, n=213 men)
- Perspiration over untreated psoriatic plaques about 50% lower, rising after scale removal (Ständer 1983)
Every study we reviewed
1 found no effect
Each study was checked on PubMed. The colored edge shows the direction of the result. The research library lists 6 studies on psoriasis, across all heat and cold therapies, including case reports and older work not graded here.
[Psoriasis patients in the sauna].
Ständer M et al. Hautarzt. 1983. PubMed 6643057
- Who
- men with psoriasis
- What
- sauna bathing
- Measured
- skin lesions; evaporation (sweating) over plaques; skin temperature
- Result
- No influence on lesions in 87.9%, improvement in 10.7%, deterioration in 1.4%; perspiration over untreated plaques reduced by 50%, increasing after scale removal; skin temperature did not differ.
- Limitations
- uncontrolled; men only; how lesion change was assessed is not given in abstract
Protocols used in the studies
Ordinary sauna bathing; the abstract gives no temperature, duration or frequency.
What is still unknown
Controlled trials of sauna as an adjunct to topical or systemic therapy; effects on pruritus and quality of life; tolerance in psoriatic arthritis.
Safety
Cautions for sauna in this condition
- Psoriatic plaques sweat less (PMID 6643057), which may reduce local heat loss; extensive plaque psoriasis or erythroderma warrants caution with heat exposure.
- See general-safety.
For clinicians
Suggested rationale
In an uncontrolled series of 213 men with psoriasis (Ständer 1983), sauna bathing left lesions unchanged in most, improved them in about 1 in 10 and worsened them rarely; there is no trial evidence that sauna treats psoriasis.
Suggested wording only. The treating clinician decides whether it reflects their clinical judgment for this patient.
Typical ICD-10 codes: L40.0. Examples only; the clinician assigns the code.
What a letter of medical necessity should containWho can write it: physicians, NPs, PAs and others