DEAD SEA MUD & CUTANEOUS BLOOD FLOW 269 during mud application as well as directly and 15 min posttreatment. This confi rms that Dead Sea mud application for 30 min did not increase skin blood fl ow as compared with baseline values. However, because cutaneous microcirculation is a physiological parameter that is subject to dynamic regulation and rapid variation and infl uenced by many environmental and individual factors, it is important to compare fl ux readings simultaneously at the same time point in a contralateral site (13). Taking this in consideration, and after confi rming that baseline fl ux and temperature readings were stable and comparable for each circular area in both treated and control forearms, we compared fl ux and skin temperature read- ings of the treated forearms with their simultaneously recorded values of the control forearms for each circular area at each measured time points in both protocols. CONCLUSION Our two clinical studies showed the lack of a signifi cant increase in skin blood fl ow and skin temperature during, as well as 15 min postapplication of all types of Dead Sea mud “Salted” mud, “As is” mud, and “Over-the-Shelf” mud. We may conclude that the increase in skin blood fl ow and temperature advertised by the manufacturer after mud application is not attributed to skin irritation rather, it could be attributed to the direction of use suggested by the manufacturer. The manufacturer direct mud user to warm the mud before application. This warming may enhance skin blood fl ow and skin temperature as it is well documented that heat increases skin blood fl ow in healthy subjects (17). This LDF study confi rms the mildness of all Dead Sea mud regardless of their salt con- tent. DSM mildness previously confi rmed in our laboratory by the lack of any marked differences in skin erythema as well as skin pH in mud-treated forearms compared to baseline values (18). REFERENCES (1) Z. Ma’or, S. Yehuda, and W. Voss, Skin smoothing effects of Dead Sea minerals: comparative profi lomet- ric evaluation of skin surface, Int. J. Cosmet. Sci., 19(3), 105–110 (1997). (2) S. Halevy, H. Giryes, M. Friger, N. Grossman, Z. Karpas, B. Sarov, and S. Sukenik, The role of trace elements in psoriatic patients undergoing balneotherapy with Dead Sea bath salt, Isr. Med. Assoc. J., 3(11), 828–832 (2001). (3) M. Harari, J. Shani, V. Seidl, and E. Hristakieva, Climatotherapy of atopic dermatitis at the Dead Sea: demographic evaluation and cost-effectiveness, Int. J. Dermatol., 39(1), 59–69 (2000). (4) C. M. Schempp, H. C. Dittmar, D. Hummler, B. Simon-Haarhaus, J. Schulte-Monting, E. Schopf, and J. C. Simon, Magnesium ions inhibit the antigen-presenting function of human epidermal Langerhans cells in vivo and in vitro. Involvement of ATPase, HLA-DR, B7 molecules, and cytokines, J. Investig. Dermatol., 115(4), 680–686 (2000). (5) J. Shani, R. Sharon, R. Koren, and Z. Even-Paz, Effect of Dead-Sea brine and its main salts on cell growth in culture, Pharmacology, 35(6), 339–347 (1987). (6) J. Shani, S. Barak, D. Levi, M. Ram, E. R. Schachner, T. Schlesinger, H. Robberecht, R. Van Grieken, and W. W. Avrach, Skin penetration of minerals in psoriatics and Guinea-pigs bathing in hypertonic salt solutions, Pharmacol. Res. Commun., 17(6), 501–512 (1985). (7) D. Poensin, P. H. Carpentier, C. Fechoz, and S. Gasparini, Effects of mud pack treatment on skin microcirculation. Joint Bone Spine, 70(5), 367–370 (2003).
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