About two million people in Germany suffer from psoriasis. This is a reaction disorder of the skin that manifests itself as inflammation and flaking in very different forms, but is not contagious or infectious. According to the bathing regulations, people with psoriasis were forbidden from entering public swimming pools until 2005. Today, however, like others, they can visit public bathing establishments.
Swimming association rewrites model bathing regulations
In 2005, after negotiations with the German Psoriasis Federation (DPB), the German Bathing Society changed the model bathing regulations for public swimming pools. The passage “People who (…) suffer from skin changes, in which, for example, scales or scabs come off and go into the water” has been deleted from the model bathing regulations. Instead, § 2 c was changed to:
“Access is not permitted: People suffering from a reportable, communicable disease (in case of doubt, a medical certificate may be required) or open wounds”.
Nevertheless, some bathing regulations still contain stigmatizing or exclusionary formulations against people with psoriasis. For example, people who suffer from “unaesthetic” skin changes or rashes are sometimes denied entry. According to the assessment of the German Psoriasis Association, this is a violation of the General Equal Treatment Act (AGG). Anyone who discovers such formulations in bathing regulations can contact the DPB, who will try to take action against it.
Psoriasis isn’t unsanitary
Dander flakes off everyone’s skin while bathing. Even in people suffering from psoriasis, it is not to be expected that many dandruff will come off, which could pollute the bath water. The normal hygiene measure that applies to all bathers, namely a thorough shower before bathing, is sufficient to rinse off loose flakes.
“We recommend that our patients take a nice shower beforehand and brush them carefully with a soft brush, then there won’t be more dandruff in the water than with others,” explains dermatologist Prof. Dr. Joachim Barth: “What remains is the sight of a skin disease that other bathers may find unpleasant.” The bathing staff could help to mediate and inform bathers who should take offense about the disease.
Swimming despite a skin disease
One can only hope that many psoriasis patients will make use of their rights: It takes courage to visit a public swimming pool with a visible skin disease and to expose yourself to the gaze of others. Most of all, people with psoriasis suffer from being stared at and ostracized because of their skin. They tend to hide themselves and their diseased skin as they often feel left out and rejected.
The change in bathing regulations was therefore seen primarily as a moral victory against social stigmatization and exclusion. Now no psoriasis patient needs to be afraid of being thrown out of the bathing establishment because of his skin disease. A piece of normality for around 2 million people affected in Germany.
Bathing is an important part of psoriasis therapy
Psoriatics (people with psoriasis) can benefit greatly from bathing. “Bathing is an important part of therapy,” explains Prof. Barth. According to a study by the German Dermatological Society (DDG), the effectiveness of therapeutic baths with brine has been proven on 1,200 patients.
Bathing softens the upper layer of skin, which can therefore be penetrated better by UV rays. The optical density of the skin is improved, so that the radiation of the sunlight can penetrate deeper into the skin. The UV-B radiation causes the inflammatory cells, which play an important role in the disease process, to be killed.
Nibble fish: treatment by small fish?
Another form of bathing treatment – not in a swimming pool, but in an aquarium or (even better) in a thermal bath in Turkey – is bathing with nibble fish, also known as kangal fish therapy. Certain fish, the garra rufa (reddish mullet) and the carp-like surgeonfish (Leucsicus chephalus), are known to simply nibble away the scaly skin, similar to a peeling. After such treatment, psoriasis sufferers can rest for a while from their illness. Many report positive experiences.
But be careful: the benefits of this form of therapy have not yet been scientifically confirmed. In addition, there are indications that the treatment in Turkey could show the greatest effect, since the mixture of medicinal water, climate, sun and holiday relaxation also has an influence on the success.
Conclusion: bathing is recommended for psoriasis
Bathing, ideally in brine water, and then sunbathing help to reduce psoriasis. Especially in the outdoor pool season, psoriasis patients benefit greatly from being able to enjoy the healing power of water and sun.
Bathing in a sauna is particularly beneficial for psoriasis sufferers. Sweating and frequent water applications cause the top layer of the skin to swell. The stubborn cornifications of the skin areas affected by psoriasis can be softened and removed.