Skin is an amazingly complex organ and, by weight, the largest of the body. It covers some 22 square feet and weighs around 9 pounds (roughly 7 percent of body weight).1 Its integumentary system provides the front line of defense for the body, as well as being expressive of physiological conditions and emotional states. Skin is the extension of our nervous system to the outside of the body. Often referred to as our third lung, it is involved in processes of exchange between the internal and external environments — respiration, absorption and elimination.
Eastern and Western Viewpoints
In Traditional Chinese Medicine (TCM), the Lung Qi is seen to rule the surface of the body. The lungs, in this view, can be understood as an involution of the external body surface, a largely epithelial surface in direct contact with the atmosphere. “It is the lungs which both differentiate the individual from the environment, via the skin surface, and connect him or her to it, via the breath.”2 In addition to extracting Qi from the air, lungs disperse body fluids as a fine “mist,” especially to the skin. The health of the lungs, and the ability to breathe, is reflected in the skin. Lung Qi generates Wei-Qi (defensive Qi), which is a pervasive energy circulating on and around the skin, and moving through the Cou Li (the space between the skin and muscles). This defensive energy acts as a protective “force-field” against external pathogens. Wei-Qi regulates temperature in the body by opening the pores to release heat and bathe the skin with cooling, waste-laden fluids (perspiration), as well as by closing the pores in response to cold, thereby conserving body heat. Wei-Qi is said to warm the muscles, it regulates the circulation of blood to the muscles and skin. Lung Qi and its yang partner, Large Intestine Qi, are associated with the metal/air element and the complementary processes of taking in and letting go.
From a Western point of view, too, the skin is understood as both a semi-permeable membrane and as a front line of defense against “noxious external influences.” Through the secretion of sebum, sweat and salts, the skin maintains its important bacteria-inhibiting acid mantle. The keratin layer, a tough, compact sheet of interwoven proteins, protects the body from the external environment and virtually waterproofs it. Water-resistant molecules protect the pores and interstices in this keratin covering, keeping water in to prevent dehydration, as well as keeping water and other foreign substances out. However, under certain circumstances, these openings can allow fluids, dissolved gases and compounds, bacteria and other microscopic elements to penetrate the skin barrier. Small molecules that have both lipid and water solubility can quickly penetrate the skin and enter into the circulatory system. Heat, activity and body temperature facilitate the ease with which these “border exchanges” can take place. Herbal poultices, homeopathic remedies, flower essences, aromatherapy oils, therapeutic baths, and now, transdermal patches, rely on the permeability of the skin for either introducing substances into systemic circulation via the skin or mucous membranes, or for drawing toxic substances out of the system via the eliminative channels of perspiration.
Absorption and Elimination
Generally, substances directly enter systemic circulation through the skin’s surface in a dissolved solution which diffuses into extracellular fluids and then through the extremely thin walls of lymph ducts and capillaries. Aromatherapist Patricia Davis3 cited an example, using oil of garlic rubbed into the skin of the feet. Within 10 minutes, the garlic was noticeable on the subject’s breath. The essential oil had been absorbed through the skin and into the bloodstream, and had already reached the deoxygenated blood returning to the lungs within the span of 10 minutes. Not all substances are assimilated so quickly, nor will all substances be absorbed through the skin. Some of the substances readily absorbed include oxygen, carbon dioxide, fat-soluble vitamins (A, D, E and K), steroids, plant resins such as poison oak and poison ivy, organic solvents such as paint thinners, and heavy metal salts such as lead, mercury and nickel.4 Fortunately, the skin does contain its own defense system consisting of internal antigen-processing, an apparatus for chemical detoxification, and enzyme systems for DNA repair from radiation damage.5
The skin is an important organ of detoxification and elimination. Toxins are absorbed from the external environment, but there is also an accrued buildup of wastes and toxic residues the body has been unable to eliminate. These materials form a crystalline coating of organic protein metabolites, by-products of muscular activity and cellular dentritus, around the fascial sheaths surrounding the body’s muscles. As these toxic wastes accumulate, tissues become more dense and less pliable, with decreased sensitivity and responsiveness.6 Massage facilitates the release of these toxins, which then can be moved out of the body through the lymphatic system and the eliminative systems of the kidneys, bowels, lungs and skin. When toxins are released through bodywork, particularly where there are accumulations of substances the body was already having difficulty eliminating, symptoms of acute detoxification, or “healing crisis,” may appear within 24 hours. These include the flu-like symptoms of sore muscles, aching joints, headache, nausea, depression and irritability. Drinking plenty of fluids and taking detoxification baths are a simple and effective way to assist the body’s elimination systems to cope with the sudden concentrations of toxins in systemic circulation.
There is a long history of cleansing/detoxification baths used by naturopaths and by spas in Germany. Hot baths (98-105 F) sedate and relax the body, relieve minor aches and pains, and assist in the elimination of toxins. Moist heat causes profuse sweating with loss of water, salt and small amounts of urea, uric acid, creatinine, phosphates, sulfates and lactic acid. Body temperature rises, blood pressure drops, metabolism accelerates, skin becomes flushed, blood is drawn to the extremities, white blood cells increase and blood becomes more alkaline.7 Hyperthermia, overheating the body, stimulates the immune system, and in reasonable amounts is safe for most adults. Where there is an existing medical condition, it is always prudent to seek the advice of a primary health care provider as to the suitability of hot baths. General contraindications include high or low blood pressure, cardiac problems, vascular conditions (including varicose veins, phlebitis, diabetes), pregnancy, systemic or chronic diseases, seizures, hypo- or hyperthyroidism, significant obesity, infectious or inflammatory conditions, and the influence of alcohol or drugs.8 It is advised to wait 15-20 minutes after strenuous exercise, and 30-60 minutes after a meal, before taking a hot bath. Progressively work up from five minutes to 15 and then to 20-30 minute soaks. Those 65 and older should limit hot baths to 5-10 minutes at a time.
Drink cool (not cold) water both during and after a hot bath to prevent dehydration, fatigue and muscle weakness. Drinking 8 ounces of purified water per 20 pounds of body weight, per day, is recommended to promote the optimal filtration of the blood by the kidneys and to keep the tissues hydrated. Coffee and sodas have a dehydrating effect and are not a substitute for water. Orange juice after a hot bath can help replenish lost potassium. Flushing the system by drinking plenty of water after a massage will help to eliminate toxins which would otherwise accumulate in fat cells, muscles and joints.
After a hot bath, to continue sweating and further assist the skin in excreting heavy metals and other toxins, wrap the body (including the head) in towels. Shower afterwards to remove toxins from the skin surface which could otherwise be reabsorbed and retoxify the blood. A cold shower is best if your constitution is up for it. Cold water closes the pores that were opened during sweating. It acts as a tonic, and invigorates, enlivens and awakens. Remain in the cool shower or bath for three minutes to constrict blood vessels and stop sweating.
Below are four of the most common, and most broadly beneficial, detoxification baths.
Epsom salt baths provide a broad spectrum cleanser, clearing lymphatic congestion, removing some heavy metals (mercury, lead, aluminum, arsenic), and eliminating residual radiation from medical tests (X-rays or CAT scans), computer monitors and televisions, and UV exposure from frequent air travel. It is also helpful for chemical exposure — automobile exhaust, solvents, formaldehyde, glues, styrofoam, synthetic perfumes, printer and copier toners, art supplies, printing inks, particle board, household cleaning items, as well as chemical residues in foods or from inoculations.9 This is an important general maintenance bath for hospital personnel, computer operators, workers around toxic chemicals and those who fly regularly.
Epsom salts (magnesium sulfate) are a smooth muscle relaxant and will help with muscle strains and pain. They will induce profuse sweating. The high saline concentration makes the bath water more dense than the body’s interstitial fluids. Consequently, osmotic pressure pulls toxin-laden fluids out of the body.
This bath should be taken as hot as is tolerable, for 12-15 minutes, 1-4 pounds of Epsom salts in a full bathtub is recommended (the more salt, the more perspiration). Acupuncturist and health educator Irene Newmark suggests 2 pounds as a maintenance bath, for clearing lymphatics and the energetic body, and 4 pounds for radiation. Former AOBTA president Carl Dubitsky recommended a much higher concentration — 12-16 pounds for the first detox bath and 8-12 pounds for subsequent baths. One every three days is the maximum frequency, as this bath can have a draining effect.
Apple Cider Vinegar
Apple cider vinegar baths restore a natural pH to the skin and hair, as well as rejuvenate and build up the body’s resistance. This bath helps restore acid mantle protection to the skin, which is lost from swimming and from routine use of soaps on the skin. Thus, apple cider vinegar baths help combat “unfriendly” bacteria, fungal overgrowth, and are helpful with vaginal and bladder infections. Apple cider vinegar baths are soothing to the skin, alleviating itchiness, poison ivy and sunburn discomfort. As with all hot baths, it causes the pores to open and aids in general systemic detoxification.
Make certain to use pure, unprocessed apple cider vinegar. Commercial vinegars have lost much of the mineral content and make for a weak electrolyte solution. Apple cider vinegar contains potassium, phosphorus, natural sodium, magnesium, natural fluoride, iron, silicon, sulfur, and other trace minerals which are nourishing to the skin. Use 2-4 cups in a hot bath.
Baking Soda & Sea Salt
A hot bath with equal parts of baking soda (sodium bicarbonate) and sea salt assists in detoxification from exposure to heavy metals and radiation. It is also beneficial for cleansing the auric field and for soothing itchy skin. In combination, use 1-2 pounds of each. Sea salt is recommended, as opposed to rock salt or common table salt, which are depleted of nourishing minerals. Strongly alkaline, 2-6 pounds of baking soda may be used alone in a bath for clearing radiation resulting from television and computer monitors, X-rays, CAT scans, cancer treatments or frequent airplane travel.10
Adding hydrogen peroxide to bathwater increases oxygen available to the body. One of the reasons rain feels so refreshing is because the moisture (H2O) in the air picks up an extra molecule of oxygen (O2) as it interacts with ozone (O3) in the atmosphere, and as the raindrops fall they contain an abundance of this natural hydrogen peroxide (H2O2).11 When hydrogen peroxide is added to bathwater, the extra molecule of oxygen is released. The famous healing waters of Lourdes, in France, contain concentrations of hydrogen peroxide. Hydrogen peroxide baths often leave the body feeling alert and revitalized, like spending a day in the fresh country air.
This gentle bath is antibacterial, antiviral and cleansing to the emotional and energetic bodies. It is believed to be helpful in eliminating some chemicals and some radiation from body tissues. It has been found to be a good support during chemotherapy. The use of 35 percent food-grade hydrogen peroxide is recommended. Add 6 ounces of food-grade hydrogen peroxide to a hot bath and soak for 20-30 minutes. Be careful in handling this concentrated solution of hydrogen peroxide as it can “burn” or irritate the skin. Diluted in the bathwater, it is fine for skin contact and Dr. Kurt Donsbach, health author and chair of the National Health Federation’s Board of Governors, suggests that skin problems such as eczema, psoriasis, athlete’s foot and rashes, respond well to this. If you cannot find food-grade hydrogen peroxide, the normal 3 percent hydrogen peroxide found in any drugstore may be used. When using standard 3 percent hydrogen peroxide, use 2-4 pints. Don’t immerse the face or hair.
Detox baths are a simple and valuable adjunct to normal self-care health maintenance. They can be very helpful in facilitating the elimination of toxins that are released into systemic circulation by massage and bodywork therapies, as well as encouraging the ongoing immune and eliminative functions of the skin. Best of all, baths are enjoyable and relaxing — medicine that “tastes good.”
By Barry Kapke, ACST, CI, the program director of Asian Bodyworks at San Francisco School of Massage, where he has taught for more than a decade. He is also the founder of Insight Bodywork, integrating mindfulness, movement and massage. He can be reached online at firstname.lastname@example.org.
Originally published in Massage & Bodywork magazine, August/September 2000.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.
1. Salvo, Susan G., Massage Therapy: Principles & Practice (Philadelphia: W.B. Saunders, 1999), 87.
2. Beresford-Cooke, Carola, Shiatsu Theory and Practice (Edinburgh: Churchill Livingstone, 1996), 210.
3. Davis, Patricia, Aromatherapy: An A-Z (UK: C.W. Daniel, 1988).
4. Salvo, 87.
5. Lappe, Marc, The Body’s Edge (New York: Henry Holt, 1996), 112-125.
6. Dubitsky, Carl Bodywork Shiatsu (Rochester: Healing Arts Press, 1997).
7. Moor, Fred B., et al., Manual of Hydrotherapy and Massage (Boise: Pacific Press, 1964), 2, 19-21.
8. Miller, Erica, Day Spa Techniques (Albany: Milady, 1996), 20.
9. Newmark, Irene, From private conversations, 1988-1998. Also, Serinus, Jason, ed., Psychoimmunity & the Healing Process (Berkeley: Celestial Arts, 1986).
10. Wittenberg, Janice Strubbe, The Rebellious Body: Reclaim Your Life from Environmental Illness or Chronic Fatigue Syndrome (New York: Insight Books, 1996).
11. Pitchford, Paul, Healing with Whole Foods, revised edition, (Berkeley: North Atlantic Books, 1993), 38-44.
- Beauty Within – How detoxifying diets can improve skin health (hofholistichealingcenters.com)
- Detox Days – Internal Spring Cleaning (hofholistichealingcenters.com)
- All Waters Are Not Created Equal – Healing Remedies of the Sea (hofholistichealingcenters.com)
- Spring Cleaning for Your Body, Mind, and Spirit (intimatealchemy.wordpress.com)
- Mark Hyman, MD: 4 Steps To Get Rid Of Toxic Weight (huffingtonpost.com)