Salt therapy (also known as Halotherapy, from the Greek hálos, meaning salt) is a complementary therapeutic approach that involves controlled inhalation of aerosolized sodium chloride (NaCl) in a regulated indoor environment, typically maintained at temperatures between 18–24°C and relative humidity levels of 40–60% (Chervinskaya & Zilber, 1995; Chervinskaya, 2003). Contemporary salt therapy developed as a standardized and technologically mediated alternative to speleotherapy (from the Greek spḗlaion, meaning cave), a practice traditionally conducted in natural salt caves and mines and reported in Eastern Europe since the early nineteenth century (Maghsoudi-Ganjeh et al., 2021).
Modern salt therapy is usually administered in climate-controlled indoor environments, commonly referred to as halochambers or salt rooms, in which micronized sodium chloride aerosol is dispersed under regulated conditions of temperature, humidity, and air purity. These environments are designed to replicate key microclimatic characteristics of natural salt caves while allowing greater standardization, reproducibility, and accessibility. The primary active component of salt therapy is dry NaCl aerosol, composed of fine particles capable of penetrating multiple levels of the respiratory tract. Proposed mechanisms of action include antibacterial and anti-inflammatory effects, facilitation of mucociliary clearance, and modulation of immunological responses, including potential reductions in immunoglobulin E (IgE) levels (Wasik & Tuuminen, 2021).
Within this context, salt therapy has gained increasing popularity as a non-pharmacological intervention implemented in wellness centers, respiratory clinics, and rehabilitation settings. Despite its widespread dissemination and growing clinical interest, the empirical evidence supporting the efficacy and underlying biological mechanisms of salt therapy remains limited and methodologically heterogeneous. The present review examines the current scientific literature on salt therapy with the aim of synthesizing available findings.
Accumulating evidence suggests that salt therapy may confer therapeutic benefits for individuals with respiratory disorders (Barber et al., 2022; Chervinskaya & Zilber, 1995; Lazarescu & Kozma, 2019). In asthma, scientific studies have reported a protective effect against nocturnal exacerbations following exposure to hypertonic saline aerosol (Borges et al., 2008). Furthermore, randomized and controlled clinical investigations have documented improvements in respiratory symptoms, functional outcomes, and patient-reported quality of life in both acute and chronic asthma (Bar-Yoseph et al., 2017; Crisan-Dabija & Mihaescu, 2012; Forouzan et al., 2017; Hedman et al., 2006; Karaganova & Mindova, 2024).
Notably, Crisan-Dabija and Mihaescu (2012) evaluated the long-term effects of dry salt aerosol inhalation in patients with asthma and chronic obstructive pulmonary disease (COPD), reporting sustained improvements in quality of life up to 12 months after treatment cessation. These improvements included enhanced breathing comfort, reduced dyspnea, and decreased limitations in daily activities, suggesting a potential role for salt therapy in supporting longer-term symptom management.
Beyond asthma, available evidence indicates benefits of salt therapy across a broader spectrum of chronic respiratory conditions. Clinical and observational studies have reported improvements in pulmonary function parameters, mucus clearance, and subjective respiratory comfort in individuals with COPD (Oprița et al., 2010; Sevostyanova et al., 2016; Vanitha, 2020) and bronchiectasis (Rabbani et al., 2013). Additional investigations have documented its benefits in chronic bronchitis (Abdrakhmanova et al., 2000), chronic obstructive lung diseases more broadly (Chernenkov et al., 1997), upper airway obstructive conditions such as sub-obstructive adenotonsillar syndrome (Gelardi et al., 2013), and other respiratory complaints including dyspnea and chronic cough, particularly in post–COVID-19 rehabilitation contexts (Kwiatkowska et al., 2021).
Beyond respiratory conditions, salt therapy and salt therapy have also been investigated in selected dermatological disorders. Studies have reported benefits in inflammatory skin conditions such as atopic dermatitis and psoriasis, possibly mediated by anti-inflammatory and barrier-modulating effects of salt exposure (Ben-Amitai & David, 2009; Chervinskaya, 2006; Puryshev, 1994). However, evidence in this domain remains limited and requires further validation through controlled trials.
Collectively, these findings suggest that salt therapy may represent a complementary therapeutic approach capable of enhancing symptom control and potentially extending exacerbation-free intervals, without substituting established pharmacological treatments. Importantly, across published studies, salt therapy appears to be well tolerated, with no serious adverse events consistently reported to date (Crisan-Dabija et al., 2021).
In contemporary societies, exposure to air pollution represents one of the most significant environmental risk factors for respiratory morbidity and mortality worldwide. Data from global air quality monitoring systems (e.g., the World Air Quality Index project, which provides real-time mapping of ambient air quality across regions) indicate that large segments of the population are chronically exposed to elevated concentrations of particulate matter, nitrogen dioxide, ozone, and other airborne pollutants. Prolonged exposure to these pollutants can be associated with the development and exacerbation of respiratory conditions, particularly among vulnerable populations such as children, older adults, and individuals with pre-existing respiratory disorders. Within this environmental context, interventions that promote airway hygiene, mucociliary clearance, and recovery from pollutant-induced airway irritation are of increasing clinical and preventive interest. salt therapy, by providing controlled exposure to clean, climate-regulated air enriched with dry sodium chloride aerosol, may offer a supportive strategy to mitigate some of the adverse respiratory effects associated with polluted urban environments. Although salt therapy should not be considered a substitute for environmental policy measures or evidence-based pharmacological treatments, its potential role as a preventive and adjunctive intervention (particularly for populations residing in areas with poor air quality) warrants further consideration. This perspective reinforces the relevance of salt therapy not only as a complementary therapeutic tool for established respiratory disorders, but also as a supportive intervention aligned with the respiratory health challenges characteristic of modern, industrialized societies.
In recent years, increasing attention has been directed toward the integration of salt therapy with complementary digital interventions aimed at enhancing psychological comfort, treatment adherence, and overall wellbeing. One emerging approach involves the incorporation of virtual reality (VR)–based relaxation experiences during salt therapy sessions, capitalizing on the multisensory and immersive properties of VR to augment the therapeutic environment.
In practice, combining VR with salt therapy engages the user’s senses on multiple levels, creating a richer therapeutic encounter. VR provides vivid visual and auditory stimulation through immersive scenarios, while the salt therapy environment itself contributes subtle gustatory and olfactory inputs. For example, fine salt particles dispersed in the air can settle in the oropharynx (throat and mouth), often leaving a faint salty taste on the lips and tongue. Some salt therapy participants can describe this sensation as being akin to breathing in ocean air. Similarly, the clean, mineral-rich atmosphere of a salt room may impart a subtle fresh scent or feeling in the nasal passages, indirectly stimulating the sense of smell. By engaging sight, sound, taste, and smell in tandem, the VR-salt therapy combination offers a truly multi-sensory experience that can deepen the user’s sense of immersion and relaxation during treatment.
Salt therapy sessions are typically conducted in calm, low-stimulation settings that already favor anxiety and stress reduction. VR technology may further enhance these effects by providing immersive natural environments (e.g., forests, beaches, caves) or guided relaxation and breathing experiences that promote attentional engagement, emotional regulation, and perceived comfort during treatment. From a psychophysiological perspective, such immersive experiences may help reduce anxiety, modulate autonomic nervous system activity, and facilitate deeper, more regular breathing patterns, potentially complementing the respiratory benefits attributed to salt aerosol inhalation.
Importantly, psychological factors such as stress, anxiety, and emotional dysregulation are known to influence respiratory symptoms and disease perception in chronic respiratory conditions. VR-based relaxation interventions have demonstrated efficacy in reducing stress and anxiety, across a range of clinical and non-clinical populations (Alsina-Jurnet, 2025), suggesting that their integration into salt therapy may offer additive benefits at the level of psychological wellbeing. Moreover, immersive VR experiences may increase treatment acceptability and engagement, particularly among pediatric populations, individuals with anxiety-related respiratory symptoms, or patients undergoing repeated or long-term salt therapy sessions.
From a preventive and public health perspective, the combination of salt therapy and VR may also be relevant in contemporary societies characterized by high levels of environmental stress and air pollution exposure. While salt therapy provides a controlled, clean-air microenvironment that may support airway recovery, VR-based relaxation can simultaneously address the psychological burden associated with urban living, chronic stress, and respiratory vulnerability. This integrative approach aligns with biopsychosocial models of health (Engel, 1980), emphasizing the interaction between physiological, psychological, and environmental determinants of wellbeing.
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