Clinical and Mechanistic Evidence for Comano Thermal Water: A Narrative Review

Comano thermal water (CTW) is a hypotonic, bicarbonate–calcium–magnesium mineral water traditionally used to manage chronic inflammatory and relapsing skin diseases. This review summarizes and discusses the available clinical, experimental, and translational evidence on CTW, with a particular focus on dermatological indications. The physico- chemical properties of CTW, along with the presence of a stable, non-pathogenic microbial community, are examined in relation to their potential biological activity. Clinical studies indicate that CTW-based balneotherapy, alone or in combination with narrowband Ultravi- olet B (UVB) phototherapy, is associated with improvements in disease severity, symptom burden, and quality of life in patients with psoriasis and atopic dermatitis, and has a favorable safety and tolerability profile. Experimental data further suggest that CTW may exert anti-inflammatory and immunomodulatory effects, modulate keratinocyte function, support skin barrier restoration, and influence the cutaneous microenvironment, including microbiome-related pathways. The review also outlines emerging evidence for CTW in skin regeneration and in upper airway inflammatory conditions treated via inhalation-based approaches. Overall, this review suggests that CTW may serve as a biologically active therapeutic resource, warranting further investigation as a complementary approach within integrative management strategies for inflammatory and barrier-related conditions.