Salt therapy (halotherapy) for immunity improvement and respiratory health support

Prevention and treatment

Halotherapy, also known as dry salt inhalation therapy, is well documented for its ability to strengthen immunity of the respiratory system.1The use of dry salt aerosol has long been proven in the treatment and relief of symptoms of respiratory viral infections; ear, nose and throat ailments; and upper and lower respiratory tract problems.2

Salt is hygroscopic – meaning that it attracts moisture from the environment. When micronized salt is inhaled, it attaches to the tissues that line the respiratory tract. This results in a decongestant effect because the salt draws water from the mucosal tissues into the air passages of the respiratory tract, thinning mucosal secretions and boosting rapid expectoration. It promotes the removal of bacteria and viruses, decreasing bacterial or viral load, which can help prevent or lessen the severity of disease. This matter is confirmed by studies that proved that after halotherapy sessions, bacteria were inhibited from attaching to mucosal cells.3

Salt inhalation therapy can be considered an important preventive tool in reducing the development of secondary bacterial infections, including pneumonia, which result from the initial infection caused by viral respiratory infections. This is important during viral epidemics in which large numbers of people experience secondary bacterial infections caused by viral epidemics that target the respiratory systems of their unfortunate hosts. 

Halotherapy can be an especially useful wellness method for people with chronic bronchopulmonary diseases, including asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and cystic fibrosis. In the case of COPD and bronchial asthma, dry salt aerosol therapy safely and effectively clears the airways and lungs of Impurities, waste products and mucus. 

Prof. A.V Chervinskaya, M.D., Ph.D., has for more than 30 years researched and developed the scientific and practical application of halotherapy. “Sodium chloride aerosol improves the fluidity of bronchial secretions, contributing to the normalization of mucociliary clearance, “ she notes, adding, “During halotherapy treatments, due to the action of salt aerosol, the drainage function of the respiratory tract improves: sputum separation is facilitated, its viscosity is reduced, and cough is relieved. Dry salt aerosol can both inhibit the growth of bacteria and, in other cases, kill bacteria that inhabit the microflora of the respiratory organs, improving microcirculation and supporting breathing comfort.” 4, 5

Dr. Chervinskaya believes that all these benefits from the use of halotherapy on the human body can reduce the risk of serious complications and significantly accelerate rehabilitation from respiratory viral infections.

According to pulmonologist A.G. Malyavin, M.D., general secretary of the Russian Scientific Medical Society of Therapists, halotherapy offers two key benefits: In the context of contagious respiratory viruses, halotherapy offers not only effective preventive but also therapeutic measures for people with severe infections caused by acute respiratory distress syndrome (ARDS). Unfortunately, for certain patients who have been successfully treated for ARDS, a numbers of them will be left with lingering, long-term chronic fatigue, brain fog and congestion. Dr. Malyavin credits halotherapy with providing relief for those left with these secondary complications of ARDS.

Professor Malyavin notes that in this situation, halotherapy – the inhalation of dry salt aerosol that occurs during salt therapy sessions – can be very useful. This natural method, as shown by earlier studies, favorably affects the severity of post-SARS patients, decreasing weakness and increasing effective mucociliary clearance. 

Halotherapy is available in salt rooms equipped with halogenerators, devices that effectively micronize pharmaceutical grade salt and disperse dry salt aerosol at controlled levels in rooms with special ventilation. Halotherapy can also be delivered at home with halogenerators designed for use in smaller rooms. 


Dry Salt Aerosol Works by

+     Acting as a gentle“brush”to effectively and safely clean the airways and lungs of Impurities, waste products and mucus

+     Improving microcirculation

+     Providing anti-bacterial,  anti-inflammatory benefits, and reducing swelling

+     Supporting breathing comfort


1Khan M.A., Chervinskaya A.V., Mikitchenko N.A. Dynamics of indicators of mucosal immunity, cytobacteriological and morphological and functional state of the oropharynx mucosa in frequently ill children under the influence of halotherapy (Part 1) // Allergology and Immunology in Pediatrics. - 2011. - No. 1 - p. 33-35.
Chervinskaya A.V. Dry sodium chloride aerosol against acute respiratory viral infections/Eur Respir J 2009; 34: Suppl. 53.
3Chervinskaya A.V., Kvetnaya A.S., Korzhenevskaya T.B. The effect of dry fine-dispersed sodium chloride aerosol on the physiological properties of Streptococcus pneumonia, persistent on the mucous membrane of the laryngopharyngeal epithelium, in the experiment // Clinical and laboratory conference of specialists. - 2010. - No. 1 - p. 61-62 
4Alina V. Chervinskaya - pulmonologist, professor, MD, founder of controlled halotherapy method, professor of the department of physical and rehabilitation medicine with a course in psychology and pedagogy of the Central State Medical Academy of the Presidential Administration in Russian Federation.
Mucociliary clearance (mucociliary system, MCC) is a non-specific mechanism that provides local protection of the mucous membrane of the respiratory system from external influences, including infections.
6Andrei G. Malyavin - pulmonologist, professor, MD, general secretary of the Russian Scientific Medical Society of Therapists, professor of the department of phthisiology and pulmonology of the medical faculty, deputy head of the science department of the Moscow State Medical University, General Director of the Center for Respiratory Medicine, Chief part time Pulmonologist of the Ministry of Health of the Russian Federation in the Central Federal District.


 Disclaimer: The U.S. Food and Drug Administration, Canadian Medical Device Bureau of the Therapeutic Product Directorate (TPD) and Australian Therapeutic goods administration (TGA) have not evaluated statements of this text.  Halogenerators are not intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in humans or animals.



Halotherapy in the salt rooms may reduce anxiety and improve psycho-emotional state, which undoubtedly affects the quality of life.x c3ff2adb


The mechanism of action of halotherapy consists of many components. Salt inhalations affect the metabolism of various biologically active substances, including hormones. There is evidence that halotherapy regulates the secretion of serotonin, the “hormone of happiness,” so it stabilizes the emotional state. The same effect contributes staying in the salt room - a comfortable environment, isolated from stress factors. Halotherapy improves the condition in diseases of the lungs and ENT organs, which improves the quality of life. 


Some interesting clinical studies were conducted and they illustrate the effect of halotherapy on the psycho-emotional state:


  •  In 2013, 40 adult patients in Iran received daily salt inhalations for 2 months. Before and after the course, they filled out the standardized questionnaire for the quality of life SF-36. It evaluates different spheres of human life - physical, social, emotional. After a course of halotherapy, improvement was noted on all scales of the SF-36 questionnaire, but the best effect was observed in the sphere of emotional functioning and mental health (reference: (ссылка: Rabbani B. et al. Efficacy of halotherapy for improvement of pulmonary function tests and quality of life of non-cystic fibrosis bronchiectatic patients // Tanaffos. – 2013. - №12 (2). – P. 22-27.) 
  • In 2016, a group of 52 children aged 5–13 years old with bronchial asthma was participating in clinical study in Israel. Children received 14 sessions of halotherapy in the "salt room" (45 min. session, twice a week, 7 weeks in a row). 28 children received a "real" halotherapy - during the session a halogenerator produced a dry salt aerosol. The remaining children - 24 people - received a placebo procedure: the halogenerator worked without salt and did not produce an aerosol. Before and after the course of procedures, all children passed the questionnaire for assessing the quality of life in children with asthma - PAQLQ. After the "real" and placebo procedures, the results were different. After 14 sessions of salt aerosol inhalation in children, asthma symptoms greatly diminished, activity increased and emotional functioning improved. After placebo procedures, there was no difference with the baseline condition (reference: Bar-Yoseph R, Kugelman N, Livnat G, Gur M, Hakim F, Nir V, Bentur L. Halotherapy as asthma treatment in children: a randomized, controlled, prospective pilot study // Pediatric Pulmonology. – 2016. – 9999. – XX-XX. DOI 10.1002/ppul.23621.)
  • From 2012 to 2016, the level of anxiety in children with various chronic illnesses was investigated at the National Medical Research Center for Children's Health (Children's Scientific and Practical Medical Information Center) in Moscow. In treatment, 119 children opcion5received 10 halotherapy procedures in a salt room (30 minutes daily), 89 children of the same age were treated without halotherapy. Anxiety before and after treatment was assessed by the Luscher color test: from 0 to 12 points. Before treatment with both groups of children, anxiety score was about 7 points. After halotherapy, it dropped to 4.15 points, and in children without salt inhalations, it decreased to only 5.13 points (reference: Chervinskaya AV, Konova OM, Khan MA. Halotherapy for prevention and medical rehabilitation in child health // Questions of modern pediatrics. - 2017. - №16 (5) - p. 406-412.)

Observations of some practicing salt therapy specialists confirm the results of research. Parents whose children received halotherapy sessions are noticing a calming effect and improvement of the kids’ mood during a day. Many notice that the child has become easier to
fall asleep and less often wake up at night. We recommend a course of halotherapy in the salt rooms to children and adolescents with high nervous excitability and anxiety, for example, during the exams and chaotic periods. This allows stabilizing the psycho-emotional state of the child and helping him more easily cope with the load.



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Myth: Salt Walls Provide Benefits

FACT: Salt walls and salt bricks or blocks do not generate dry salt aerosol.

A number of salt rooms have been built in recent years, constructed of natural salt blocks, yet with no means to produce aerosol.

  • Studies show that without a halogenerator producing dry salt aerosol, it is impossible to recreate natural salt mine benefits even with large masses of salt applied to salt room walls.
  • Salt walls are pleasing to look at, and insulate rooms, reduce noise and reduce humidity and temperature fluctuations, but they offer no benefits in supporting breathing or skin health.
  • Only a special device can create salt aerosol – a halogenerator.

Myth: Himalayan & Dead Sea Salts Have Beneficial Minerals

FACT: There are no scientific studies to support this statement.

Some businesses insist that the Himalayan or Dead Sea salts they use in halotherapy provide superior benefits over plain, pharmaceutical grade salt, but there is no science to support the claim.

  • Minerals in unstandardized salt crystals vary widely. It is impossible to predict the amount of inhaled minerals in these salts, which also may also contain impurities, such as clay, mud, soil, or even radioactive potassium.
  • Use of anything other than pharmaceutical-grade sodium chloride is considered experimental, possibly unsafe, and can cause allergic and other unpredictable reactions. The great body of halotherapy research was conducted using pharmaceutical-grade or pure rock salt.

Myth: It is Not Necessary to Control Aerosol Concentration

FACT: Only halogenerators controlling the aerosol concentration provide effective and safe salt room sessions.

Many aerosol generators cannot control aerosol concentration.

  • Aerosol is finicky, and can be affected by many factors, from the size and moisture in the salt granules used, air-pipe conditions, temperature and humidity and air circulation.
  • Inhaling too much salt aerosol can cause bronchospasms and other side effects.
  • Halogenerators must control aerosol concentration to keep the salt room environment safe and beneficial.
  • Controlling the concentration of salt aerosol requires a halogenerator with a sensoring system that constantly monitors the aerosol level, signaling the halogenerator to adjust and self-correct its output.

Myth: Wet & Dry Salt Therapy Are the Same

FACT: Dry salt aerosol is the main acting factor in halotherapy.

Some businesses claim to provide halotherapy using devices that produce aerosol from a water-based saline solution. However, research has shown:

  • Wet aerosol mainly settles in the upper respiratory tract and the central trachea and bronchi, due to the hygroscopic characteristics of moist particles.
  • This can cause airway swelling and bronchospasm
  • And can provoke a hyper-reactive response in people with asthma and COPD.
  • Also, moist air can increase the risk of microbial contamination

Research shows that moist saline aerosol is significantly less effective than dry salt aerosol and can cause adverse effects.

Misunderstood: The Importance of Ventilation During Sessions

FACT: Inadequate ventilation adversely affects the efficiency of salt room sessions

Some salt room operators do not provide fresh air during sessions.

  • People can become uncomfortable without fresh air circulating through the room during sessions.
  • Localities generally require fresh air circulation.
  • Air flow, or ventilation, contributes to optimal aerosol distribution in salt rooms

Salt rooms require properly designed ventilation systems, a critical matter in supporting client comfort and wellness. A well-designed halogenerator works in harmony with ventilation systems.



What is Impaired Airway Clearance and why can it happen?

When mucus secretion and mucus clearance are not in balance, too much airway mucus can cause serious problems. This condition is called “impaired airway clearance.”

Impaired secretion clearance can occur when any event or dysfunction disturbs normal airway clearance systems. When this occurs, excess and often sticky mucus may build up in the airways. This makes breathing more difficult. More energy and effort are required to take in oxygen and to exhale carbon dioxide.   

People at risk for impaired clearance may have one or more of the following problems:

  • Ineffective Ciliary Clearance. Normal cilia beat in a coordinated unidirectional fashion to mobilize mucus and clear particulate matter from the airways. Damaged or poorly functioning cilia perform this function inadequately or not at all. Ciliary impairment is associated with conditions including:
  • Cystic fibrosis
  • Primary ciliary dyskinesia
  • Kartagener syndrome
  • Status post heart-lung or lung transplantation
  • Smoking or exposure to second-hand smoke
  • Excessive or Abnormal Mucus Production

Certain disorders and/or their treatments can cause excess mucus production and, in some cases, mucus that is abnormally thick and sticky. Large quantities of mucus, or mucus with altered physical properties, may overwhelm the mucociliary apparatus, inhibiting normal airway clearance.
Abnormal amounts of mucus with altered physical properties may be present in:

  • Cystic fibrosis
  • Bronchiectasis
  • Asthma
  • Chronic obstructive pulmonary disease (COPD), emphysema, chronic bronchitis
  • Mechanical ventilation

Impaired secretion clearance can occur as a result of any event or dysfunction that disrupts normal airway clearance mechanisms.

  • Ineffective Cough

Cough function may be weak or ineffective in diseases and conditions where:

  • Diaphragm muscle weakness or spinal deformity diminishes ability to inhale
  • Poor coordination of the expiratory muscles compromises expulsive force and mucus shearing.
  • Poor coordination of the bulbar muscles impairs closure of the glottis and the ability to build up intrapleural pressure

Cough function is frequently impaired in:

  • Neuromuscular diseases, such as muscular dystrophy, spinal muscular atrophy, and multiple sclerosis
  • Neuromotor conditions including cerebral palsy, spinal cord injury, and severe traumatic brain injury
  • Individuals who depend on mechanical ventilation
  • Individuals who have received heart and/or lung transplants
  • Dysphagia/Aspiration/Gastroesophageal Reflux

Dysphagia, or difficulty in swallowing, is a consequence of anatomical abnormalities or weakness of the muscles associated with swallowing. Gastroesophageal reflux occurs when a defective lower esophageal sphincter allows stomach contents to surge backwards into the esophagus. Aspiration involves the inhalation of secretions, vomit, or foreign material into the lungs. Because saliva and gastric contents contain bacteria, aspiration introduces microorganisms into normally sterile airways.

  • Seizures

Seizures are disorders of cerebral function characterized by sudden, attacks of loss of consciousness and motor control. There is a risk of aspiration during seizures.
Conditions associated with dysphagia/aspiration/gastroesophageal reflux include:

  • Neurologic and neuromuscular disorders including cerebral palsy and muscular dystrophy
  • Seizures
  • Developmental delay
  • Disorders of the esophagus
  • Endotracheal intubation and tracheostomy
  • Immobility

Some individuals are unable to exercise because of diminished exercise capacity, neuromuscular weakness or neuromotor dysfunction. As a result, they cannot maintain adequate aerobic capacity, chest bellows function, and lung volume.
Conditions associated with immobility include:

  • Spinal cord injury, quadriplegia
  • Severe cerebral palsy and/or developmental delay
  • Advanced muscular dystrophy, spinal muscular atrophy, severe spina bifida
  • Dependence upon assisted ventilation
  • Restrictive Lung Disease

Fixed or diminished lung volumes and vital capacities characterize restrictive lung disease. In conditions where respiratory muscles are weak or the spine and thorax are deformed, the ability to take a deep breath, to generate expiratory force, and to cough effectively are often affected.
Restrictive lung disease occurs commonly in:

  • Muscular dystrophy
  • Spina bifida
  • Spinal muscular atrophy
  • Severe cerebral palsy
  • Obstructive Lung Disease

Obstructive lung diseases include conditions where airway size is decreased as a result of structural changes, bronchospasm and/or excess mucus — limiting the ability to exhale.
Obstructive lung diseases include:

  • Bronchiectasis
  • Chronic Bronchitis
  • Alpha1-antitrypsin deficiency
  • Asthma
  • Cystic fibrosis
  • Primary ciliary dyskinesia
  • Kartagener syndrome

The Impaired Airway Clearance is one of the main pathological mechanism, which leads to development of respiratory disorders. At the same time it can take place as a result of obstructive lung diseases and other respiratory dysfunctions, which we’ve just covered above.

Although underlying causes of impaired airway clearance are diverse, the consequences are the same: vulnerable individuals are caught up in the vicious cycle of recurrent, ever-worsening episodes of inflammation, pulmonary infection, increased production of excess mucus, and airway obstruction, lung damage, and respiratory failure.