Complementary & Alternative Medicine

Spa Tourism: Trends and Prospects

Complementary & Alternative Medicine

Thermal spas, many of which have received international acclaim for their therapeutic properties, are a significant part of the Greek economy. Improving city spas with contemporary infrastructure and equipment is of vital importance to making the most of the medicinal properties of water and springs.

The contemporary tourism product in Greece has met heated international competition and has prompted calls for ongoing renewal and diversification. But, enhancement must cover both the needs of new market sectors and contribute to the overall competitiveness of the tourism economy as well.

Infrastructure: Facilities and Resources Despite efforts to improve thermal spa infrastructure, significant facility deficiencies remain. The integration of springs to a web of multiple facilities that combine activities, such as athleticism for all ages, cultural events, recreational areas for the young and children, as well as green parks, is equally essential.

Thalassotherapy Indicators

• Protection from the ailments of modern life including cardiovascular diseases, obesity, metabolic disorders, stress, insomnia, migraines, psychosomatic disorders, fatigue syndrome, and depression;

• Rheumatic, orthopedic, dermatological and neurological disorders;

• Recovery;

• Weight loss, cellulite and Cosmetology.


• Iodine allergy;

• Hyperthyroidism;

• Moist hydric dermatosis;

• Heart failure.

Hotel and Resort Health and Wellness Services

• Medical check-ups including cholesterol levels, blood sugar tests and blood pressure;

• Vegetarianism or special diets;

• Vitamin preparations;

• Daily exercise programs;

• Yoga;

• Acupuncture;

• Thermal swimming pools — indoor or outdoor;

• Hydro massage;

• Hand massage;

• Combating cellulite;

• Sauna;

• Hydrotherapy treatments

• Clay epithems;

• Smoking cessation;

• Baths — eucalyptus, Turkish

• Epithems and herb infused beverages;

• Radiation;

• Muscular development and relaxation;

• Cosmetic treatments – facial.

Rejuvenation: Luxury Spa Centers in Athens Modern units of the term, “spa” — derived from salus per aqua, meaning health through water — was developed in Greece and later throughout the world. Spas are characterized by three distinct, yet absolutely codependent parameters: location, design — namely, the organization and aesthetics of their surroundings — and the treatment or care they offer. Thus, spas can be distinguished in several types:

Destination — where accommodation including treatments is offered. Through specialized and professional spa programs, hotel customers are provided with a wealth of services leading to an improved way of life and health.

Resort — facilities are an essential part of a resort hotel. Through an integrated menu of services, resort spas offer customers not only professional spa services, but also structured wellness and fitness proposals.

Cruise — facilities inside a cruise ship, where the customer can choose among different spa services including well-being and fitness proposals as well as a menu of various products and services.

Holistic — facilities focusing on alternative therapeutic and dietary methods aiming at a high level of physical and mental well-being.

Medical — treatments and protocols are created by doc- tors and professionals and are compatible with the original purpose of these spas, which was to attain well-being through medical therapies.

Thermal spring (thermal- ism), Cities, Thalassotherapy — spas located around natural springs. The basic element for the hydrotherapies they predominantly offer is either mineral-thermal water or hot spring water as well as heated sea water. They usually provide specialized diet and overnight accommodation.

Day or City — spas, usually developed in urban centers, use running water and provide multiple applied treatments, such as beauty and healthcare completed in either one or more sessions lasting at least an hour. No overnight accommodation is offered.

Structured — facility which operates under strict rules as well as a predetermined direction, such as weight- loss, smoking cessation and fitness.

Spa Club — sport facilities in which fitness and team programs are prevalent. Hydro-therapeutic equipment includes opposite current pools, Kneipp systems, massage with varying water temperatures, sauna, steam rooms and roman baths, as well as aesthetic treatment programs.

Adventure — centers that have specialized sports including tennis and golf and adventure activities, such as rafting, hiking, and fishing, as their core attractions. These centers offer hydro- therapy programs as well as facial and body treatments.

Third Age — centers provide physical activities including special gymnastics and walking and social events, such as dance and team games, in combination with nutritional programs as well as anti-aging and rejuvenating treatments.

Exclusive/VIP — spas aimed at a select audience and can only be accessed by sea/ship or air/helicopter, seaplane.

Many luxury hotels throughout Greece feature ultra-modern thalassotherapy centers with excellent equipment and well-trained staff. Some are:

• Aldema Royal Marethalsso Hersonissos, Crete

• Aldema Royal Olympian Spa & Thalasso – Peloponnese

• Blue Palace – Elounda, Crete

• Candia Maris – Heraklion, Crete

• Club Med Mare Nostrum – Brauron Coast

• Grecotel Kos Imperial Thalasso – Kos Island

• Grecotel Daphnila Bay Thalasso – Corfu

• Imperial Myconian – Mykonos

• Perle Resort Hotel – Akroti-ri-Chania

• Rodian Amathus Beach Hotel – Rhodes

• Galini – Kamena Vourla


Most spa tourism in Greece remains uncoordinated. Recreational activities that should accompany them are almost nonexistent. Springs are classified by modern spa units or Hydrotherapy Center of Thermal water. Indicative of the minimal requirement are the following:

• Hydrotherapy, Physiotherapy and Infirmary centers operate simultaneously in only 4 (12,5 percent) springs, while most of them provide only simple bathtubs (59,3 percent);

• Spa – Rejuvenating centers, (Sanitas per aqua=health through water), are introduced for the first time and protected by the nation’s legislative system. They are officially incorporated in the modern tourist services provided by major hotel complexes.

Spa Staff

Most thermal treatment units and spa tourism centers employ main, administrative and technical staffs. Main staff is entrusted with the provision of services at the
unit or center in accordance with the authorization granted regarding its establishment and operation.

Staff — including doctors, beauticians, bath-settlers, gymnasts, physiotherapists and nutritionists — must hold a relevant professional license or a recognized degree of higher education – subject to Article 12, par. 1. Assistants must hold a degree or a post-secondary training certificate from an accredited institution.

Vocational Training

Balneotherapy spa specialists are instructed:

• In functional knowledge and versatile skills in the field of specialized and alternative forms of tourism with an emphasis on thermal treatment and environmental tourism; • To assist units of the Hellenic tourism organization and even small as well as large businesses in the sectors of modern high-level services;

• To be in a position to control and maintain the quality of services in health tourism;

• As valuable assistants at multiple points in the business structure, aiming at the desired improvement of bath services for incoming visitors and especially people with disabilities and their escorts of all ages;

• They possess certified theoretical and technical knowledge which renders them competent and responsible in the implementation of balneotherapy – spa programs for each bather or group of bathers.

More specifically:

• They ensure complete understanding and satisfaction of the spa customers’ needs and guide each bather through the process of thermal treatment;

• They contribute to the materialization of the spa care program – either simple or combined;

• They assess the quality and provide an update on the implementation of the spa program and monitor the balneotherapy process of each bather and report potential problems to the physician in charge. In emergency cases, they take the requisite steps and provide assistance;

• They supervise parameters, such as water temperature, air conditioning and sanitation before the use of the balneotherapy equipment. They set the equipment and use the appropriate materials in accordance with instructions of the doctor.

Spa Tourism Business — Origin, Demographics Until 2012, the, the social security sector was insured for the cost of annual hydrotherapy treatments. About half of those are now. The demand for spa activities comes primarily from domestic tourism. Foreign consumers are found in certain spa springs, but are usually temporary and circumstantial.

In a sampling of 29 thermal springs from 1993-1996 [8], the Centre of Planning and Economic Research estimated the majority of bathers came from another jurisdiction within the country, 41 percent; regionally, 33.8 percent; locally, 23.3 percent; and few from abroad, 1.8 percent.

International Trends

Health tourism, which is constantly evolving in many European countries, includes health-related services, such as medical examinations, nutritional programs, vitamin treatment, herbal medicine and gymnastics as well as smoking cessation regimens, anxiety treatments, psychotherapy, physiotherapy, aesthetics, relaxation, sleep-promoting and body posture techniques.

Hydrotherapy is categorized under Spa Tourism Centers or SPAS, which were named after the city in Belgium where the first organized facility operated with success. Health Tourism Centers have similar facilities, but have expanded to relaxation and recreation.

European health tourism attracts 15-17 million consumers from countries within and outside Europe. About 1.5 million foreign health tourists reside overnight in Europe including visitors to aesthetics medical centers for rejuvenation and anti-cellulite treatments.

European Union Comparisons

• Greece — demand comes from domestic tourism. •

Germany — Visit destinations outside their country.

• Italy — Very few Italians travel abroad for that particular reason.

• France — French generally travel domestically.

Demand for spa tourism services is declining. Limited media advertising and low public awareness both domestically as well as abroad have played an important role in this decline. An- other reason is attributed to competition from the pharmaceutical industry and the reluctance of physicians – particularly abroad — to recognize hydrotherapy as a medical treatment.

Health tourism combines travel with relaxation, physical regeneration, thalassotherapy, spa and exercise. Greece has all the prerequisites to develop both spa and health tourism. A beautiful Mediterranean landscape and a long-established tradition of healthy eating and highly trained medical professionals are existing trademarks. Without development, potential tourists will disregard Greece for other countries in the European Union and beyond.

Despite problems, the potential for development of spa tourism in Greece is huge, but action must be taken quickly. According to the Community Directive 24/2011 for cross-border healthcare, all insured members of the EU may receive hydrotherapy services wherever they please. These services will be covered by the insurance fund of their country.

Millions of new potential buyers have been created for spa tourism and Greece must strive to attract them. Development strategies must attract investment for the construction of modern health tourism centers similar to those in Central European countries, where demand is heavy.

Foreign investors, who wish to exploit the nation’s thermal springs, have already expressed interest in Greece and the conversion to modern centers of health tourism (Thessaloniki Ikaria). The financial benefits will be significant for the local community including:

• Foreign exchange influx for long-stay tourism;

• New job opportunities due to the development of springs and infrastructure — health and sports facilities (hospitals, stadiums);

• Demand for the development of market services including banks, shops, and restaurants;

• Demand for goods and services throughout the year as well as smoothing methods concerning the seasonality of tourism during the summer months — tax and other revenue for local authorities;

• Improvement in the services of the transportation sector including airports and road-connections;

• Demand for facilities and specialized high-level medical infrastructure for spas and clinics.

Even though market research and advertising are of paramount importance, Greece, in comparison to other European nations, trails. As a result, thermal springs in Greece lack international notoriety. Still, Greece has superb thermal springs which, in combination with marine tourism and city spas, can set the standard for the cities around the Mediterranean.

Certification is of crucial importance. The fast and efficient implementation of certification processes for facilitators and their medical tourism services will provide the impetus for efficient and effective procedures. Greece can expect much from spa tourism in the years to come. By expanding spa tourism throughout the year, employment opportunities will expand beyond the summer months and the GDP will grow.

About the Author

Jenny Pavlakou Panagiotopoulou is general director of Gnosi S.A. – foreign languages and information technology – as well as Nea Gnosi S.A., a certified organization offering accredited adult training in the fields of health science, management, education, Information technology, tourism and technical occupations. E-mail: epavlakou@


1. Sotiriadis, M.; “Tourism Policy, Alternative and Special Forms of Tourism”; TEI Heraklion; 1994.

2. Koumelis, T.; “The Contribution of Thermal Therapeutic Tourism in Tourism Development”; GREEK TOURISM Myths & Realities; Anubis Editions.

3. Didaskalou, E.; “Therapeutic Tourism: Moving Toward a Model for Development of Therapeutic Tourism Centers and Impact Assessment in Areas of Tourism and Health”; Department of BusinessAdministration; University of Piraeus.

4. Spathi, S.K.; “Spa Tourism and Development of Health Tourism in Greece”; Centre of Planning and Economic Research; Report 29; 2009.

5. “Spa Tourism Supply and Demand Data”; TEI Management and Economics Department of Tourism Management; 2010.

6. Danas, M.; “The Next Day of Spa Tourism in Greece”; 2013.

7. Sinnefakis, G.; “Research Pro- gram, Methodology and Parameters for Systematic Development of Thermal Spas in Greek Area.”

Learn about how you can become a Certified Medical Tourism Professional→
Disclaimer: The content provided in Medical Tourism Magazine ( is for informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. We do not endorse or recommend any specific healthcare providers, facilities, treatments, or procedures mentioned in our articles. The views and opinions expressed by authors, contributors, or advertisers within the magazine are their own and do not necessarily reflect the views of our company. While we strive to provide accurate and up-to-date information, We make no representations or warranties of any kind, express or implied, regarding the completeness, accuracy, reliability, suitability, or availability of the information contained in Medical Tourism Magazine ( or the linked websites. Any reliance you place on such information is strictly at your own risk. We strongly advise readers to conduct their own research and consult with healthcare professionals before making any decisions related to medical tourism, healthcare providers, or medical procedures.