Background: This study investigates microvascular changes in the dermis and muscle following a balneotherapy regimen prescribed by therapeutic protocols. Methods: Thirty-five inpatients participated in a two-week balneal course involving the application of mud and hypersaline water. Mud was applied outdoors in the summer as cold mud ointment and indoors year-round as mud packs or mud baths alternated with hypersaline water baths. Biopsies of the skin and muscle were obtained twenty-four hours post-discharge and prepared histologically. Results: Analysis focused on the epidermis, dermis, and muscle. Microvascular changes observed included increased caliber and number of open capillaries, as well as the presence of angiogenesis vessels. Statistical analysis showed significant differences in angiogenesis vessels between cold mud ointment and mud pack treatments compared to control and mud bath groups. A higher number of angiogenesis vessels were observed in the dermis in the mud pack group and in the muscle with mud cold ointment. Repeated thermal stimulation with mud and hypersaline water over two weeks produced histologically evident tissue modifications, persisting in the dermis and muscle at least twenty-four hours post-treatment completion.
