Spas in the form of public baths with attendants to massage and oil the body have been around for more than two thousand years, since ancient Greek and Roman times, and prescriptions for a healthy life even longer, with the Ayurvedic approach to well-being formulated about 4,000 years ago.
Although its barely 20 years since a spa became obligatory at every posh hotel, we have come a long way since hoteliers first started ripping out the basement disco, installing a few treatment rooms and sending the receptionists on a weekend massage course. Basement spas don't really impress us these days. Nor do inexperienced therapists or an unclear focus.
What we want to encounter now is a sound health philosophy, as practised at the Mayr spas; to sweat out our toxins in a sauna with a view, as at SHA in Spain; to be massaged in a setting of sensory delight, listening to the sea or wind in the trees, as at Thailand’s Kamalaya or St Lucia’s BodyHoliday; and to have our dosha diagnosed in cutting-edge surroundings, as at Vana in India. Excellence in all things, basically. Happily, that’s not always too much to ask. And there are now a few specialist spa operators worth consulting, too (prices are per person and include all taxes, unless stated otherwise):
Kamalaya, Koh Samui, Thailand
With its focus on naturopathy – there's invariably one of Australia's excellent naturopaths in residence – traditional Chinese medicine, yoga and counselling, and its laid-back, nurturing vibe, Kamalaya, ranged down a jungly hillside on a quiet section of coast of this peaceful little island, doesn't have the glamour and gloss of Chiva-Som, the best known of Thailand's numerous spas. Instead, what has brought it so many awards is its atmosphere of absolute integrity. That is thanks to the owners, John Stewart, a Canadian former monk who spent his 20s and 30s building schools in Nepal, and his Mexican-American wife, Karina Stewart, a doctor of traditional Chinese medicine.
They founded Kamalaya to show guests the many alternatives to pharmaceutical-based mainstream medical protocols that aim to improve health and well-being and the mind-body balance rather than just masking symptoms. Night-times here feel particularly engaging, when you can pick your way back from dinner in the semi-open-air restaurant, a counselling session or an after-dark massage via paths lit by stone Japanese lanterns. But then early morning yoga in the hilltop pavilion feels pretty special, too. The hillside villas are better than those on the beach, which can suffer from mosquitoes.
A three-night detox costs from 60,873 baht (Dh7,180); kamalaya.com
SHA Wellness Clinic, ALICANTE, Spain
Its medical excellence makes Switzerland the spa destination of choice for many of the world's wealthy, because its top spas – Clinique La Prairie, Spa Bad Ragaz, Villa Stephanie, Burgenstock – all run in tandem with a top clinic, but a Swiss spa stay can be prohibitively expensive. That's one reason many who insist on staying only at a spa with medical staff have turned to Spain and its less-costly medi-spas, such as SHA.
Here you get the professional advice and input from a doctor, along with medically approved treatments, but not the coronary-inducing moment at check-out. Also distinguishing SHA is that it is owned by a family – one on a mission to save others from the ill-health that nearly cut short the life of their beloved patriarch. It was him curing himself via macrobiotic diet that, 10 years ago, drove the family to launch a state-of-the-art clinic.
Now others can experience a blend of natural therapies and western medical excellence in regenerative, genetic and preventive measures, contemplate the view across distant Alicante and the Mediterranean, and above all experience the almost-immediate health and weight-loss benefits of a diet of simple, fresh foods.
A seven-day SHA Essence package costs €2,600 (Dh11,489), excluding accommodation; shawellnessclinic.com
BodyHoliday, St Lucia
This looks like a typical Caribbean beach resort: surf boards drawn up on the sand, an airy restaurant yards from the slapping wavelets. It’s actually devoted entirely to enhancing health and could well be a model for the family resort of the future. While its easy-going atmosphere belies the rigour of some of the activities on offer – the 7am beach aerobics class is super-tough – its killer element is the huge choice of treatments and activities available.
You can make a stay as rigorous or undemanding as you like. That explains its popularity among couples, groups of friends, and families with teenage or 20-something children with different interests. Everyone can follow their own particular likes all day, then meet at dinner. For every boot camp option there's yoga or Pilates, with 100-plus weekly classes ranging from early morning tai chi to moonlit snorkelling and triathlons.
Massages are never less than good, and the reflexology from the blind therapist is outstanding. Food focuses on the fresh without being punishingly pure – such as the mouthwatering desserts. Impressively, the Body Science genetic testing medical programme begins with blood tests carried out before you arrive – meaning the doctor starts you on a corrective treatment programme on day one.
Double rooms cost from US$588 (Dh2,160) for two people, including meals and daily treatment; Body Science genetic testing packages cost from $2,700 (Dh9,918) per person; thebodyholiday.com
VivaMayr Altaussee, Austria
Disease starts in the gut, as Hippocrates told the world more than 2,000 years ago. And now we know so much more about how poisonous toxins can spread from overloaded intestines, the Mayr philosophy – developed by the Dr F X Mayr in the 19th century and based on the idea that good digestion is the foundation of good health – seems ever more sensible. Eat only at mealtimes, chew your food until it's the consistency of cream and choose primarily alkaline rather than acidic foods (vegetables
and fruit rather than meat, fish or cheese). Those are the basic Mayr rules. Guests go home thinner, fitter and wiser. Some – those who arrived in a wheelchair and left walking, finally conceived or lost 30 kilograms or more – see their lives transformed. High in the Alps by Lake Altaussee, this glass-and-wood eyrie is the most luxurious of Austria's Mayr spas.
From its outstanding doctors, all possessing mainstream as well as Mayr medical training, and its exquisite little meals, to the level of privacy available, it impresses in every way.
Seven nights cost from £1,889 (Dh9,489); healingholidays.co.uk
Espace Henri Chenot, Palace Merano, Italy
Hormonal analysis, body-composition analysis, a toxicity test: you come away from the elegant old Palace Hotel, the first of the locations that French biologist Henri Chenot set up as a medical spa, several kilos down and with a sheaf of print-outs about your unseen self. As to your exterior, seen self, that is tended to with deep-tissue massages, lymphatic-system-stimulating baths, cellular resonance treatments, feather-light facials and so on, all designed to shift physical and emotional toxicity.
The impressive mix of treatments and focus on anti-ageing using Chenot's multi-pronged tactics combining western, traditional Chinese and nutritional approaches makes this hard to beat as a place to detox, lose weight and regain some equilibrium. It's so popular among Eastern Europeans, as well as Middle East guests, that Chenot has now opened a highly advanced new medical spa – with cryo-chamber and advanced facilities for metabolic testing, in Azerbaijan, in Qabala. See Rosemary Behan's report starting on page 29 for more details.
A seven-night detox costs from €5,145 (Dh23,505); chenot.com
Hotel Royal, Evian-les-Bains, France
Ever practical, the French like a natural approach to health – drinking two litres of natural mineral water each day, taking a daily walk in the open air, eating so carefully that they avoid dessert except at the weekend. But they're also fond of super-smart hotels with impeccable furnishings, service, food and fellow guests. The Evian resort is a place to enjoy all of the above, with the bonus of an exceptionally lovely setting, backed by woods and looking down across Lake Geneva. Another highlight the fact that one person can spend their time in the spa, while the other takes to the golf course, plans which of the hotel's three gourmet restaurants to book into next or just walks in the woods.
Research suggesting that simply walking among trees not only produces a measurably de-stressing effect, but that the air-borne oils trees emit to deter potentially damaging insects and viruses also have a beneficial effect on the human immune system, means that's not just a lazy option. Evian has grown up around the source of the famous mineral water. Here you can drink Evian water, clean your teeth in Evian and bathe in Evian, before strolling off to the woods to relish the feel-good treatments that the natural world can give us, free of charge. The Hotel Royal is the opposite of free, but oozes every ounce of the grandeur its name suggests.
Double rooms cost from €296 (Dh1,308); hotel-royal-evian.com
Dunes by Al Nahda, Barka, Oman
"Make the most of what you have": this is a good rule in life and applies to spas as much as anything else. One exasperating aspect of spas is when they go to great expense (passed on to you, the consumer) to import skin scrubs and creams from halfway around the world when they could do a better job by sending a therapist into the garden to pick an avocado, as well as into the kitchens for a handful of sugar or sea salt. The move from unnecessary sophistication to sensible simplicity is exemplified at this remote resort an hour and a half from Muscat.
Here, surrounded by mountains and a sea of sand dunes, with quad biking and camel rides on offer, you stay not in a hotel room but in a tent – one of the 50 39-square-metre oversize desert camp tents (or three tents if you book one of the two royal suites). When you wander to the Sand Spa, it’s not for some pointlessly complicated ritual, but to be buried in a shallow bed of fragrantly oil-soaked sand, where your head will be tenderly wrapped in cotton to protect your hair and you simply sweat, enjoying the world’s most natural detoxifier.
One-bedroom tents cost from 238 rials (Dh2,270); dunesbyalnahda.com
Grayshott health spa, Surrey, England
Sometimes you need to just retreat from noise and rush. An hour's drive from central London, with 59 rooms and 39 treatment rooms, Grayshott has been just such a bolthole for decades. The heart of 19 hectares of gardens and woodland, the big old house – once home to 19th-century poet Alfred Tennyson and converted to a health centre in 1965 – feels like the kind of place thriller writer Agatha Christie might have stayed in the 1930s to take a break from contemplating crime; a place where you wake up to birdsong and a slight mist over the great lawn; where exercise doesn't extend much beyond walking in the surrounding woods.
Director of natural therapies Elaine Williams is a great draw. An impressively knowledgeable, sympathetic former nurse with decades of subsequent experience in alternative approaches to health, she is kind, calm, collected and has helped improve the well-being and outlook of hundreds of visitors. But the gentle atmosphere that prevails here makes the whole place especially suitable for the exhausted, the reticent, the shyly overweight and anyone recovering from illness, surgery or cancer treatment.
The seven-day all-inclusive Health Regime package cost £1,950 (Dh9,799); grayshottspa.com
Vana, northern India
For a week or more of Ayurvedic or traditional sowa rigpa Tibetan treatments, this is an obvious destination. India is home of Ayurveda, described as "the most complete lifestyle philosophy in existence". It is an ancient prescription for enhancing your health according to your intrinsic dosha, or constitution, by way of the correct foods, exercises and massages, and regular detoxing, and nowhere else offers its practices in such beautifully executed surroundings. Surrounded by a sal tree wood that's home to monkeys, Vana has a profound sense of mission about it.
Owner Veer Singh's grandfather brought western medicine to India, his father introduced private health insurance to the continent, and now Veer is keen to turn India's attention to the region's own great health heritage. The entire complex – huge lobby, airy rooms, spa, medical and treatment areas, yoga pavilions, pool – has been built to the least-toxic, highest specification and furnished with clean-cut elegance. It's utterly calm and quiet – a place to sink into the serenity of a regime of yoga, four-handed massages, and beautifully prepared meals, and to be between the (organic cotton) sheets by 9pm.
Seven nights, all inclusive, cost from 210,000 rupees (Dh11,571); vana.co.in
Buchinger Wilhelmi, Uberlingen, Germany
On a hillside overlooking Lake Constance, with functional rather than five-star rooms because the owners spend their budget on retaining an excellent team of doctors, this is one of Europe's few spas offering medically supervised therapeutic fasts. Against all expectation, feelings of hunger disappear after a day or two of fasting, and Buchinger's regime, with 10 or 21 days spent consuming just herbal teas and broths, guarantees that you will lose a few kilos.
Naturally, though, weight quickly lost is weight quickly regained if you then run back to the chocolate and cheese. But fasting also provides long-term health benefits. The clinic came into being after its founder, Dr Otto Buchinger, invalided out of the German navy for chronic rheumatism, found himself cured after following a friend's advice to undertake a 21-day fast. Today, its doctors have fat files of testimonies from grateful patients who have seen everything from diabetes, heart problems and high blood pressure to migraines and psoriasis greatly alleviated or cured via fasting.
A 10-day fast costs from €2,440 (Dh10,778); buchinger-wilhelmi.com