Modern spas have their roots in the ancient towns that grew up around mineral waters and hot springs that were famous for their healing powers. Use of the hot springs goes back even further–probably whenever humans first discovered them. They were used by indigenous peoples, and the Greeks were known for bathing in hot springs and mineral waters. For the Romans, the baths were a place not just for cleansing, but for socializing, a tradition that spread to the east and transformed to the Middle Eastern hammam.

The Roman bathing tradition fell with the empire, but people still valued hot springs and mineral springs. At a time when Western medicine offered very little in the ways of cures, people would travel to the springs to treat their ailments. In medieval times, facilities were primitive and the rich and poor were not separated, but bathed in the same pools. That practice would end as the wealthy discovered they could "take the waters" in much nicer facilities.

The Great 19th-Century Spa Towns

By the 19th century, Europe's great Kurorte (“cure-towns”) such as Baden-Baden, Bad Ems, Bad Gastein, Karlsbad, and Marienbad were lavish destinations for the wealthy and rising bourgeoisie class. According to David Clay Large, author of The Grand Spas of Central Europe (Rowman & Littlefield, 2015), these great spa towns were "the equivalent of today’s major medical centers, rehab retreats, golf resorts, conference complexes, fashion shows, music festivals, and sexual hideaways—all rolled into one."

One reason for the allure was that Western medicine didn't have much to offer at the time. Healing waters were the best choice for symptomatic relief of arthritic, respiratory, digestive and nervous ailments. "People went to the spas in hopes of curing everything from cancer to gout," Large writes. "But often as not 'curists' also went to play, to be entertained, and to socialize. In their heyday the grand spas were hotbeds of cultural creativity, true meccas of the arts. High-level politics was another grand spa specialty, with statesmen descending on the Kurorte to negotiate treaties, craft alliances, and plan wars."

The Rise of the Modern Spa

The two world wars and the rise of modern medicine did much to reduce the fortunes of the great spa cities. Europe still has a healthy bathing tradition, as can be seen in the great baths of Germany and the thalassotherapy spas of France, Spain and Italy.

In America, people began to see hot springs and mineral spas as antiquated and attendance plummeted. The rise of the new generation of spas began in 1940, when Edmond and Deborah Szekely opened Rancho La Puerta in Mexico as the first destination spa for "health nuts." Deborah went on to start Golden Door in southern California in 1958. Both spas are still among the finest in the country spas.

They helped pave the way for The Oaks at Ojai in 1977, which inspired Mel and Enid Zuckerman to open Canyon Ranch Tucson in 1979. The 1990s and beyond were a period of great growth, with resorts adding lavish spas, and an explosion of day spas. In 2015 there were more than 21,000 spas in the U.S., the vast majority of them day spas, according to the International Spa Association.

Spa Etymology

No one knows exactly where the word "spa" comes from, but there are two main theories. The first, and most popular, is that "spa" is an acronym for the Latin phrase salus per aquae or "health through water." Others believe the origin of the word "spa" comes from the Belgian town of Spa, known since Roman times for its baths. They speculate that the town was so prominent that the very word spa became synonymous in the English language with a place to be restored and pampered.