You know exactly what to expect from a modern spa. There will be ambient music, subdued lighting, vases with artfully arranged twigs and branches, displays of smooth pebbles and a pervading scent of expensive, brand-name oils. The same reassuringly familiar environment is replicated in luxury hotels across the world.

But it wasn’t always this way. For centuries, spa resorts were the product of their immediate environment. They came into being around thermal springs or close to natural sources of volcanic clay, minerals or endemic plants. Indigenous treatments evolved in situ, and people traveled great distances to benefit from them.

Some of these treatments have been appropriated by hotel spas, detaching them from their origins. For instance, you can now experience Ayurvedic therapies in any major city, where they are often listed on spa menus alongside an eclectic selection of other treatments from around Asia and elsewhere.

Translocated to Europe and North America, Ayurveda is wonderfully exotic and fashionable; yet in southern India and Sri Lanka, it is an integral part of everyday life and has been for thousands of years.

Strictly speaking, Ayurveda is a branch of alternative medicine. In dedicated Ayurvedic hospitals, patients can be treated for a wide range of conditions, the treatments tailored to each individual, taking into account his or her body type and lifestyle.

This holistic approach extends to Ayurvedic spa therapies. My first experience was in the spa of the Kempinski Hotel on the Mediterranean island of Gozo. Before heading to a private treatment room, I was given a thorough consultation by an Ayurvedic doctor. With a questionnaire of increasingly personal questions, Dr. Kiran was able to identify my body type (or dosha). Apparently I was kapha-pitta. With matter-of-fact bluntness, he explained that basically I was overweight and unfit. He prescribed my therapies accordingly.

The Kempinski treatment room was predictably tasteful (ambient music, subdued lighting, vase with artfully arranged twigs and branches). For the next two hours, the Indian masseuse expertly subjected me to ancient Ayurvedic techniques, culminating with shirodhara, in which a constant stream of warm oil was directed onto my forehead for 30 relaxing minutes.

I could understand why some of my fellow guests had come here from as far afield as New York and Los Angeles specifically for Ayurvedic treatment. Yet although the staff and therapeutic oils had been brought in from South Asia, could the experience genuinely be described as authentic?

A few months later, I found myself in Sri Lanka, one of the heartlands of Ayurveda. Here I was immersed in the world from which Ayurvedic medicine emerged. I drove through the forests that produce the indigenous herbs and spices that are the raw materials for Ayurvedic oils. I visited the Hindu and Buddhist temples that extol the philosophies which underpin Ayurveda, especially the concept of physical and mental balance.

The spa at the Mermaid Hotel, close to the west coast town of Kalutara, was rustically decorated, very much of its place. Part of the ceiling of the treatment room was deliberately open to the elements. The Indian Ocean provided the constant soundtrack. Occasional rain showers pattered on the floor.

Here, during a succession of Ayurvedic therapies, I began to appreciate the relationship between a spa and its setting. My senses were responsive not just to the treatments but also to the environment. The benefits of Ayurveda were complemented by three spicy Sri Lankan meals each day, daily doses of vitamin D from the tropical sun and lungfuls of clean ocean air.

Roman Bath Museum, Bath, England © Ollietaylorphotography | Dreamstime.com

In Europe, it was the Romans who started the fashion of traveling to a place for therapeutic reasons. Some of the spa resorts they created are still active today, 2,000 years later. The city of Bath in southern England owes its existence to the natural hot springs that bubble up from beneath the surrounding limestone hills. The original Roman baths preserved as a museum, modern spa tourists now enjoy the state-of-the-art rooftop New Royal Bath, which opened in 2006. The nearby Cross Bath enables bathers to take a dip in waters that were regarded as sacred by the ancient Celts.

Another thriving spa city which can trace its origins to the Romans is Baden-Baden in southern Germany. Besides making full use of the natural thermal springs, the contemporary spas of Baden-Baden also offer treatments using local volcanic clay, which is especially rich in minerals and sulfur.

Volcanic clay has long been incorporated in some of the indigenous treatments offered by spas in Hawaii. It is taken to magnificent extremes at Mauna Lani Resort on the Big Island, where guests can experience an open-air lava sauna while covered head to toe in sulfurous mud.

Many Hawaiian spas also draw on an indigenous Polynesian therapeutic tradition known as lomi lomi. Translated as “massage massage,” lomi lomi is a holistic philosophy that also embraces diet and spiritual well-being. At Ihilani Spa Resort on Oahu, lomi lomi treatments are supplemented by a range of therapies employing local elements such as seawater, ti leaves and ginger sugar.

Even in locations where there isn’t an unbroken therapeutic tradition to draw on, spas are becoming much more proactive in utilizing locally relevant ingredients to create indigenous treatments. At Stowe Mountain Lodge in Vermont, what could be more indigenous than a maple syrup and brown sugar body scrub?

Chocolate facial © Subbotina | Dreamstime.com

Other spas draw inspiration from under their own roof. The venerable Hotel Sacher in central Vienna is synonymous with its legendary chocolate cake, the Sacher-Torte. It was therefore entirely logical for the hotel’s spa to introduce a portfolio of treatments based on the nourishing effects of chocolate. Therapies include chocolate wraps, body masks and cacao massages.

In Chodova Plana, in the Pilzen region of the Czech Republic, there could be only one source for indigenous spa treatments. For around 500 years, the town’s fortunes have been tied to the Chodovar brewery. What better place for the world’s first beer spa? Treatments include beer baths as well as massages and scrubs using beer-related ingredients. Far from being a novelty, the spa menu has been carefully devised to make best use of the curative properties of beer, which can boost the immune system and relieve tension. There are also plenty of opportunities between treatments to enjoy excellent beer the old-fashioned way — by drinking it.

Similarly, Yunessun Spa Resort in Japan looked to local beverages to provide an indigenous strand to its spa menu. Here you can take a bath in a wooden cask of real saké followed by a dip in a pool of green tea. As at Chodovar, additional treatments ensure you don’t reek of alcohol (or tea) when you leave the spa.

In the Caribbean, spas draw on tropical abundance for indigenous inspiration. At the Cotton House Resort on the verdant island of Mustique, therapies include exfoliation and massages incorporating coconut oil and cream, and also a lime and pineapple body wrap supplemented by local sea salt. All of the main treatments at Cotton House include a Caribbean Welcome Ritual, using local ingredients to “reflect the environment and stimulate the senses.”

At the Regent Palms on Turks and Caicos, the signature Mother of Pearl Body Exfoliation uses hand-crushed queen conch shells to clean the skin, followed by a soothing rain shower. After dark, the outdoor Moonlight and Stars massage makes best use of two ingredients beyond the reach of more northerly spas: the glittering tropical sky and the hypnotic sound of the Caribbean Sea.

Other indigenous treatments are easier to replicate elsewhere. In the early 20th century at the natural thermal springs in the town of Kangal in central Turkey, a local species of freshwater fish was observed enjoying nibbling the dead skin off bathing humans. This observation turned into a formal therapy with real benefits in the treatment of skin disease.

Unfortunately, the “doctor fish” turned out to be easy to export, and in recent years enterprising entrepreneurs in Japan and Croatia set up their own fish spas. A fad was born and quickly took off around the world, often without regulation. Health concerns were raised, and fish spas were banned in some U.S. states. But back in Turkey, the treatments have long been certified by the Department of Health, and people continue to be drawn to Kangal for sessions with the original shoals of doctor fish.

Although there is always a possibility of indigenous spa treatments being appropriated, they are inevitably diluted (or corrupted) when removed from their geographic source. As modern spas become more homogenized, the incentive to seek out locally specific spa treatments has never been greater.

In the Ayurveda spas of South Asia, in the lomi lomi treatments of Hawaii, in the beer baths of the Czech Republic and in the fish spas of Turkey, there is living proof of the physical and mental benefits of the world’s diversity.