Not long ago, spas were sanctuaries for the elite and affluent, places of pampering for a privileged few to rest, relax and indulge in luxurious treatments. Typical of these were world-renowned retreats such as the Golden Door in Escondido and the La Costa Resort and Spa along the Carlsbad coast.

Nowadays, nearly everyone can enjoy the spa experience: A proliferation of day spas and other businesses offering less expensive and less time-consuming spa treatments has made the experience more accessible and affordable.

"Spas are no longer for the rich and famous," said Robert Rauch, a hotelier who is also chairman of the San Diego County Hotel-Motel Association and director of San Diego State University's Center for Hospitality and Tourism Research. "It's no longer a luxury. It's very mainstream now."

The worldwide spa industry has grown 40 percent in the last three years to a booming and diverse $15 billion industry, according to Spa Finder Inc., a spa marketing and publishing company.

Spa-going, according to the company, dates back thousands of years and involved social bathing in "healing waters." (The word "spa" comes from the Latin verb "spagere" -- to pour forth.) In recent years, the meaning has expanded greatly to encompass a variety of treatments, from aromatherapy massage to plastic surgery.

North County's near-perfect climate, abundant open space and casual environment make the region a perfect location for spas, according to Cami Mattson, president and chief executive officer of San Diego North Convention & Visitors Bureau. The bureau even bills North County as "San Diego's resort region."

The region is a microcosm of spa trends: In addition to world-renowned destination spas such as the Golden Door, La Costa, the Four Seasons Resort Aviara and Cal-a-Vie, North County has dozens of day spas and spa-related businesses.

Day spas, which offer an assortment of a la carte spa treatments from facials to massages to fit just about every budget and schedule, are one of the fastest-growing segments of the spa industry.

"Destination resorts are lovely, but a lot of people can't afford that," said Joyce Carboni, founder and general manager of Skinsational, a Carlsbad day spa. "Here, they don't even have to come for the entire day."

Many day spas offer services that complement traditional spa treatments: Bella D'ora, a Carlsbad day spa, offers hair cutting, coloring and styling, manicures and pedicures, waxing, sunless tanning and makeup application in addition to massages, facials and other body treatments. Bella D'ora's co-founder and general manager, Christine Alvarado, said she is exploring other crossover opportunities such as teeth whitening and an on-site chiropractor.

"The possibilities are endless," Alvarado said.

Some day spas also offer certain medical (or "medispa") treatments such as chemical peels, injectable wrinkle treatments and even plastic surgery.

Carboni said that Skinsational recently began providing services such as Botox and Restylane injections, glycolic peels and laser hair removal at the request of clients.

To capitalize on the growing demand for spa treatments, some businesses in other industries now offer facials and massages in addition to their normal services, such as Bella Faccia Dental Spa in Poway. It offers a full spa menu, as well as cosmetic and general dental procedures.

Spa director Wendy Whang said that she and her husband, Dr. Calvin I. Whang, decided to add spa treatments when their office opened last year and learned that most clients regularly visited spas for facials and other treatments.

"We thought that would be something we could offer," said Wendy Whang, who said that the spa services have attracted both current and new clients.

Lynne Walker McNees, president of the International SPA Association, an industry professional association, said she believes that the demand for spa treatments combined with other services in one location will continue to grow.

"People are busier than ever before -- they are looking for a one-stop shop," McNees said. "They want a place where they can get it all, which frequently includes having a spa treatment."

According to McNees, there are 57 million active spagoers in the United States, and one in four American adults has been to a spa. Still, McNees said that most spagoers fit a certain profile.

"The average spagoer is female, in their 40s, is married and is a college graduate," McNees said.

Carboni of Skinsational said the profile fits her clientele. "The bulk of our clients are upper middle-class baby boomers," she said. "They are well-educated people with high-stress jobs."

Not surprisingly, local spa representatives report that anti-aging treatments are among their most requested spa services. Aside from massage, the most popular treatment at The Spa at Rancho Valencia, on the grounds of the Rancho Valencia Resort in Rancho Santa Fe, is the Catio Lift Facial, a treatment that spa director Mechelle Hill describes as "a nonsurgical face-lift."

"Everyone wants to look more youthful," said Alvarado, who said she believes that celebrities drive the demand for anti-aging treatments. "Everyone who is 40 looks 30, and everyone who is 30 looks 20."

However, the main reason most people go to spas is more than skin-deep. The No. 1 reason spagoers cite for visiting a spa is to reduce stress, said McNees of SPA Association.

"With e-mail, Blackberries, cell phones, et cetera, we are all working at a crazier pace than ever before," McNees said. "People are realizing they must take time out to recharge their batteries."

"Our clients really are so stressed," said Carboni, who said that may account for the increase in male clients at Skinsational, which now offers a Gentleman's Journey package that includes a Men's Facial Optimizer, Eucalyptus Soak and Sports Massage.

"I think it's more accepted nowadays," said Wendy Whang of Bella Faccia Dental Spa, who said that she and her staff were surprised by how many men are getting facials.

Increased interest in leading healthier, more balanced lives directly correlates to increased interest in spas, local spa managers said.

"Everyone wants to stay healthy and fit and mobile," said Brenda Buono, co-owner of Spa Party Central, a mobile spa that serves all of San Diego County and provides spa treatments to individuals and groups of clients in their homes, hotel rooms or the location of their choice.

"There is more of a heightened consciousness and awareness of the value of good health," said Debbie Zie, general manager of Cal-a-Vie, an upscale destination spa in Vista that offers three-, four- and seven-day stays ranging in price from more than $3,400 for three days to more than $7,000 for seven days.

The all-inclusive experience, which has reportedly been enjoyed by celebrities including Julia Roberts and Oprah Winfrey, includes luxury accommodations and a daily regimen of spa treatments, fitness activities, mind/body exercises and nutritious meals, all customized for each guest.

Whereas total wellness programs were once the exclusive domain of destination spas such as Cal-a-Vie, more and more day spas are beginning to offer components of those programs.

Many local day spas reflect this trend: Bella D'ora also offers yoga, pilates, meditation classes, personal training and nutrition programs, and Skinsational offers its clients free monthly wellness seminars.

Some local spa representatives said they are also beginning to see a much younger clientele.

"Sometimes I get surprised about the age," said Alvarado, whose Bella D'ora day spa now offers a Teen Facial Treatment.

Not only are a wider range of people going to spas, it seems that they are also going more often. Most local spa representatives said that repeat customers account for a significant portion of their business: Cal-a-Vie's return guest rate is 45 percent, and half of Bella D'ora's clients are regulars.

Still, many people only splurge on spa treatments on special occasions. Buono said many of Spa Party Central's clients host "spa parties" in their homes for a variety of reasons, from bachelorette parties to baby showers to "just because." Other spa managers said that weddings, birthdays and anniversaries are regularly celebrated at their spas.

Many clients come in with at least one friend or with their significant other. To accommodate and encourage this trend, many local spas offer group specials such as Bella D'ora's Ladies Night Out package, which includes customized mini facials, massages, hair styling and makeup application, plus beverages, hors d'oeuvres and a three-hour limousine rental.

Others have even built rooms especially designed to accommodate couples and offer specials, such as the Terra Cotta Couples Clay Bake at Rancho Valencia. The treatment for two includes a soak in a secluded outdoor pool followed by clay application, a shared outdoor shower and a moisturizing massage.

Visitors bureau President Mattson said she believes spas have become so mainstream that they will soon be considered essential to all hotels.

"Spas will become as common as fitness centers and business centers in corporate hotels," said Mattson, who has seen the change reflected in local resorts. "Even our casinos are opting for a fabulous spa over a golf course."

Rauch, whose Hilton Garden Inn at Torrey Hills will be the first Hilton Garden Inn in the nation to have a spa when it opens this September, said: "Just about every resort being built or renovated is making the spa a major component. I think the growth is going to be exponential."

McNees of SPA Association said that because 15 percent of spagoers are new to spas each year, she believes that their popularity will continue to grow.

"As consumers continue to become educated on the benefits of the spa experience, they will return to spas and introduce the experience to their friends, family and colleagues," McNees said.

Mattson said she believes that spas are here to stay in North County and nationwide.

"This is not a temporary trend," Mattson said. "As long as we are stressed, there will be spas."

Spa treatments: from hot stones to cool cucumbers

Massages, facials and relaxation are the staples of most spas, but treatments and costs vary widely. The following is a sample of typical offerings from several local spas.

- Bella D'Ora Spa, Carlsbad

(760) 438-7404

www.belladoraspa.com

Acquazzone: A 45-minute treatment in an herb-infused steam room, which includes a Hungarian mud body treatment, head massage, Exfoli-Sea Salt Glow body exfoliation, Body Blends moisturizing treatment and hot stone massage ($100).

- Bella Faccia Dental Spa, Poway

(858) 487-8090

www.bellafacciadentalspa.com

Asian Centric Massage: A five-minute massage in the spa's outdoor cabana that combines elements of Thai and Shiatsu techniques ($85).

- Cal-a-Vie, Vista

(760) 945-2055

www.cal-a-vie.com

Thalassotherapy: A 25-minute full body seaweed wrap that allows the body to detoxify while absorbing the vitamins and minerals in seaweed, coupled with a simultaneous face and scalp massage. (Included in most plans for destination visitors.)

- Skinsational Skin & Body Spa, Carlsbad

(760) 434-8118

www.skinsationalspa.com

Javanese Lulur: A 110-minute treatment that includes a Balinese massage with essential oils; an herbal exfoliation; a cool, yogurt splash; a fragrant shower; and a soak in a flower petal-filled tub ($225).

- Spa Party Central, serving all of San Diego County

(760) 781-4133

www.spapartycentral.com

Sensational Sugar Exfoliation & Moisturizing Massage: A 50-minute treatment exfoliating the body with an organic sugar scrub (in scents such as coconut papaya or orange blossom) and moisturizing with body butter ($135).

- The Spa at Rancho Valencia, Rancho Santa Fe

(858) 759-6490

www.ranchovalencia.com/spa.asp

Tip to Toe: A 90-minute treatment that includes the spa's Signature Oil Blend massage; a lavender orange hair and scalp treatment; and a citrus, sea-salt foot exfoliation with a hot-towel foot wrap ($195).

A spagoers glossary

Spas now offer a variety of services. Here are the six main categories:

- Day spa: A spa that offers a variety of traditional spa treatments, including massages and facials, and may also include salon services and other amenities.

Treatments generally range in length from 20 minutes to 1 1/2 hours and can be bought a la carte or as an all-day package. Accommodations are not provided.

- Dental spa: A dental office that offers traditional spa treatments in addition to general and cosmetic dental procedures. Accommodations are not provided.

- Destination spa: A spa that offers an all-inclusive wellness program featuring a daily regimen of spa treatments, nutritious meals, fitness activities and educational programs. Accommodations are provided, and stays may range in length from a few days to more than a week.

- MediSpa: A spa specializing in cosmetic medical procedures, which may include chemical peels and microdermabrasion, Botox and Restylane injections, laser hair removal, vein reduction and even plastic surgery. Traditional spa treatments may also be offered, and accommodations may be provided.

- Mobile spa: A spa service that brings spa treatments to a client's home, office, hotel room or any other location. All equipment and products are provided, and services may range from traditional spa treatments to select salon services. Mobile spas typically serve individuals, couples and groups.

- Resort spa: A day spa on the premises of a hotel or resort that may be used by hotel guests as well as the public. In addition to traditional spa treatments, a resort spa may also offer salon services, fitness and wellness programs and spa cuisine. Accommodations are provided by the hotel or resort.