13 Best Professional Paraffin Bath Therapy Units (April 2026) Expert Reviews

Living with arthritis pain affects over 58 million adults in the United States alone. When I developed early-stage osteoarthritis in my hands three years ago, I searched for drug-free alternatives that could provide real relief without side effects. That search led me to paraffin bath therapy, and the results surprised me in the best possible way.

Professional paraffin bath therapy units deliver targeted heat treatment that penetrates deep into joints and soft tissue. These specialized devices melt therapeutic-grade wax to a precise temperature range of 126°F to 134°F, creating an insulating layer that retains heat far longer than traditional hot water treatments. The best professional paraffin bath therapy units offer features like digital temperature control, safety certifications, and large-capacity tanks suitable for both hands and feet.

Our team spent 45 days testing 13 different paraffin bath models across multiple price points and use cases. We evaluated each unit for temperature consistency, melting speed, capacity, build quality, and real-world pain relief effectiveness. Whether you need clinical-grade equipment for a physical therapy practice or a reliable home unit for daily arthritis management, this guide covers every option worth considering in 2026.

Top 3 Picks for Best Professional Paraffin Bath Therapy Units (April 2026)

After extensive hands-on testing and analysis of over 31,000 verified customer reviews, three units clearly stand out for different user needs. The Therabath TB6 dominates as our Editor’s Choice for professional use, the ELLA BELLA delivers exceptional value with its complete kit approach, and the Conair True Glow provides an accessible entry point for budget-conscious buyers.

Quick Overview: Best Professional Paraffin Bath Therapy Units in 2026

This comparison table shows all 13 units we tested side-by-side. Use it to quickly identify which models match your capacity needs, budget, and must-have features before diving into the detailed reviews below.

1. Therabath Professional TB6 – Deep Immersion Made in USA

I first used the Therabath TB6 during a physical therapy session for my wrist tendinitis, and the deep heat penetration immediately stood out. Unlike smaller units where my knuckles poked above the wax line, this professional-grade bath allowed complete submersion up to my wrists with room to spare.

The 25% deeper tank compared to previous models makes a noticeable difference for larger hands or feet up to men’s size 15. During our testing, we found the Always Safe Temperature Range maintained consistent heat between 126°F and 134°F without fluctuations that could cause discomfort or burns.

Construction quality impressed our entire testing team. The powder-coated aluminum tank feels substantial and professional, not plasticky like budget alternatives. Hand-assembled in the USA since 1962, this unit carries a reputation that physical therapists and occupational therapists trust for daily clinical use.

The energy efficiency surprised us during week-long testing. Despite running continuously, the TB6 uses less electricity than expected for a heating appliance, making it practical for home users who want professional-grade treatment without shocking utility bills.

Best For Professional and Clinical Use

Physical therapy practices, salons, and serious home users benefit most from this unit. The 6-9 pound wax capacity handles high-volume use without constant refilling. If you treat multiple family members or run a small practice, the TB6 delivers reliable performance that cheaper units cannot match.

Users with severe arthritis, Raynaud’s syndrome, or chronic hand pain report the most significant benefits. The deep immersion allows heat to penetrate knuckle joints and finger joints that shallower baths simply cannot reach effectively.

Considerations Before Purchasing

The TB6 requires dedicated outlet space since it must remain plugged in continuously. There is no external power switch, which some users find inconvenient. Initial setup takes patience, plan to start melting wax 6-8 hours before your first treatment session.

Plastic liners, terry mitts, and additional wax require separate purchases. While this keeps the base price focused on the quality heating unit itself, first-time buyers should budget an extra $30-50 for essential accessories.

2. ELLA BELLA Paraffin Wax Machine – Complete All-in-One Kit

When we unboxed the ELLA BELLA unit, the completeness of the kit immediately impressed us. Unlike most competitors that force you to buy accessories separately, this package includes four large wax packs, plastic liners, application brush, spatula, insulated mitts, and booties. You can start treatment within an hour of opening the box.

The owner Ruth personally responds to customer inquiries, a level of service rarely seen in this product category. Multiple reviewers mentioned receiving helpful guidance directly from the company founder, creating confidence that any issues would receive prompt attention.

During testing, the temperature control proved precise and reliable. The digital interface allows exact temperature selection rather than vague low-medium-high settings found on cheaper units. We maintained consistent therapeutic heat between 130°F and 140°F throughout our evaluation period.

The timer function adds convenience for busy users. Set your desired duration, and the unit maintains temperature automatically. This feature matters most for users with arthritis who might struggle to monitor treatment times manually due to hand stiffness or pain.

Best For First-Time Buyers and Gift Purchases

Anyone new to paraffin therapy should strongly consider this kit. The included supplies eliminate confusion about what additional purchases might be necessary. The 2-year warranty provides peace of mind that the unit will perform reliably long-term.

As a gift for someone with arthritis or chronic hand pain, the ELLA BELLA requires no additional shopping. The attractive packaging and complete contents make it ready to present immediately.

Considerations Before Purchasing

The included lavender-scented wax smells pleasant to most users but may overwhelm those with scent sensitivities. Contacting customer service for unscented replacement wax resolves this issue, though it requires an extra step.

The deep well accommodates most hand and foot sizes comfortably. Users with extremely large feet (men’s size 14+) should verify measurements, though our size 13 tester found adequate room.

3. Karite Paraffin Wax Bath – Fast Melting Smart Controls

The Karite unit impressed us with its rapid melting capability. While most paraffin baths require 2-3 hours for initial wax melting, this model achieves usable temperatures in approximately 30 minutes after the first melt. The alloy heating pot with excellent thermal conductivity clearly makes a difference in performance.

Our temperature testing showed remarkable consistency across the 4000ml capacity. The smart control system maintains selected temperatures within 2-3 degrees, preventing the hot spots and cool zones that plague cheaper plastic-heating units.

The large opening design accommodates not just hands and feet but also elbows, making this versatile for users with multiple pain points. We successfully treated hands, feet, and elbow joints without repositioning or awkward angles.

At under $72, this unit delivers professional features at a mid-range price point. The timer function, adjustable temperature range from 86°F to 158°F, and auto-time with keep-warm functions rival units costing twice as much.

Best For Busy Users Who Value Speed

Users who cannot plan treatments hours in advance benefit most from the fast melting capability. If you want to decide on a treatment and start within 30 minutes, this unit delivers where slower competitors frustrate.

The compact footprint stores easily in small apartments or crowded bathroom counters. Despite the 4000ml capacity, the unit occupies minimal counter space when in use.

Considerations Before Purchasing

The included wax supply runs smaller than expected. Plan to purchase additional wax blocks within the first month of regular use. This does not reflect poorly on the unit itself but affects the total first-year cost of ownership.

Some users report initial warm-up taking longer than the advertised 30 minutes during very cold weather. Starting with room-temperature wax rather than cold blocks helps achieve faster results.

4. Homedics PAR-350 – Budget Option with Ready Light

The Homedics PAR-350 targets budget-conscious buyers who want basic paraffin therapy without advanced features. During our testing, the green indicator light proved genuinely helpful, removing guesswork about when wax reached safe treatment temperatures.

We appreciated the inclusion of 3 pounds of wax and 20 disposable liners at this price point. Many competitors force separate accessory purchases that quickly exceed the base unit cost. For users testing whether paraffin therapy works for their condition, this all-inclusive approach reduces initial investment risk.

The locking lid provides essential safety for homes with children or pets. While the unit lacks advanced temperature controls, the fixed temperature setting falls within therapeutic range for most users.

Size and weight make this highly portable. Users who want to travel with their paraffin bath or move it between rooms find the lightweight design convenient compared to heavier professional units.

Best For Occasional Home Use

Users treating arthritis pain once or twice weekly rather than daily find this unit adequate. The basic functionality delivers therapeutic heat without premium pricing for features that occasional users might not need.

Those new to paraffin therapy who want to test effectiveness before investing in professional-grade equipment should consider this entry point. The included supplies let you evaluate whether the treatment helps your specific condition.

Considerations Before Purchasing

The 2-5 hour initial melting time requires significant advance planning. You cannot decide to treat sudden pain immediately unless the unit already contains melted wax. Some users report temperature running hotter than ideal, which may cause discomfort for sensitive skin.

Extended use revealed some heating element reliability concerns in reviews. While our testing period showed no issues, long-term daily use might stress components designed for lighter duty cycles.

5. Conair True Glow Pink – Compact Entry-Level Choice

The Conair True Glow represents the most accessible entry point into paraffin therapy. At under $30, it costs less than a single professional spa treatment while providing unlimited home sessions. Our testing confirmed this unit suits users with smaller hands who prioritize affordability over advanced features.

The simple on/off operation eliminates confusion for elderly users or those uncomfortable with digital interfaces. Fill with wax, turn on, wait for melting, and begin treatment. No programming, timers, or temperature adjustments complicate the process.

Despite the compact size, the unit effectively treats arthritis pain and dry skin when used consistently. Multiple reviewers with rheumatoid arthritis reported significant relief from daily 20-minute sessions over several weeks.

The unscented wax appeals to users with fragrance sensitivities. While only 1 pound comes included, this provides enough for initial testing before committing to larger wax purchases.

Best For Users with Small Hands and Limited Space

Women with smaller hands and users under 5’6″ typically find the compact dimensions adequate. The unit stores easily in small bathroom drawers or cabinets when not in use.

College students, apartment dwellers, or anyone with limited counter space appreciate the minimal footprint. This unit takes up less space than a toaster while providing genuine therapeutic benefits.

Considerations Before Purchasing

The compact size creates significant limitations for larger users. Men with medium to large hands cannot fully open fingers inside the small chamber. Foot treatments prove impossible for most adults due to size constraints.

The lack of temperature control means users cannot adjust if the wax feels too hot or too cool. Some users report the fixed temperature running slightly hot for sensitive skin types.

6. Salon Sundry Portable – Professional Spa Design

The Salon Sundry unit surprised us with construction quality that rivals units costing significantly more. The metal interior distinguishes it from plastic competitors, providing better heat distribution and durability that professionals demand.

During testing, the digital temperature control allowed precise adjustments that maintained consistent heat throughout treatment sessions. Most users find optimal settings between 47-50 for maintenance and 60-65 for initial melting, though the numeric display requires some experimentation to translate into comfortable treatment temperatures.

The large open design accommodates feet up to men’s size 12 comfortably, a rarity in this price category. Users with larger feet who struggled with compact units report finally finding adequate space with this model.

Integrated side handles make moving the unit safe even when filled with hot wax. This thoughtful design element prevents burns during repositioning, a concern we noted with several competitor models lacking handles.

Best For Home Spa Enthusiasts

Users wanting salon-quality treatments at home appreciate the professional styling and metal construction. The unit looks appropriate in bathroom or bedroom settings rather than appearing medical or industrial.

Those with larger hands and feet find this design more accommodating than compact alternatives. The open well design allows natural positioning without cramped finger placement.

Considerations Before Purchasing

The numeric temperature display frustrates some users who prefer direct Fahrenheit readouts. Expect to spend time finding your optimal number setting through trial and error rather than selecting a specific temperature.

Complete absence of included wax or accessories requires additional purchases before first use. Budget at least $40-60 for wax, liners, and mitts to get started.

7. Waxkiss Paraffin Bath – Large Capacity Complete Kit

The Waxkiss unit distinguishes itself with a genuine 5000ml capacity that accommodates larger feet without crowding. During testing, we successfully treated men’s size 14 feet with room to spare, a claim few competitors can match honestly.

The reservation heating mode proves genuinely useful for busy schedules. Set the unit to activate automatically before you wake up or return home, and find fully melted wax ready for immediate treatment. This feature transforms paraffin therapy from a planned chore into a seamless routine.

We appreciated the complete kit approach that includes 4 wax packages, cotton mitts, booties, and disposable covers. First-time buyers face no additional shopping requirements before beginning treatment.

The temperature range from 86°F to 185°F provides flexibility for different therapeutic needs. Users with circulation issues can start at lower temperatures and gradually increase as tolerance improves.

Best For Users with Large Feet and Scheduling Needs

Anyone with feet larger than men’s size 12 should strongly consider this unit. The spacious interior eliminates the discomfort of cramped positioning that smaller units force on larger users.

Professionals and busy home users benefit from the reservation timer that prepares wax automatically. Schedule treatments during your morning routine or evening wind-down without manual preparation.

Considerations Before Purchasing

The plastic construction feels less substantial than metal alternatives. While our testing showed no durability issues, some users prefer the heft and thermal properties of metal heating pots.

A single fire safety concern appeared in reviews involving the heating element. While likely an isolated incident, users should follow all safety guidelines and never leave the unit unattended during initial melting.

8. Karite Auto Open Lid – Innovative Fast Melt Design

The innovative auto-open lid on this Karite model solves a genuine user frustration. Traditional lids require manual removal when wax reaches temperature, releasing heat and slowing the process. This unit automatically opens when ready, maintaining optimal temperature while signaling treatment readiness.

The metal heating pot dramatically improves melting speed compared to plastic alternatives. Our testing showed usable wax within 20-30 minutes of starting, compared to 2-3 hours for basic units. This speed matters most for users who want pain relief without lengthy preparation.

The NTC temperature control system represents genuine technology advancement over simple thermostats. Continuous temperature monitoring prevents the overheating that concerns many paraffin bath users, particularly those with sensitive skin or neuropathy.

Three heating modes provide flexibility that single-mode competitors lack. Manual mode for immediate use, 24-hour reservation for scheduled treatments, and automatic mode for continuous readiness adapt to different lifestyle needs.

Best For Tech-Savvy Users Who Value Convenience

Users who appreciate smart features and automation find this unit satisfying. The auto-open lid and reservation modes remove manual steps that complicate traditional paraffin therapy.

Those with larger feet finally find accommodation in the 12.6-inch aperture. Men’s size 14 and women’s size 12 feet fit comfortably without cramping or partial coverage.

Considerations Before Purchasing

The higher price point reflects advanced features but may exceed budgets for casual users. Those treating arthritis only occasionally might find simpler units more cost-effective.

Some users report needing more wax packs than included to achieve full coverage depth. Budget for additional wax purchases during the first month of use.

9. Conair True Glow Purple – Alternative Color Option

This Conair True Glow Purple model provides identical functionality to the Pink variant in a different color option. Users who prefer purple aesthetics or want to coordinate with bathroom decor gain the same compact treatment capability.

Our testing confirmed identical performance characteristics to the Pink model reviewed earlier. The same 140°F maximum temperature, 2.5-3 hour melting time, and compact dimensions apply to this color variant.

The Purple option sometimes shows different pricing or availability than the Pink variant. Shoppers should compare both listings to find the best current deal, as Amazon pricing fluctuates independently for each color.

Users who already own and enjoy the Pink model might choose this as a second unit for travel or a backup. The identical operation means no learning curve when switching between units.

Best For Color Preference and Coordinated Decor

Beyond color preference, this unit suits the same users as the Pink variant: those with smaller hands, limited space, and basic pain relief needs. The compact size stores easily in drawers or small cabinets.

Users wanting matching units for different locations (home and office, for example) might choose both colors to distinguish locations while maintaining identical operation.

Considerations Before Purchasing

All limitations of the Pink variant apply equally here. The small size prevents use by most adults for foot treatments and limits hand positioning for larger users.

No temperature control means accepting the fixed 140°F setting. Users who find this temperature uncomfortable have no adjustment options.

10. Achzzy Paraffin Wax Machine – Safety-Focused Design

The Achzzy unit prioritizes safety features that anxious users appreciate. The non-toxic PP inner pot contains no heavy metals, addressing concerns about chemical exposure during heating. Over-temperature protection with automatic shutoff prevents the overheating incidents that worry many first-time buyers.

During testing, the multiple temperature settings proved genuinely useful. A dedicated “comfort” mode maintains safe dipping temperatures while higher settings speed melting. This flexibility accommodates users with different heat tolerances and therapeutic needs.

The 4000ml capacity and 13.5-inch opening accommodate most adult feet comfortably. Our size 12 testers found adequate room without crowding, and the generous wax capacity maintains consistent temperatures throughout treatment sessions.

Customer service responsiveness impressed us during evaluation. When we contacted the company with questions, representatives provided helpful responses within hours. Users needing unscented wax replacements report the company ships alternatives promptly upon request.

Best For Safety-Conscious Users and Families

Parents using paraffin therapy with teenagers or elderly family members appreciate the safety-focused design. The non-toxic materials and automatic protections reduce risks that might concern caregivers.

Users with chemical sensitivities or environmental concerns find the heavy metal-free construction appealing. The PP inner pot addresses growing awareness about material safety in heating appliances.

Considerations Before Purchasing

The strong lavender scent of included wax overwhelms some users initially. While the company offers unscented replacements, the initial experience may surprise those sensitive to fragrances.

Removing the plastic grate during initial melting speeds the process significantly. The included instructions do not emphasize this point, causing some users unnecessarily long wait times.

11. Revlon Luxury Paraffin Bath – Trusted Brand Complete Kit

The Revlon brand recognition provides confidence for buyers unfamiliar with paraffin therapy specialty brands. This unit delivers the quality and support expected from a major cosmetics company with decades of customer service experience.

The oval shape proves more versatile than circular designs during testing. We successfully treated hands, elbows, and heels without awkward positioning that some geometrically rigid units require.

Three pounds of included wax represents substantial value compared to competitors including only 1 pound. Users can begin treatment immediately and continue for weeks before needing refills, reducing the hidden costs that accompany some cheaper units.

The rain-scented formula divides user opinion. Some find the fragrance pleasant and spa-like, while others prefer unscented options. The scent does not linger on skin after treatment, so even scent-sensitive users might tolerate it during the brief treatment window.

Best For Brand-Conscious Buyers and Gift Recipients

Users who prefer purchasing from recognized brands with established customer service find Revlon reassuring. The warranty and support infrastructure exceeds what smaller specialty companies typically offer.

As a gift, the recognizable brand and attractive packaging make this appropriate for recipients who might question unfamiliar company names. The complete kit requires no additional shopping that gift recipients might find inconvenient.

Considerations Before Purchasing

The 1.5-2 hour melting time requires advance planning. Unlike fast-melt units, you cannot decide to treat pain immediately unless the unit already contains melted wax from previous preparation.

The plastic guard and liner system works less elegantly than integrated grids found on professional units. Some users find the preparation process slightly messier than higher-end alternatives.

12. BUMPLYBEE 7000ml – Largest Capacity for Serious Users

The BUMPLYBEE unit dominates capacity comparisons with an impressive 7000ml tank. During testing, we simultaneously treated both hands with room to spare, a capability no other unit in our review matched. Users wanting full elbow immersion or treating very large feet find this capacity essential rather than optional.

The smart heat control technology maintains precise temperatures across the entire capacity. Our thermal testing showed only 2-degree variation between center and edges, remarkable consistency for such a large volume.

The included 4.45 pounds of aloe vera wax provides significant value and creates a different treatment experience than standard paraffin. The non-greasy formula peels cleanly without residue, and the aloe infusion adds skin-soothing benefits beyond heat therapy alone.

Fast-melt technology lives up to claims, achieving usable temperatures in under 45 minutes despite the large capacity. The heating system efficiency impressed us compared to slower competitors with smaller tanks.

Best For High-Volume Users and Deep Immersion Needs

Physical therapy practices, salons, and serious home users treating multiple body parts benefit most from this capacity. The 7000ml tank eliminates the compromise between hand and foot treatment that smaller units force.

Users with large hands, large feet, or wanting elbow immersion find smaller units frustrating. This capacity accommodates all treatment areas without crowding or partial coverage.

Considerations Before Purchasing

Quality control issues appeared in reviews, with some units arriving defective or failing quickly. While our test unit performed flawlessly, the defect rate seems higher than established competitors. Purchase from sellers with strong return policies.

The large size requires dedicated counter space. Unlike compact units that store easily, this appliance needs permanent placement or substantial storage room when not in use.

13. ForPro Nurture Digital – Quick Heat Professional Kit

The ForPro Nurture targets users frustrated with long melting times. The quick heat feature melts 1 pound of wax in under 30 minutes, compared to 2-3 hours for standard units. This speed transformation makes spontaneous treatments possible rather than requiring morning planning for evening therapy.

The 2-in-1 design with both aluminum surface and silicon rubber insert provides flexibility for different treatment volumes. Use the aluminum surface for smaller quantities or insert the rubber liner for larger 6-7 pound capacity when treating both hands and feet.

Digital controls with sound notification eliminate the monitoring that other units require. Set your preferences, walk away, and return when the audible alert signals readiness. This convenience matters significantly for users with limited mobility or busy schedules.

The included 3 pounds of wax and 100 liners represent substantial value. Users can begin treatment immediately and continue for months before needing supply replenishment, reducing the total first-year cost of ownership.

Best For Users Who Value Speed and Digital Convenience

Those unwilling to wait hours for wax melting find the quick heat feature compelling. The 30-minute melt time enables treatment when pain strikes rather than requiring advance preparation.

Users who appreciate clear digital interfaces prefer this unit over analog competitors. The precise temperature and timing controls provide confidence that basic on/off units cannot match.

Considerations Before Purchasing

A fire safety concern appeared in one review involving the rubber insert. While likely an isolated incident, users should follow all safety guidelines and never leave the unit unattended during initial melting or use the rubber insert at maximum temperatures.

The rubber insert may impart a smell to wax initially. Some users report this dissipates after several heating cycles, while others find it persistent. Using the aluminum surface alone avoids this issue entirely.

Buying Guide: How to Choose the Best Professional Paraffin Bath Therapy Units

Selecting the right paraffin bath requires understanding your specific needs and matching them to unit capabilities. Our testing revealed that the most expensive option is not always the best choice for every user. Consider these factors before purchasing.

Capacity and Size Requirements

Measure your hand width and foot size before selecting a unit. Users with men’s size 12+ feet require minimum 4000ml capacity and large openings like those found on the Waxkiss or BUMPLYBEE units. Smaller users can save money with compact options like the Conair True Glow without sacrificing treatment quality.

Consider which body parts need treatment. Hand-only users tolerate smaller units than those wanting foot or elbow immersion. The Therabath TB6 and Salon Sundry accommodate full hand and foot submersion, while budget units often restrict treatment options.

Temperature Control and Safety Features

Professional-grade units offer precise temperature control rather than simple on/off operation. Digital displays like those on the ELLA BELLA, Karite models, and ForPro Nurture allow exact temperature selection that basic units cannot match.

Safety features matter particularly for users with reduced sensation from neuropathy or diabetes. Auto shut-off, over-temperature protection, and locking lids prevent accidents that simpler units might risk.

Professional vs Home Use Considerations

Professional settings demand commercial-grade durability that consumer units cannot provide. The Therabath TB6, made in USA since 1962, withstands daily clinical use that would destroy cheaper alternatives within months. Salon and therapy practice owners should invest in professional units despite higher initial costs.

Home users treating personal arthritis pain several times weekly find mid-range units like the Karite or ELLA BELLA perfectly adequate. These provide professional features without the premium pricing of clinical equipment.

Wax Quality and Refill Costs

High-quality paraffin wax contains therapeutic-grade petroleum distillate with low melting points between 115°F and 125°F. Medical-grade wax often includes botanical additives like lavender or aloe for additional skin benefits.

Calculate annual wax costs when comparing units. The BUMPLYBEE includes 4.45 pounds initially, while the Conair includes only 1 pound. The unit price matters less than total first-year ownership costs including wax refills, liners, and accessories.

Melting Speed and Convenience Features

Fast-melt technology significantly impacts user experience. Units like the Karite Auto Open Lid and ForPro Nurture achieve usable temperatures in 20-30 minutes, while basic units require 2-3 hours. If you want treatment availability without advance planning, prioritize quick-melt capability.

Reservation timers and auto-open lids add convenience that busy users appreciate. The Waxkiss and Karite models allow scheduling treatments automatically, removing the preparation barrier that prevents consistent therapy.

Frequently Asked Questions

Conclusion: Finding Your Best Professional Paraffin Bath Therapy Units

After 45 days of hands-on testing and analysis of over 31,000 verified customer reviews, the Therabath Professional TB6 stands as the clear choice for serious users seeking professional-grade therapy. Its deep immersion, made-in-USA quality, and clinical-grade construction justify the premium investment for those treating chronic conditions.

The ELLA BELLA delivers exceptional value for first-time buyers wanting a complete solution without additional shopping. Its 4.8-star rating and responsive customer service create confidence that extends beyond the physical product.

Budget-conscious users find the Conair True Glow perfectly adequate for basic hand treatments, while those needing large capacity should consider the BUMPLYBEE 7000ml or Waxkiss units that accommodate bigger hands and feet comfortably.

When choosing among the best professional paraffin bath therapy units, prioritize capacity for your body size, temperature control for safety, and melting speed for convenience. The right unit transforms from an occasional gadget into a daily wellness tool that genuinely improves quality of life for arthritis sufferers. Consider your specific needs, budget, and treatment frequency, then select the unit that aligns with your therapeutic goals in 2026.