Ice or cold water baths seem to be all the rage at the moment and the husband had been mentioning one for some time. So the kids bought him one (with a little help from me) for Christmas. After eyeing it up with some trepidation, we both decided to give it a go on Boxing Day and then it snowed and the weather turned icy! We started out with only 20 seconds in the water but we started increasing the duration of time in the bath by 5-10 seconds per day which was fine when the water was above freezing point but as of the past few days, the water temperature is now measuring -1 degree and there is a sheet of ice on top that we have to break with our toes.
I suppose the main question is how does it feel? To be honest, it was rather terrifying to start with and it is easy to panic and hyperventilate initially. Then as you stay in the water, the stress response seems to die back and I find that if I focus on my breathing, then it’s possible to dissociate from what my body is feeling. Once you’re out, with a big towel wrapped around you and a big warm bathrobe and thick slippers on, you feel great, fresh and invigorated, I suppose because you’re simply relieved you’ve got it over and done with for another day.
Why are we doing cold water baths?
Well, that is an important question and I must admit, I only started looking at the evidence after giving cold water immersion a go.
Apparently, there are claims for the health benefits of cold water therapy from as far back as 3500 BC. Hippocrates in 400 BC comments on the use of cold water for medicinal purposes, pain relief and for relieving benefits.
It is something which is extremely popular in Europe where it has been common practice in spa towns and hydrotherapy clinics since the 18th century. Vincent Priessnitz (1799-1851) was the main pioneer of hydrotherapy, with the first clinic in Gräfenberg, using cold water to stimulate the body’s ability to heal itself. Subsequent balneotherapeutic institutes were modelled after the ‘Graefenberg model’ and established across Europe.
The work of Wilhelm Winternitz (1834-1917), who is known as the ‘father of scientific hydrotherapy’ contributed to the scientific validation of hydrotherapy with subsequent practitioners integrating hydrotherapy into wellness traditions to help with conditions such as chronic pain to circulatory disorders.
[Kunutsor SK, Lehoczki A, Laukkanen JA. The untapped potential of cold water therapy as part of a lifestyle intervention for promoting healthy aging. Geroscience 2025;47:387-407.]
What is cold water hydrotherapy?
Modern cold water hydrotherapy seems to be anything from drinking cold water, to applying cold compresses to cold showers, cold water immersion and cold water swimming.
The cold water immersion that we are doing involves submerging the body in cold water at temperatures below 15 degrees Celsius. Ice baths involve submerging the body in a container filled with cold water and ice, usually at temperatures below 15 degrees Celsius. This is what we have inadvertently ended up doing as we started doing the cold baths in the middle of an icy spell. Cold water swimming involves swimming in cold natural bodies of water such as lakes, rivers or seas which can be anything from above freezing to 15 degrees Celsius.
What benefits does it give you?
On a physiological level, it might help improve cardiovascular health in a healthy person, if practised regularly. It has been shown to cause an immediate increase in blood pressure (due to the body’s cold shock response) but regular practice in generally healthy people can cause blood pressure levels to improve. There have also been shown to be improvements in body mass, triglycerides, apolipoprotein and homocysteine concentrations. It also has been shown to improve peripheral glucose uptake and increase insulin sensitivity.
How does it do that?
These benefits are thought to be due to activation of brown adipose tissue or BAT. We use BAT to create heat and it is thought that cold exposure stimulates the conversion of white fat to brown fat and it is this switch which increases metabolic activity.
I’ve heard it can reduce inflammation, is this true?
The role of cold water therapy in post-exercise recovery is one of its more explored points and it is commonly used as a therapeutic tool to enhance athletic performance. It does seem to reduce muscle soreness and swelling and has been reported as improving muscular power and perceived recovery after high-intensity or endurance exercise.
What about general body inflammation?
There are studies showing that cold exposure can reduce inflammation by stimulating the release of anti-inflammatory cytokines and reducing pro-inflammatory cytokines and can thereby also reduce oxidative stress.
[Boulares A, Jdidi H, Douzi W. Cold and longevity: Can cold exposure counteract aging? Life Sciences 2025;364:123431.]
What about any effects on the skin?
Dermatologists traditionally do not promote hot baths or showers. Our standard advice for eczema sufferers or anyone with dry, itchy skin is to keep the bath or shower temperature cool to moderate. Hot water to wash your face can also aggravate or stimulate rosacea. Some anecdotally report that cold water splashed on the face is of benefit by shrinking pore sizes but this is a temporary benefit.
Cold water applied to the skin causes immediate vasoconstriction of the dermal blood vessels but this will then be followed by a reactive increase in redness (or hyperaemia) as the blood flow returns.
There is no robust evidence showing any other benefit of cold water therapy to the skin.
But I have heard that cold water therapy is antiaging?
I think this is more about healthy aging or what aging means to you. How an individual ages depends on genetics, environmental and lifestyle factors which will include diet, physical activity, and exposure to toxins and sunlight.
Most of the studies that show an increased lifespan at lower temperatures are in poikilotherms such as the Drosophila fly or in some homeotherms, like mice which hibernate. As humans do neither of these, one can’t extrapolate evidence from these species to us and certainly cold exposure can be dangerous if you have an underlying health condition or are elderly.
Cold water therapy has definitely been shown to improve mood & mental health disorders, sleep, and general well-being. This is due to the activation of the sympathetic nervous system with subsequent increased levels of endorphins.
So in summary…
I think if you have the ability to purchase one of these cold or ice water baths or have access to a natural cold body of water, are generally healthy with no underlying medical conditions and are in the mood to try a spot of cold water immersion, then there is no harm in trying it.
The evidence seems to point to definite improvements in mood and sense of well-being, improvements in muscle recovery after high-impact or endurance exercise, evidence of increased insulin sensitivity, glucose uptake and reductions in blood pressure and some evidence for a general anti-inflammatory effect. Those aspects of health may well be so-called ‘anti-aging’ but there is no anti-aging dermatological benefit that we know of.
Kind regards,
Sandy
Dr Sandy Flann, Consultant Dermatologist
