Whole Body Cryotherapy – can it reduce cellulite and improve your skin or should you give it the cold shoulder? Dr Haran Sivapalan finds out.

Remember the ice-bucket challenge of 2014 when millions of people around the globe dowsed themselves in ice to raise money for the ALS (amyotrophic lateral sclerosis) – an undoubtedly cold and unpleasant experience for a good cause. Well multiple that by about a million and you’ve got whole body cryotherapy – the practice of subjecting yourself to freezing temperatures for short periods of time in the belief that it will make your skin better, improve your mental and physical well being, help cure sporting injuries and maybe even drop a few kilos and smooth out your cellulite.

Could these things be true? For fans of “Whole Body Cryotherapy,” the answer is “yes.” While there’s no doubt the experience leaves people feeling energised as it activates their ‘fight or flight’ response and gives them an adrenaline rush, but does it do more or is it just too soon to say?

What is Whole Body Cryotherapy?

Whole body cryotherapy (WBC) is a procedure that involves exposure to extremely cold temperatures  (typically between –100°C and – 140 C) for a period of a few minutes. Essentially, it’s “super-cooling” your body. To begin with, a person disrobes down to their underwear and puts on special thermal socks and gloves to protect against frostbite of the extremities.

A cryotherapy ‘sauna’ or upright cryotherapy unit cooled by liquid nitrogen.

They then stand in a ‘cryochamber’  – a specially designed cabin that uses a mist of liquid nitrogen or other refrigerated gas to produce air at very low temperatures. The person remains in the cryochamber for between 2 and 3 minutes. Normally, the head and face are covered or not exposed to the cold air.

Sound painful? Well, whole body cryotherapy has been shown to be safe and has been used for years in sports recovery and in the treatment of joint conditions such as rheumatoid arthritis, where it is thought to reduce pain and inflammation. Unfortunately, the evidence supporting its effectiveness in both these areas is far from overwhelming.

What does Whole Body Cryotherapy claim to do to the body and skin?

Aside from promoting recovery in athletes and helping joint conditions, whole body cryotherapy has been touted as a key to better circulation, reduced anxiety and depression and a higher metabolism. A quick internet search also reveals far more nebulous and pseudoscientific benefits of WBC, such as “increasing energy levels” – a vague and difficult to prove term.

When it comes to the skin, WBC is claimed to:

• reduce cellulite
• reduce inflammation
• improve circulation to the skin
• eliminate toxins from the skin
• increase collagen production
• reduce appearance of wrinkles

That’s quite a sales pitch. Alas, rigorous scientific evidence for these claims is lacking. Let’s take a closer look at these individual claims. First though, biomedical researcher, Giovanni Lombarid, who has done several studies on WBC says it’s important to note that the studies were done in cryochambers where the individual stands in a room rather than an upright chamber. In the chamber their whole body, including the head, is cooled.  So any results from these studies may not transferable to the upright, liquid nitrogen cooled versions.

Too cool to be true?

– Reducing cellulite and burning fat

Cellulite refers to deposits of fat under the skin, which may give it a dimpled or puckered appearance. Exercise for weight loss and muscle toning is probably the best way to get rid of cellulite – but proponents of WBC claim there are two ways in which it’s purported to reduce cellulite:

• Increasing the metabolic rate to burn fat – when your body is cold (as in a cryochamber), your metabolism ought to rise, converting more chemical energy (including that from fat) into heat energy. Your body thus burns off fat and you warm up in the process.
• reducing circulation to fat deposits – when we are cold, part of the brain called the hypothalamus sends signals to constrict certain blood vessels and divert blood away from the skin. It’s called vasoconstriction. Some proponents of WBC believe that reduced blood circulation to fat cells under the skin causes them to shrink or die off.

Sounds good, but is there any evidence for WBC helping shed cellulite? In a word, no. In fact, a study of professional tennis players found that 5 days of twice-daily WBC caused no increase in resting metabolic rate and no change in the amount of fat burned.

And what about reducing circulation to shrink cellulite? It’s actually possible that WBC might have the opposite effect. Evidence suggests that vasoconstriction can worsen the appearance of cellulite by causing movement of fluid into tissue.

 – Reducing inflammation

If you ever sprain your ankle, you’ve probably been advised to apply ice or put a bag of frozen peas on the affected area. This quick solution reduces pain and dampens inflammation. If it works for a localised part of the body, is it possible that subjecting your whole body to cold temperatures using WBC also dampens down inflammation?

Most of the studies in this area have looked at athletes, whose heavy training can cause damage and inflammation of muscles. The jury is still out on WBC here though – some studies show decreased levels of inflammatory markers in the blood, others show no difference after WBC.

The jury is also out when it comes to the skin. Some studies show that oxidative stress – a process involved in both the inflammation and ageing of the skin – can be reduced with WBC. Others show the complete opposite – cooling the body using WBC actually mildly increased oxidative stress. In short then, more research is needed before anything conclusive can be said.

– Improving circulation and eliminating toxins

One of the most touted benefits of WBC is improved circulation and blood flow to your skin. But, hang on a minute? If exposure to cold temperatures causes your blood vessels to constrict, then how can it improve your circulation?

The answer is that the soon after coming out of the cold chamber, your blood vessels then reflexively dilate (vasodilatation). With repeated WBC sessions, this vasodilatation is supposed to cause long-term improvements in circulation and oxygen delivery to the skin. Better circulation is also marketed as helping to clear any ‘toxins’ from the body – the result: healthier looking skin.

Thermal imaging studies that monitor blood pressure, heart rate and peripheral blood vessels do indeed show changes in blood circulation during and after WBC. Nevertheless, such studies have not specifically looked at the microcirculation of the skin; nor have they examined the long-term effects of repeated WBC. There doesn’t seem to be any evidence either that WBC helps the body get rid of toxins.

– Boosting collagen and reducing wrinkles

The idea that WBC can boost collagen may stem from the notion that WBC reduces inflammation and oxidative stress, processes that are associated with the breakdown of collagen in the skin. Of course, if the evidence base for WBC reducing inflammation is shaky, then, by extension, the evidence base for WBC boosting collagen will also be on shaky ground. Indeed, studies of rat muscle show that cryotherapy does not increase collagen production. Similarly, the evidence for WBC for combating wrinkles is also lacking.

Take home point

It’s a relatively new therapy and currently there is lack of scientific studies to show that whole body cryotherapy is good for your skin. Nevertheless it has been shown to be safe and harmless when studies in a cryochamber. Giovanni Lombardi isn’t so certain about the upright, liquid nitrogen models though as he says inhaling the gases could be dangerous and may even result in asphyxia. One woman in Nevada died of asphyxia and the coroner ruled she had passed out and become unconscious after inhaling the oxygen depleted gas.

Obviously that’s not a common occurrence but it might be worth asking about the ventilation in the salon offering the treatment, and what resuscitation training staff may have.

On the whole though, some people swear by it. They experience a ‘buzz’ immediately after the therapy, similar to a post-exercise high – that sounds both literally and metaphorically cool!