Are Ice Baths Dangerous? The Risks of Cold Exposure Therapy

Ice baths, also known as cold water immersion or cold plunging, have become popular for their purported health and recovery benefits. Many people practice cold exposure techniques safely, but it is important to know the risks.

Ice baths are generally considered safe, but can be dangerous if not done safely. Dangers of cold water therapy include: hypothermia, shock, heart issues like arrhythmias, and frostbite. Most risks can be mitigated by starting with short 2-5 min baths at 50-59°F, having someone monitor you, enter and exit slowly, and consulting your doctor before starting this practice.

In this article, we will go deeper into the potential risks you should be aware of and then look into temperature and duration guidelines to practice cold water therapy safely.

Dangers of Ice Baths

While ice baths are touted for their numerous health benefits, it’s essential to acknowledge the dangers of cold water therapy too.

So, are ice baths bad or good?

Let’s plunge into the five primary ice bath and cold plunge risks to gain a clearer understanding of their safety and efficacy. These risks are based on a review of 104 studies to examine the health effects of voluntary cold water exposure [1].

1. Hypothermia

Ice baths carry the serious medical risk of hypothermia, a dangerous drop in core body temperature below 95°F (35°C). This impairs brain function and can be fatal if left untreated.

Cold water cools your body much faster than air – about 25 times faster! This rapid cooling leads to immersion hypothermia.

The onset of hypothermia may be gradual at first. Early symptoms like shivering and loss of coordination can be easy to overlook. But as core temperature continues to fall, more severe signs will emerge. Slurred speech, confusion, and stumbling are clear indicators that the body is struggling to function normally.

Eventually, shivering will stop entirely as the body’s thermal regulation system shuts down. This is a dire sign, marking an increased risk of unconsciousness. Without swift intervention and rewarming, the results could be fatal — especially if the person is alone.

To stay safe, ice bath durations should be kept short to avoid progressive hypothermia. Having an observer present is strongly advised to monitor for concerning symptoms. By understanding these risks and catching early signs, ice bathers can take key steps to avoid this dangerous cold-induced hazard.

2. Heart Issues

When the body is plunged into cold water, it instinctively triggers a “fight-or-flight” response. This primal reaction causes the heart rate and blood pressure to surge as the body prepares to respond to what it perceives as a threat.

This natural defense can place significant strain on the cardiovascular system and comes with risks like:

• Arrhythmias: The shock of cold water can disrupt the heart’s normal rhythm, leading to arrhythmias. Conditions such as atrial fibrillation or ventricular fibrillation are particularly concerning as they can be life-threatening if not promptly treated.
• Heart Attack: The stress induced by cold immersion may precipitate a heart attack, especially in those with underlying conditions like coronary artery disease, where the heart’s blood supply is already compromised.
• Stroke: Elevated blood pressure from the acute stress response can also increase the risk of stroke, where blood flow to the brain is interrupted.
• Sudden Cardiac Death: In rare instances, the shock from cold water immersion can lead to sudden cardiac death, a risk that exists even for individuals without prior heart issues.
• Afterdrop Phenomenon: Upon exiting the cold environment, the peripheral blood vessels dilate, and colder peripheral blood returns to the core, which can further lower the body’s core temperature and exacerbate stress on the heart.

For individuals with the following cardiovascular conditions, the risks associated with ice baths outweigh the potential benefits.

• Individuals with coronary artery disease or a history of heart attack.
• Those diagnosed with arrhythmias or irregular heart rhythms.
• People with heart failure or valvular heart disease.
• Anyone with a pacemaker or defibrillator.
• Individuals with high blood pressure.
• Those who have recently suffered a stroke.

The following groups may not have to avoid ice baths entirely, but they should exercise caution due to potential cardiovascular strain.

• Elderly Individuals
• Pregnant Women
• People with a Weakened Immune System
• Individuals on Beta Blockers
• People on Blood Thinners
• Newcomers to Cold Water Immersion
• People with Other Health Concerns

For these groups, it is essential to start with shorter durations in slightly warmer water and gradually work down to colder temperatures. Monitoring heart rate and blood pressure before and after ice baths can provide insight into how the body is handling the stress.

At temperatures below 60 degrees Fahrenheit, the body’s “fight-or-flight” response is significantly triggered, causing a marked increase in heart rate and blood pressure. For those with heart conditions, it is recommended to limit ice bath exposure to no more than 5 minutes, even if the temperature is above this threshold.

Overall, ice baths and cold plunges can do wonders for your health, but if you have health concerns of any kind, speak to your doctor and take it slow— making gradual steps on your cold plunge journey.

3. Sickness

While cold exposure through ice baths and similar therapies have been reported to bring certain benefits to individuals when sick, such as stimulating immune cells, enhancing circulation, controlling fever, and stimulating lymphatic drainage, it is essential to weigh these benefits against potential risks, particularly in vulnerable populations and specific health conditions.

Based on the risks associated with cold exposure during illness, the following individuals should exercise caution and generally avoid cold exposure when sick:

• People with Respiratory Conditions: Those battling flu, pneumonia, bronchitis, asthma, COVID-19, and other lung or airway infections should steer clear of cold exposure, as it can worsen symptoms, irritate the respiratory tract, and lead to spasms and coughing fits.
• Individuals with Excessive Mucus Production: Anyone experiencing a buildup of phlegm and mucus due to infection would likely find that cold exposure exacerbates the problem, hindering the clearance of secretions and potentially worsening breathing difficulties.
• Those Experiencing Fever: Patients with a fever should avoid cold exposure, as it can suppress the immune response and cause shivering, which may increase the body’s thermal setpoint and lead to further elevation of body temperature.
• Persons with Active Infections: Acute cold exposure might shift the body’s focus from fighting the infection to preserving heat, which can impair the immune system’s capacity to combat the invading pathogen effectively.

Considering these potential hazards, it’s advisable for individuals, especially those within the vulnerable groups, to consult with healthcare providers before undertaking cold exposure therapies while sick.

4. Shock

Shock, a critical condition characterized by inadequate blood flow to the body’s tissues, is a significant risk associated with ice baths. The body’s natural reaction to the sudden and extreme cold of an ice bath is to constrict blood vessels (vasoconstriction). This preserves core temperature but can increase heart rate and blood pressure. For some, particularly those with heart conditions, this response can be excessive, leading to shock.

Symptoms of shock may manifest as a rapid but weak pulse, shallow breathing, dizziness, fainting, cold, and clammy skin as blood flow is directed away from the extremities and towards vital organs. Confusion and weakness are also common as the brain and muscles receive less blood.

The risk of shock is heightened by the water temperature and duration of the bath. Temperatures below 59°F (15°C) increase the risk, especially with sudden or prolonged immersion. The body can typically regulate temperature in 70-80°F (21-27°C) water, but below this, the risk of cold shock response rises.

The cold shock response lasts 1-2 minutes after initial immersion and has led to drownings from gasping underwater and accidentally inhaling water. Entering slowly allows the body to acclimate and avoid the shock from rapid immersion.

Preventative strategies are key for ice baths. Gradual acclimation to the cold, closely monitoring duration, and having a partner present can significantly reduce the dangers of shock. With appropriate precautions, the risks can be minimized.

5. Frostbite

Frostbite is a condition that typically occurs at temperatures below the freezing point of water, where the skin and the tissues beneath it begin to freeze.

In the controlled environment of an ice bath, the risk of frostbite is generally low since the water is usually above freezing. While pure water freezes at 32°F (0°C), adding substances like salt can lower its freezing point, allowing for colder ice baths without the water solidifying.

However, it’s important to understand that frostbite can still occur in conditions that are not as extreme as one might expect.

Four main factors can elevate the risk of frostbite during an ice bath, even if the water is not at freezing temperatures:

• Water Temperature: The risk escalates with the decrease in water temperature. The body loses heat more rapidly in colder water, leading to potential tissue damage.
• Duration of Exposure: Extended periods in cold water heighten the risk. The body’s heat is finite, and prolonged exposure can deplete it to dangerous levels.
• Wind and Wetness: Exiting an ice bath into a windy environment can accelerate heat loss due to evaporation, increasing the risk. Conversely, while wet clothing can initially insulate, it can also hasten heat loss once it becomes soaked.
• Health Conditions: Individuals with certain health conditions, such as diabetes or Raynaud’s disease, are more susceptible to frostbite. Lifestyle choices, like smoking and alcohol consumption, can also increase the risk.

Before frostbite sets in, a person may experience frostnip, a less severe form of cold injury characterized by numbness and tingling, which is generally reversible with careful rewarming.

If someone suspects frostnip or frostbite, the first aid response is to gently warm the affected area in warm (not hot) water. It is critical not to rub the area or re-expose it to cold temperatures. In cases where symptoms persist or are severe, medical help should be sought immediately.

Are Chest Freezer Ice Baths Dangerous?

Converting a chest freezer into a homemade ice bath may seem like a convenient and budget-friendly option, but this DIY approach also comes with some significant safety hazards that must be carefully considered.

1. Risk of Electrocution: Chest freezers are not designed to hold large volumes of water, creating a serious risk of electrocution if water leaks onto electrical components. Even unplugging the freezer does not completely remove the danger, as capacitors can still retain an electrical charge. Thoroughly waterproofing the inside of the freezer with silicone sealant and using a GFCI outlet are important precautions, but unplugging before each use is still strongly advised.
2. Risk of Injury from Falling Lid: The heavy, hard lids on chest freezers can cause serious head and neck injuries if they fall unexpectedly on someone entering or exiting the ice bath. Impaired mobility, loose hinges, and lack of assistance can increase the chances of the lid slamming down. Solutions include installing lid supports, using caution when getting in and out and replacing worn hinges.
3. Risk of Cold Injuries: Prolonged skin contact with the icy metal walls and bottom can lead to frostbite. Lining the freezer interior with insulating foam panels reduces this risk. Sanding down sharp edges and carefully entering and exiting the ice bath prevents cuts.
4. Risk of Contamination: Without proper filtration and disinfection, bacteria and mold can accumulate in a DIY ice bath over time, causing skin infections or illness. Regularly draining, scrubbing, and replacing the water, along with using a sanitizing agent, helps maintain cleanliness. Also, consider a water chiller with a filter.
5. Risks for Children and Pets: An unattended ice bath poses major drowning dangers for children and pets who access it. The frigid water exponentially increases risks if someone falls in and cannot immediately get out. Always drain or secure the ice bath when not actively in use, and supervise closely when children or pets are present.

We recommend cold plunge freezers built by professionals with additional safety features, like a removable lid, GFCI-protected electronics, and automatic electronic disconnect.

How to Take an Ice Bath Safely

Ice baths can offer various benefits, but it’s crucial to approach this practice with caution to avoid potential risks.

Here are some tips on how to ice bath safely.

Consultation and Supervision

Before starting any ice bath regimen, it’s imperative to consult with your doctor, especially if you have medical conditions like diabetes or heart disease. This precaution ensures that ice bathing is safe for your specific health situation.

Never undertake an ice bath alone. Always have someone with you to monitor your safety and assist if you encounter any difficulties.

Duration and Temperature

For those new to ice baths, begin with shorter durations of 2-5 minutes to allow your body to adjust to the cold. Regardless of your experience level, limit your time in the ice bath to a maximum of 10-15 minutes to prevent any adverse effects.

For a closer look into the recommended length of cold water exposure, see our detailed guide “How Long to Cold Plunge.”

Maintain the water temperature between 50-59°F. If you wish to experience colder temperatures, make sure to decrease the temperature gradually over multiple sessions. Use a thermometer to ensure the water stays within the recommended temperature range.

See our comprehensive guide on ice bath temperatures, to see the science behind cold therapy at different temperatures.

Ice Bath Age Recommendations

Children under six years old should not take ice baths due to their higher sensitivity to cold and greater risk of hypothermia. For older children and teenagers, ice baths can be tolerated but should be limited to short sessions and always under adult supervision.

Start children at milder temperatures around 60°F and keep sessions brief (2-5 minutes), allowing them to acclimate to the cold over time. Ensure the water temperature for children does not drop below 50°F and be vigilant for any signs of distress.

Safety Measures During the Bath

Enter the ice bath slowly and avoid submerging your head or hyperventilating, as these actions can lead to shock or loss of consciousness. Keep moving your limbs gently to encourage circulation and prevent your muscles from freezing.

Listen to your body’s signals. If you experience pain, cramping, dizziness, or any form of discomfort, get out of the bath immediately.

Post-Ice Bath Care

Exit the bath slowly to avoid a rapid change in blood pressure and wrap up in warm layers right away to gradually increase your body temperature.

Avoid consuming alcohol or taking medications before ice bathing, as these can impair your body’s natural heat-regulating mechanisms.

After the bath, allow sufficient time for your body to rewarm completely before engaging in any other activities.

For some ideas on what you can do, see our guide on what to do after an ice bath.

Incorporating a Cold Plunge Tub for Enhanced Safety

For a safer ice bath experience, consider investing in a cold plunge tub. These tubs offer precise temperature control, maintaining the recommended 50-59°F, which is crucial for safety. Their design prioritizes easy and safe entry and exit, reducing the risk of accidents. Cold plunge tubs are also easier to clean, promoting better hygiene.

Available in various sizes, they can be tailored to individual needs, accommodating different body types and health considerations. Owning a cold plunge tub encourages a consistent routine, allowing for gradual acclimatization to the cold. This consistency is key to maximizing the benefits of ice baths while minimizing risks.

Benefits of Ice Baths

Final Thoughts

While ice baths offer intriguing benefits, they also carry real risks that must be weighed carefully. Used judiciously, with appropriate precautions, cold water immersion can be a valuable tool for health and recovery. But undertaken carelessly, it poses threats from hypothermia to heart attacks.

Start by consulting your doctor, then begin with brief, mild sessions to allow your body to acclimate. Have someone present to supervise, and respect your limits. By gradually increasing exposure, you can harness winter’s wonder while avoiding its wrath.

With wisdom and restraint, the restorative cold awaits. But tread cautiously on the icy path.

References

1. Esperland, D., de Weerd, L., & Mercer, J. B. (2022). Health effects of voluntary exposure to cold water – a continuing subject of debate. International journal of circumpolar health, 81(1), 2111789. https://doi.org/10.1080/22423982.2022.2111789