Recently a case report1 was published concerning a cold burn presented at a 71-year-old man following a whole-body cryo session. The cold burn was presumed to be caused by a malfunctioning nozzle in the cryotherapy chamber. Moreover, unfortunately, this was not the first reported adverse event linked to whole-body cryo.2–4
Whole-body cryo is associated with freezing temperatures, with temperatures in the range between -90°C-180°C/-130°F-292°F. Over-exposition to whole-body cryo might lead to:
- Skin damage or cold burns,
- Reduction in nerve conduction and
- Reduced peripheral blood flow in fingers and toes.
The reported adverse events and potential harms, including the one death in a cryo-sauna in 2015, are regarded the reasons that the United States Food and Drugs Administration (FDA) has not cleared or approved any of the devices for medical treatment of any specific medical condition, and thereby advice to contact your doctor before trying.5 Bouzignon and colleagues (2016)6 in line stated that professional supervision with whole-body cryo is required, and proposed that certifying the cryotherapy devices seems inevitable.
Factors to prescribe the safest whole-body cryo solution:
Based on the consensus declaration from Joch and colleagues (2006)7, additional literature and experts’ views, one should consider the following
Contraindications and precautions using whole-body Cryotherapy
Absolute contraindications are defined in which an element or condition is present that precludes exposure to whole-body cryo; the client should NOT undergo whole-body cryo in case of presence. With the relative contra-indication, the individual’s doctor should be consulted who should approve the whole-body cryo exposure. Precautions, like wearing protective gear (gloves and slippers), ensure a safe experience.
Partial- or whole-body cryotherapy. Partial body cryotherapy is based on direct contact between the patient and the nitrogen in which the cold is created by evaporating liquid nitrogen and then exposing the body of the patient in the tank to the cold gas. The clients head must be out of the tank to prevent breathing nitrogen (e.g., asphyxia).
The prescribed protocol
A longer, more intense treatment will reduce skin-, core- and muscle temperature more significantly.
The age, gender, skin type, and body composition of the client
These factors have a significant effect on skin-, core-, and muscle temperature.8,9 People younger than 18 or older than 35, women and someone with a dark colored skin type should be exposed shorter. Someone with a higher body composition will show a more significant decrease in skin temperature but a smaller effect in the core- and muscle temperature.
The right cryotherapy machine for your center
Safety can also be increased by making sure that the right technology for your center is chosen. This depends on room size, the prognosis of a number of daily treatments,….CryoChambers is specialized in helping you make the right choices.
An overview from Bleakely and colleagues (2014)10 illustrates that skin- and core temperatures stay in the safe range, even after the most intense treatment protocols.
However, the generally published skin temperature drops are general skin temperature effects. When looking at local skin temperature responses, the skin temperature, particularly on the lower legs and triceps, occasionally shows temperatures below the accepted barrier of 8°C/46°F (see illustration below)!
Although this response differs intra-individually, it is imperative to be aware of this safety-related issue.
Before exposing your client to whole-body cryo be aware that your client is in contact with extreme temperatures. Be conscious about the potential adverse events and their symptoms, and respect the absolute and relative contraindications and precautions to guarantee your client a safe exposure.
Cryochamber and ProCcare recently joined forces. ProCcare creates an optimal environment for cold and heat applications through educational programs and unique software solutions. They recently launched their online course on WBC.
- Whole-Body Cryotherapy Caused Cold Burn Injury. (2018). Available at: https://www.medpagetoday.com/dermatology/generaldermatology/76932 (Accessed: 19th December 2018)
- Cámara-Lemarroy, C. R., Azpiri-López, J. R., Vázquez-Díaz, L. A. & Galarza-Delgado, D. A. Abdominal Aortic Dissection and Cold-Intolerance After Whole-Body Cryotherapy: A Case Report. Clin J Sport Med 27, e67–e68 (2017).
- Greenwald, E., Christman, M., Penn, L., Brinster, N. & Liebman, T. N. Cold panniculitis: Adverse cutaneous effect of whole-body cryotherapy. JAAD Case Rep 4, 344–345 (2018).
- 2 Missouri State players injured after cryotherapy treatment. USAToday Available at https://www.usatoday.com/story/sports/ncaab/2018/01/29/2-missouri-state-players-injured-after-cryotherapy-treatment/109903402/ (Accessed: 28th January 2019)
- FDA. WBC a cool trend that lacks evidence and poses risks.
- Bouzigon, R., Grappe, F., Ravier, G. & Dugue, B. Whole- and partial-body cryo stimulation/cryotherapy: Current technologies and practical applications. J. Therm. Biol. 61, 67–81 (2016).
- Joch, W. et al. Consensus_Declaration_on_Whole_Body_Cryotherapy.
- Cuttell, S., Hammond, L. E., Langdon, D. & Costello, J. T. Individualising the exposure of -110C whole body cryotherapy: The effects of sex and body composition. Journal of Thermal Biology 1879, (2017).
- Hammond, L. E., Cuttell, S., Nunley, P. & Meyler, J. Anthropometric characteristics and sex influence the magnitude of skin cooling following exposure to whole body cryotherapy. Biomed Res Int 2014, 628724 (2014).10. Bleakley, C. M., Bieuzen, F., Davison, G. W. & Costello, J. T. Whole-body cryotherapy: empirical evidence and theoretical perspectives. Open Access J Sports Med5, 25–36 (2014).