I'm sure you've noticed cold plunges are pretty trendy lately. You've seen those videos of people slipping their freezing bodies into ice cold water all over your social media pages. I've tried it, kind of. But if I'm being honest, I totally prefer a hot shower. I mean, saunas and the heat, aside from being warm and cozy, can do wonders for your skin. But for those who like the cold water, they still feel compelled to keep at it, even when it sounds unpleasant.

I jumped off that boat, and I just instantly froze. And I was prepared for it, but not prepared at the same time. And I immediately just thought, I think I'm getting hypothermia instantly. And I thought, I don't know how I'm gonna make it back. I can't do this. I think I'm gonna get disqualified. I think I'm gonna get pulled. It's not gonna work. And then it just kinda did. Cause you get caught up in that excitement of a big mass event.

Hi, guys, and welcome. I'm so glad you're here. I'm Nicole Berry, and this is skin queries, a show all about our skin and its health as we grow in age. Our skin is really a record of a life well lived, because there isn't one body part that I can think of that reflects our well being as clearly as our skin. So let's go on this journey together to really understand what's going on with our skin. Let's unravel the mysteries happening inside and out. Today, we'll focus on how cold and hot water affects our skin. Growing up, my mom, who's korean, always told me to stay away from the cold water and stay away from ice, stay away from cold drinks, anything that's cold, because it can actually lead to stagnancy in the blood and circulation. She really recommended hot water, hot drinks, and all of those really warm things. But now, cold plunging is all the rage. Personally, I'm an avid sauna user. I love sweating, I love the heat, and I love that it can open up your pores and really do wonders for your skin. So I'm really intrigued and a little scared of cold plunging myself.

But eventually, I did cave into cold plunging. Recently on vacation. After reading all about the benefits and seeing my friends doing it and loving it, I did enjoy the rush of cold. And I noticed an invigoration. My skin was tighter. I really felt alive. And I was curious to know if any of these benefits were based on actual fact. Are there any consequences to putting our skin through these extreme temperatures. Let's dive in and answer once and for all, does our skin prefer cold water or hot water? Hi, Melissa. How are you?

Very good today. How are you?

It's so good to see you. My first guest is Melissa Keegler, an open water swimmer specializing in marathon, channel and ice swimming.

I love just the feeling of being in the water. I grew up in Michigan around water all the time. So when I eventually moved out to Washington in discover this amazing cold water ocean out here, it was just this new world. And that really got me into marathon swimming, which is it starts at a distance of 10, then goes up from there, and marathon swimming turned into channel swimming, which is also distance marathon swimming and eventually turned into ice swimming, which is swimming that is in water temperature 41 degrees fahrenheit, five degrees celsius or below. I just love the water. I love my animals, and I love everything about the ocean out here.

So what was it that kind of poked you, and how did you even come to learning about open water competitive swimming?

So open water competitive swimming actually got into it through triathlon. And it was my aunt who lives in Florida. She was doing a triathlon and had an injury. So my mom, sister and I, we said, florida sounds great. I mean, Michiganders love going to Florida. And we said, let's make a girls trip out of it. We'll go down to Florida, we'll do the relay, and I'll do the swimming leg. And I remember getting in and just thinking, this is so cool. It was just this moment of, I was out there, I was swimming, and I could do whatever I wanted as long as I got to the end. There weren't rules necessarily about, don't do a stroke this way, don't do stroke that way. If you touch a wall a certain way, you're going to get disqualified. It was so freeing. I remember getting out going. I have no idea what just happened, but I think I kind of like this, and I think I want to do it again.

So how did you go from then that to cold ice swimming?

My first cold water swim, I did the Alcatraz swim because I thought that would be really fun.

Okay, tell us about that.

You get on a big boat, a fairy tight boat with all the other competitors. The boat goes out to Alcatraz island, drops you off, and then you swim.

Into the San Francisco as if you're truly escaping.

Yes. Yes. And I definitely wore a black and white striped suit under my wetsuit, but I was head to toe full neoprene because I just thought it's cold, but it's a relatively short swim. So I thought, okay, I could deal with it. Nicole, I jumped off that boat and I just instantly froze.

Oh, my God.

And I was prepared for it, but not prepared at the same time. And I immediately just thought, I think I'm getting hypothermia instantly. And I thought, I don't know how I'm going to make it back. I can't do this. I think I'm going to disqualified. I think I'm going to be an ice cube. I think I'm going to get pulled. It's not going to work. And then it just kind of did because you get caught up in that excitement of a big mass event.

Then Melissa moved to Seattle for work, and she had no other option but to swim in cold water. In the summer, the average temperature of the water is 53 degrees, and in the winter, it's 45. And in 2022, Melissa shattered the us national distance record for the International Ice Swimming Association's ice mile event. She completed a 1.4 miles swim in 39.2 degrees water. So impressive and inspiring. So I had to ask her how she trains her body to handle being in the ice water.

So you're doing a lot of cold ice baths where I'll be outside in a cold plunge for, you know, 45 minutes to an hour. Oh, wow. Just sitting there, which is very different than cold plunging, I think, to what most people think it is. It's a lot of just freezing yourself intentionally as much as you can to build up and maintain that cold resistance. So there's a lot less swimming, I would say, for ice swimming season, and a lot more cold conditioning that goes on because you have to prepare your body for that level of cold exposure.

How would you describe your skin reacting when you do go into a plunge?

It almost feels like your skin is burning in a way, or like you have a sunburn and, you know, you get in a shower for the first time and maybe you don't really realize you have a sunburn until that. That first drop of water hits your skin and go, oh. And you just kind of freak out a little bit.

Right.

And it's just this strange feeling of essentially your skin in your blood vessels within your body, essentially moving the blood away from your extreme extremities and the outside of your body into your body to preserve life in your core organs.

Right.

Why it feels so painful, I have no idea. But what I can say is that after ten minutes, when you're numb, you don't feel it anymore.

So for someone who's been doing it now for years and years, I'm so interested to hear how that's affected your skin and your health.

I think the cold water, at least for me, has definitely. It makes me feel like it's kept me looking youthful and young. The esthetic benefit of the cold water, and then with salt water, it's. It's almost like you're getting a micro scrub, I guess a mini facial while you're in there.

But Melissa puts her body through extreme temperatures, and that can have detrimental effects.

One of the things I try to talk to people about, especially people I'm coaching or people that are curious about ice swimming, is the potential for nerve damage is really real in your extremities. A couple of my toes on my right foot, I'm pretty sure have nerve damage, because when I walk outside in the grass in the morning without shoes on, and, you know, you get that morning dew, the minute water hits those two toes, it's just immense pain. And one of the other interesting skin things that has actually developed just within the last year is cold urticaria. Essentially, it's an allergy to the cold. And what ends up happening is I'll go swimming and the water will be cold, and then about, I don't know, anywhere from two to 6 hours afterwards, my face will start to swell up and I'll get big hives and rashes. I did find in talking to my doctor that the people that do have this condition, they're prone to sudden unconsciousness, which on land isn't necessarily a big issue. But if you're in the water and you pass out, you could drown almost instantly, because it only takes about a half a cup of water to fill your lungs and drown.

And has that happened to you yet, or.

No.

No.

Okay.

Thank goodness.

Yeah. You can take antihistamines to hopefully calm your skin down before you get in the water. I've also tried petroleum jelly, like vaseline or other topical ointments to put on the affected areas before I get in the water. Now, I do have an epi pen that I carry with me at the beach. My swim friends know where it is just in case something happened. So I do have safety measures that I put in place for myself, but then also I accept the risk if something does happen. That that's a decision that I made for myself.

Tell us about how you prepare your skin for all the intense cold plunges. What's your skincare routine like? Is it a deliberate skincare routine to withstand the colds?

I think when the water is super cold, my skin chafes more. Anybody who's chafed understands what I'm talking about. It is one of the most painful things, and it chafes in different places, depending on the water conditions, whether it's flat or wavy, fresh or salty. So making sure I have a product for my skin that is safe for the environment that, you know, doesn't come off in the water, because one thing, it's bad for the water, the body water. You're in the plants and the animals, but also you are not protected from chafing if it comes off. So using something that's super heavy, that sticks is great, but then you have the problem of clogged pores.

And is there a way you prevent these products from clogging your pores?

So I just need to make sure I have some really, really good soap to really cleanse the area, get things off, and then, you know, just make sure I hydrate afterwards. And I think that's the other thing, too. I find in the cold water, I need to use body moisturizers and lotions a lot more because my skin gets super, super dry after the cold water.

After a cold plunge or a cold swim, do you typically take a hot shower, a hot bath, or do you take going right into the cold shower?

I don't. I don't do cold showers.

That's so ironic.

The cold shower is just horrendous. The shower, to me, is my one place of joy and warmth during the week.

That is so fair, and I like.

Keeping it that way.

So do you do it, like, extra hot, warm?

I would say average warm. I mean, whether I'm taking a shower in the summer, after a cold swim, it's, it's all the same temperature. Um, I've gotten into saunas, and for me, saunas don't work.

What do you mean, it doesn't work for you?

So for me, it actually burns my skin. I wanted to try the whole, you know, cold water, seaside sauna thing, right? And I was in the sauna. I I mean, it's warm in there. Of course it is. But I guess I didn't realize how long I was in there. And my skin, I came out, and my skin was super inflamed and red all over, and essentially, my skin almost burned, and it was like that for two days.

Well, thank you so much for sharing your practice and your experience.

Absolutely. Thank you too.

Melissa made me realize that there could be very real consequences if you stay in the water for too long. But whether that's hot or cold. Long term exposure comes with risks. Now let's talk to a dermatologist who has looked at and done research on the effects of these extreme temperatures on our skin. She'll tell us how we can reap the benefits without causing damage. Right after the break.

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Welcome back to skin queries. We're trying to figure out the real benefits of cold and hot water on our skin. Is it just a trendy craze, or is there real science behind it? And how do you take care of your skin when you're putting it through these extreme temperatures? To help me answer these questions, we're bringing in doctor Geeta Yadav, a dermatologist and the founder of facet Dermatology. Hi.

Hi.

How are you?

I'm good.

How are you?

Good. Thank you for being here with us and chatting. I'm really excited to get into the nitty gritty of water, be it cold, hot, and everything in between. Do you mind introducing yourself first?

My name is Geeta Yadav. I'm a board certified dermatologist. I've got my own practice on the east end of the city. I practice medical derm, cosmetic derm. I do clinical trials, and I love being on social media to help educate my patients and followers.

So what are some of the claims that cold plunges can do for your health, for your skin, for your complexion?

So a lot of people report feeling invigorated inside and out. They sort of get a sense of a high on endorphins after a cold plunge. But there's also sort of a thrill for most people, a cold plunge can be relatively harmless, but it still feels daring or risky and brave.

Right?

So there's a real excitement that comes with the suddenness of the change in temperature in that activity.

I can speak, like, for myself when I do a cold punch, which is rarely, because I am definitely a little scared and timid when it comes to immersing myself in cold water. I definitely do feel that high and just like that surge of energy. So is there anything you could speak to biochemically that's happening to the body when one does a cold plunge?

So cold water definitely shocks our bodies. It causes our heart rates to spike, and it can induce a host of hormones, including dopamine, cortisol, serotonin, nor epinephrine, to increase. And that all has an impact on how we feel. And there's one study that showed a short term cold water plunge can improve a person's positive affect. So a person can feel increased enthusiasm, a sense of alertness, more energy, higher ability to concentrate, all while reducing negative affects, which includes feelings of fear, nervousness, anger, and guilt. So when we're exposed to cold temperatures, our blood vessels kind of constrict to help minimize the heat loss that reduces blood flow, and that can even reduce pain and inflammation. So you have to kind of extrapolate that a little bit. But there are definitely physiologic effects that are happening when you put your body into that sudden shock of cold water. Another thing I should say is that we're related to inflammation. I think a lot of what we're talking about in healthcare today has to do with the impacts of inflammation inside the body and on our skin and how it promotes aging or unwellness. And I would say that some of the benefits of reducing inflammation throughout the body, it can be helpful for muscle recovery, chronic pain, arthritis, and other things.

It can definitely make us feel better.

So you talk about constriction of blood vessels, which I find so interesting. Does that then relate to kind of the tightening of the pores? Because I know this is something that I see on Instagram or TikTok that, you know, dunking your face in a bowl of ice water tightens and brightens everything and is like instant botox. Is that true?

There is a reduction in blood flow that occurs when you're in cold water, and that is often most noticeable on the skin. So our bodies tend to redirect blood flow towards protecting our deeper tissues, our internal organs. And that creates these noticeable changes in the skin that can make the skin rapidly firm up, make it look smoother, especially cellulite tip, and it can make your pores appear tighter as well, minimizing that look of redness. It can also be helpful for acne. Acne reducing some inflammation. It can help regulate sebum production, actually. Lastly, I would say it can help stimulate new collagen formation, helping the skin look firmer and smoother over time. But the question is how long that'll last for. So the data really supports these shorter plunges. And the durability of those results has not been measured clearly in the evidence.

I'm half korean, and what's interesting is that when it comes to eastern asian philosophy, we're taught to kind of steer away from cold water and ice plunges and everything. My mom grew up telling me that don't put ice on your face, you need to boost circulation. And exactly for what you just said, it constricts blood flow.

How do you reconcile exactly?

I just find that so interesting.

It is, it's really, it's neat how different cultures view sort of the soothing or the aggravating potential. I mean, I would say from a healing aspect, in terms of the skin. Often we use heat and energy to create changes to the skin. In office procedures, we also have to use cooling and soothing to help from a healing perspective. So I think it really depends on what you're trying to achieve in terms of the skin benefit and the skin health. And certainly if you're experiencing some inflammation in the skin, maybe not sort of a really shocking cold plunge, but, you know, a cooling cream on your face or sometimes I advise my patients, who have a lot of inflammation in their skin, like eczema, to put their medications in the fridge. So even their medications are cooling and soothing and help them when they apply it.

I mentioned before, I'm personally a big proponent of sweating sauna work, and I post about my daily infrared sauna a lot. So I'm curious, what are the benefits when it comes to the flip side of cold therapy?

There's actually a little bit more information in that area that I thought was really interesting because so there are few cultural communities that really are big proponents of, you know, sweat lodges or of saunas. The Finnish are famous for their finnish saunas and the value that that has on health. And the same goes with sweat lodges in indigenous cultures. And some data has been shown that there's improved cardiovascular benefits to going through regular exposure to these treatments. In terms of your skin health, certainly exposure to that warmth helps sort of decongest the pores and opens them up and encourages circulation so that can definitely improve healing. But in patients who struggle with pigmentation, I'm always very mindful about the exposure to heat, because all heat sort of is related to infrared radiation to the skin, and that can actually encourage pigmentation and pigmentary abnormalities.

That's so interesting.

Be a bit careful if you're prone to pigmentation. Even exposure to cooking heat, like if you're getting stuff in and out of an oven, can aggravate people's pigmentation.

Not getting too close to the oven.

For a whole variety of reasons, probably. We often think of melasma and stuff related to the sun, and everybody's pretty conscientious of sun, but protecting your skin from the heat can also be really important.

And when you talk about extreme heat, can having a hot shower, because I love getting into a scalding hot shower and then ending it with the cold. But can that be detrimental to skin?

Yeah, so definitely I advise my patients who have eczema or psoriasis, even though sometimes those burning hot showers can feel so amazing, they actually can be very drawing to the skin and very irritating. And that increased circulation to the skin actually means that all those blood vessels vasodilate and all those itch factors, it all gets aggravated, the inflammation, the skin gets aggravated, and then patients start scratching their skin. So even though it can kind of feel satisfying initially, it can be quite damaging in the long run. So I really do advise my patients to avoid hot showers and certainly prolonged hot showers.

My daughter, actually, she has eczema from time to time, and our doctor recommends against sitting in the warm, hot bath for too long. Can you explain why that is? Because my daughter loves her baths.

Oh, I know. How old is she?

Five.

Oh, yeah. And, you know, it's hard to kind of take that away, for sure.

I know.

You know, I would say that at the very least, if the bath water is warm and not too hot, certainly being in the water for prolonged periods is drying to the skin. So one of the strategies that you can do when you come right out of that wet environment is moisturize the skin immediately, because that's when the skin barrier is the most permeable to hydrating moisturizers as well as medication. So if she has an eczema cream, that's a great time to put it on and then to kind of lock in that moisture. And I find younger kids can really tolerate those sticky, occlusive moisturizers, sometimes better than adults. So I like to go with really rich moisturizing creams for my young patients who suffer from dry skin and eczema.

So going back to cold plunges and ice cold showers, you mentioned that there is a sudden shock to the system. And even though there can be some benefits, is it possible that it could be harmful as well?

So I think if you have any heart conditions or circulatory issues, then you should definitely talk to your doctor before doing that. A specific example might be something like Raynaud. So Raynaud's is a circulatory condition of the distal hands, the tips of your fingers, where they tend to go white, and the blood vessels really constrict. And it's actually quite common. It's common in people with autoimmune conditions, but you don't have to have an autoimmune condition to suffer from this. And so in that case, something like a cold water plunge might really aggravate your Raynaud's, and that might be painful and not great for your joints and your skin. So you do have to be careful with cold extremes because it can become to feel and become like a burn. So frostbite is cold injury. So you can definitely injure the tissue with extreme cold in the same way that you can injure it from extreme heat. So, again, you just have to be mindful of your underlying health conditions before you do that. And you can easily talk to your doctor and they can advise you if there's going to be a trigger there.

And are there any certain precautions that anyone should take before embarking on that?

So what's really important is, I think, number one, protecting the skin from those extreme temperatures. So something like a cold plunge or cold bath, I think once a week is totally sufficient. It's not something I would recommend every day. And so the same goes for any kind of repeated cold exposure. It can just actually aggravate the skin. It's not really meant to be in that environment for prolonged periods on a regular basis.

That makes sense.

Most of the literature on cold plunges refers to this brief exposure. So ten minutes or less. Okay, so you might be able to get similar benefits by washing your face with cold water.

And what would you say the best way to maintain our skin barrier would be like? What are the top three habits that you recommend to your patients?

Oh, it's like a ride or die kind of question. The three things you couldn't live without. I mean, the first is, obviously, if you're going to cleanse your skin using a moisturizing cleanser so you're not stripping the skin of too many natural oils and soaps. Actually can often irritate the skin because they're drying, they're a little bit too alkaline. The second is using a moisturizer that contains ceramides or colloidal oat or ingredients that are known to soothe the skin and to put moisture back in the skin and help lock in that moisture. And I think the third is protecting the skin from the elements.

I think that, you know, skin barrier is such a hot topic and buzzword now. I think that we hear about moisturizing and all of that for so long, but now, even in products, you're seeing that a lot.

Yeah. And where more that research is going that I think is really cool is conditions that we normally associate with, say, like oily skin or like acne, let's say, that are now being better understood as some component of that is, is a problem with the skin barrier. So even if you think you've got oily skin or you're prone to acne, you still need to moisturize, because improving that skin barrier is part of healing that skin.

Right. I think back in the day was all about, you know, drying out your skin with these strong astringents and, you know, basically ruining our skin. Last question for you. Hot shower or cold shower?

Warm shower. Totally helpful.

That's fair. I think that, that, you know, it's the most pleasant.

Yeah, I think that's the most regular use for probably most people.

But I would say that I'm all about the extremes.

Well, it's great, though. It really does get you going. And I would say that that is one way to start the day. If you can get up and go, I think, do it, but then make sure that it's tolerable for you to do all the rest of the things you want to do in the shower.

Exactly. Exactly. Thank you. Thank you so much, Geeta. Thank you for taking the time, and it was so great chatting with you.

It was an absolute pleasure. Thank you.

Thank you to both my guests, Doctor Geeta Yadav and Melissa Keegler, for sharing their stories and knowledge with us. I personally learned so much about cold plunges and the effects extreme temperatures of water can have on our body. And even though I've been a little intimidated to do cold plunges regularly, I'm now a little more apt to try it because of all the benefits I've heard. I love the idea of the constriction of blood vessels and then the expansion and release, creating an invigorating mental and physical boost. And, of course, moderation is key. We don't want to overdo it. Just like with anything, we want to approach cold therapy in a way that feels intuitive and right for us. Skin Queries is hosted by myself, Nicole Berry, an executive producer by Ivan Sheehan. Our senior producer is Tori Weldon. Our junior producers are Reem Al Maghrabi and Jenny Cunningham. The show is mixed and features original music by Sam Sige. If you enjoy the show, share it with your friends. You can also listen and follow on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. We'd love to know what you think, so make sure you leave a review until next time.

I had fun tonight. See you again Wednesday. That sounds great.

I'll be there Wednesday, too.

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