Ep41: Skin Icing – Dermatologist Take on Putting Ice on Your Face
Dr.Teo: Hi guys, welcome to this week’s episode of Dermatologist Talks: Science of Beauty. I’m Dr. Teo Wan Lin of TWL Specialist Skin and Laser Centre and today we’re going to be talking about skin icing. Skin icing is a relatively new term coined because of certain viral social media videos on TikTok of celebrities and laypersons who have incorporated this process of putting ice on face into their daily skincare routine.
What is skin icing? How does putting ice on face work?
Chelsea: Yes, this is a topic I’ve always wanted to find out more about. I have come across many skin icing videos on TikTok, and even the selling of skin icing tools. Well, placing skincare products in the fridge isn’t new. And we have talked about cryotherapy before in a previous episode. Could you share with us what happens during when I put ice on face and does it actually work?
Dr.Teo: From what I’ve personally observed, it refers to the application of ice globes. I believe, which are frozen, taken from the freezer or ice cubes, which you directly apply on facial skin. In certain cases, these are wrapped in gauze or some sort of cloth, which is then rolled over their facial skin.
Does this process of skin icing actually work? Well, it is actually based on certain principles of skin physiology. Previously, I had discussed this in a podcast episode entitled “The use of thermal energies in skincare routines“. In conditions like rosacea, where your skin is red, because of the blood vessel hyper-activity, blood vessels are constantly vasodilating. This means they are in an expanded state, usually in response to increased environmental temperatures. Therefore, when the body is trying to cool down by expanding the blood vessels and increasing blood flow to release the excess heat, the skin consequently gets redder.
Skin conditions related to thermal regulation
In certain individuals, this manifests as increased skin inflammation. The disease process in a condition like rosacea is such that even when the individual transfers to a cooler environment, unlike in another individual who doesn’t suffer from rosacea, in this patient with rosacea, the redness actually persists. Over time, this causes changes in the skin, such as skin thickening, and enlarged pores. In extreme cases, the end stage of rosacea is a condition – Rhinophyma. This is where you have irregular skin thickening that is cosmetically disfiguring.
Chelsea: I didn’t know that there was a link between rosacea and our environmental temperatures! Well are there other conditions that can link to thermal regulation?
Dr.Teo: In facial eczema, one observes that the associated symptoms of redness alongside scaling, swelling, itch, stinging and pain are actually due to underlying inflammation. All that links to blood vessel activity as well. In theory, as it is in rosacea, using cold therapy can improve the symptoms of these conditions. Besides, cold helps to relieve itchiness by distracting a set of certain nerve receptors in the skin
Can putting ice on face be an effective form of cold therapy?
Dr.Teo: Skin icing in terms of the trend that we have just described previously, has certain downsides to it. I would say it’s a rather crude application as a form of cold therapy. For cold therapy, this is how we usually recommend it in our practice in dermatologist offices. We tell our patients to put their skincare products in the refrigerator. Especially if they live in a summer or tropical climate like in Singapore, and if they have rosacea or eczema. Same goes for their face masks.
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When you apply the cool products from the refrigerator on your skin, it offers temporary relief of certain sensations such as stinging, itch, and overall reduces skin inflammation. My patients currently use a polysaccharide mask material that increases absorption of the moisturizer. You can refrigerate this reusable mask. The cooling effect of the skincare will also help to reduce the skin redness or erythema in specific terms.
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Chelsea: That is a great tip that I definitely am going to start implementing in my skincare regimen. Lately, there has been a rise in mini beauty fridges that can keep your skincare products nice and cool. Well, if cool therapy does work for the skin – especially in terms of anti-inflammatory functions. Could you elaborate more on the downsides of putting ice on face? I have heard about how cryotherapy is widely used in dermatologist clinics, isn’t it similar to skin icing?
Is skin icing really safe? Are there any downsides to it?
Dr.Teo: What exactly is wrong with putting ice on face? Are there alternatives for us to safely harness the benefits of cryotherapy for skin? There are obvious downsides to applying ice directly on your facial skin. The first being that it may damage your skin barrier. We have spoken about the skin being a barrier that protects us from the external environment. That’s the reason why we apply moisturizers that rebuilds the skin barrier. A ceramide-dominant moisturizer is one that is most consistent with the lipid ratio of our healthy, natural skin barrier.
When you have a case of barrier dysfunction, that’s when you develop dermatitis or eczema. When you apply ice to normal skin, the tendency is that your skin will actually become dehydrated. This same concept is as if you were to take a long shower and immerse yourself in the bath for a long time. If you’ve got dry skin, that’s something that I definitely would not recommend. It increases water loss to the environment, what we know as trans-epidermal water loss.
The risk of freezer burns
The other thing is that it’s not a very practical procedure. Ice itself is in a solid state. But at room temperature, or at least in the initial stages when you are starting to ice your face. It’s not very compatible with your body skin temperature. We also know that you have a chance of catching freezer burn, a cold-induced damage on your skin. So in fact, at minus 40 degrees, which is what we use for medical cryotherapy to freeze warts on the skin that actually destroys part of the skin. Cryotherapy is essentially harnessed in the form of certain procedures that destroy tissue. To illustrate, freezer burn is an example of an adverse effect that can result from abnormally low temperatures, that we apply over the skin.
Chelsea: We do know that when we have an injury, for example, from a sprained ankle. We are often careful to put the ice pack on a towel if we’re going to be leaving in on our skin for long periods of time. This shouldn’t be any different as you’re putting ice directly on the face. Freezer burn or ice burn can damage the skin and lead to pain, blisters, itchiness and more. So we might want to think twice before putting ice on face.
Rethinking the practicality of skin icing
Dr.Teo: Well, the other thing, of course is, as we know, ice is gonna melt quite quickly. And when it becomes liquid, constantly having that water on your face increases trans-epidermal water loss. But it also leads us to question if, since it’s not going to remain as ice for very long, the practicality and the efficacy of such a procedure. While ice globes are rather interesting, I think we need to consider if it’s being put in the freezer. I feel that the temperature is way too cold, it can cause freezer burn.
Chelsea: Yes, and we definitely want to avoid that.
Are there other ways that we can incorporate the benefits of cold therapy without potentially damaging the skin?
Dr.Teo: Actually, if you simply use a massage tool made of natural stone, like a Jade roller made of Rose Quartz or true Jade. It already has a lower temperature than ordinary objects at room temperature. So when you put that in the refrigerator, it usually gets cold enough. Hence, that’s what we recommend for home massage therapies with the Jade roller. I feel that there is just so much variation in terms of how an individual may interpret and apply this skin icing skincare regimen. Also, we do know that in order for a practice to be recommended or endorsed by dermatologists. It has to be reviewed in an objective way. Usually a study with scientific literature supporting it. But at this stage because it’s not very well defined,
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The impracticality of using ice cubes on your face
I personally wouldn’t comment on how effective it is going to be. Other than discussing the physiological principles that apply to how thermal energies can change skin behaviour. Nevertheless, anecdotally, I feel that it’s a good topic to discuss. And for us to understand the benefits of applying cold therapy to your skin. In this case, I feel that the impracticality of just using ice cubes and potentially, effects such as freezer burns from using ice globes can actually cause us to rethink if this is the sort of procedure that is worthwhile to incorporate in your home skincare regimen. Because at the end of the day, we’re always talking about how efficient everything is.
Chelsea: Well in that case, what about facial ice packs? I’ve heard about gel packs that you can store in the fridge and possibly bring cooling effects on the skin. Can you tell us more about that?
Another alternative to cold therapy
Dr.Teo: There are other ways of applying this concept of cryotherapy. Facial devices that can generate a low temperature, but still in the calibrated manner, is beneficial. First of all, it’s sustained at a constant temperature that is tested to be safe for skin. CMC gel packs are biologically compatible gels which release coldness over a longer period of time. They can be inserted into fabrics to reduce the chances of freezer or cold-induced skin damage. That’s actually what we have applied for our CUIONS eye mask. For patients who are struggling with under eye circles, dark circles, eye bags, and primarily the treatment of periocular and periorbital wrinkles. The CUIONS nanoparticles help to stimulate collagen production via the copper nanoparticles which are constantly being released upon contact with the textile.
The CUIONS Anti-Aging Sleeping Eye Mask is designed for use with the CUTISCOOL Biological Gel Pack to reduce puffiness and bring a cooling sensation to the skin without the discomfort of ice cubes.
Cold therapy with gel packs
So, when you incorporate cold therapy via the biological gel pack, first of all, it’s safe, clean, practical, doesn’t leak, and it doesn’t have the sharp edges of an ice cube. I feel that while a lot of these trends can quickly catch on social media, like TikTok, people have to be a lot more discerning. Something which seems harmless like rubbing an ice cube on your face, may actually over a period of time or in individuals who have sensitive dry skin, result in an aggravation of a skin condition. Frictional dermatitis is one that can be induced by a constant friction over your skin. So the process of rubbing ice on face is hard, the edges can be sharp, and coupled with the potential for freezer burn on very sensitive skin. I think all that can be a recipe for disaster sometimes.
Chelsea: Ah so apart from ice burn, another thing we should be careful of when skin icing is the friction that it can cause to the skin. Well what about the DIY ice water facials that I’ve seen on TikTok? What is your take on that?
What is your take on ice water facials?
Dr.Teo: I also have heard of individuals who try to vary this trend a little bit by dunking their faces in a bowl of ice water. I think you know that’s pretty harmless because usually if it’s ice at room temperature mixed with water, it’s not going to be too cold. But then again, I feel that maybe the results that will be apparent from this sort of routine are very short-term. It’s got to do with the vasoconstrictive effects of exposure to the coldness. This causes your blood vessels to constrict. Your pores may look smaller because these are all pilosebaceous units connected to the blood vessels which are also reacting to your environment. However, these results will not be sustained and is not considered a part of therapy for any skin condition.
Chelsea: I see, but there have been many celebrities and influencers claiming that skin icing has helped them achieve a brighter-looking, radiant, glowy face. Does that actually work? What is the science behind that?
Can rolling ice on your face make the skin glow?
Dr.Teo: Another question that I have encountered is if rolling ice cubes on your skin can make your skin glow. The answer to that is I don’t think so. We can definitely figure this out with just logic and reasoning alone. Because, the scientific definition of a glow would have to do with your skin cells being renewed. We understand the skin cycle, which is prolonged as you grow older, resulting in slower turnover of your skin cells. This affects the radiance of your skin. The rate of epidermal cell turnover should not be affected by cool therapy.
Whether or not it can actually increase the production of collagen, so your skin is more elastic, it looks more plumped up and tight. I feel in theory from our understanding of physiological processes, the answer is again, no. But of course, if there is further research that comes up that demonstrates otherwise, I think that we have to be open-minded and change our perspective on this. But for now, I think there’s very limited reason to believe so.
Can cold therapy reduce the appearance of enlarged pores?
Overall, minimizing the appearance of enlarged pores using cold therapy is not something that will give any sort of sustained long-term results. Pores essentially are your hair follicles. Enlarged pores may be much more than just a cosmetic concern because we know there’s an association with diseases such as rosacea, and active acne individuals who have a lot of blackheads. So I feel that it’s important to know there are much better treatment options. For acne, for example, blackheads, usually chemical peels, microdermabrasion, a combination of retinoids used at home, can offer a good result.
Chelsea: I mean, who doesn’t want poreless, smooth skin? Other than cold therapy, which we now know has short term effects, how can I achieve poreless, glass skin?
Dermatologist tips on achieving poreless, glass skin
Dr.Teo: Achieving a poreless glass skin sort of appearance can also be influenced by the use of certain hydrating molecules which are larger than your usual moisturizing skincare. For example, polyglutamic acid. And the important thing is that in contrast with just dunking your face and ice water, having that temporary effect of vasoconstriction, usage of these topical prescription and non-prescription botanical actives can have a longer term effect on your skin health.
We have spoken about quite a number of methods of skin icing so far. One last method, which I’ve come across and I want to briefly touch on, is using a chilled metal tablespoon.
In this case, think about how it feels like if you go into the freezer section in a supermarket, and then you start to get goose bumps. That is the way that our body responds to cold. Our body is a living organism. There are certain functions which you can definitely observe when your skin has exposure to certain environments
Using a myriad of these methods from ice globes to ice cubes to metal tablespoons, well suffice to say that you will observe some sort of immediate physiological effect if you have normal skin. If these processes don’t seem to irritate you, it may just be fine. But if you have skin sensitivity or an underlying condition is actually causing the enlarged pores, or the redness for that matter, then these home tips which have gone viral on social media may even be detrimental if you want to try it at home.
Chelsea: That does make sense! So for those individuals with sensitive skin, what is your recommendation?
Can people with sensitive skin undergo cold therapy as well?
Dr.Teo: The key thing that we have discussed with ice globes before and using ice early on your face is freezer burn. So for sure, individuals with dry sensitive skin should not be attempting this. What you should do instead is to apply your moisturizers. Choose one which is recommended by dermatologists. The standard for moisturizer therapy is a prescription emollient device, which is a ceramide-dominant ideal lipid mixture with anti-inflammatory botanical actives.
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Your skincare – for massage and a little bit of cryotherapy or Jade roller in a refrigerator has more than sufficient results to enhance the response of your skin to the skincare. Massage is something that is probably worthwhile to mention more than the process of skin icing or any form of cryotherapy because there is evidence that it stimulates collagen production. It has to do with something called mechanobiology which means that it stimulates your skin to produce certain structural proteins that contribute to the synthesis of elastin.
Chelsea: Well that’s it for today’s episode. We’ve covered the do’s and don’ts of skin icing, the skin conditions linked to temperature sensitivity, and other safer alternatives to reap the benefits of cold therapy for your skin. We also talked about other DIY remedies such as the ice bath facial, and dermatologist tips on how to get poreless skin – without the potentially dangerous side effects of rolling ice on the skin. You can follow Dr. Teo on instagram @drteowanlin for more podcast updates, and remember to check out our website at www.scienceofbeauty.net for the full podcast transcript.