The Use of Cryotherapy in Cosmetology: History
View Latest Version
Please note this is an old version of this entry, which may differ significantly from the current revision.
Contributor:
Adrianna Dzidek
,
Anna Piotrowska

Cryotherapy is becoming an increasingly popular method used in medicine, physiotherapy, and cosmetology. It is used in the form of whole-body cryotherapy (WBC) and local cryotherapy. It is a tool for achieving analgesic and anti-inflammatory effects.

  • whole-body cryotherapy
  • local cryotherapy
  • skin hydration

1. Influence of Cryotherapy on the Level of Inflammatory Markers

Inflammation is a set of processes aimed at defending the body against an inflammatory initiating agent (e.g., microbial, chemical, or physical). It is characterized by the presence of an increased internal temperature, increased blood flow, redness, pain, and impaired function of the inflamed tissue. If the inflammation continues chronically, even at a low intensity, it will contribute to degradative changes, aging of the body, and the appearance of a number of pathophysiological changes including those affecting the skin.
It has been noted that exposure of the body to extreme cold reduces the intensity of inflammatory processes; fewer pro-inflammatory mediators are released, and more anti-inflammatory cytokines are released [1]. Under the influence of low temperatures, the concentration of the acute-phase protein CRP (c-reactive protein), erythrocyte sedimentation rate (ESR), and the concentration of IgA and IgG immunoglobulins and pro-inflammatory interleukins (IL-2, IL-8) decrease. On the other hand, the concentration of interleukin-10 (IL-10), which has an anti-inflammatory effect, increases. In addition, cryotherapy improves humoral and cellular immunity, stimulating B lymphocytes and NK lymphocytes (natural killers) [2]. Inflammation is characterized by increased plasma concentrations of circulating proinflammatory cytokines (IL-6, IL-9, and TNF-α, among others). Ziemann et al. [3] demonstrated that the application of a series of 10 whole-body cryotherapy (WBC) treatments reduces TNF-α concentrations, indicating an anti-inflammatory effect of cryostimulation. Pilch et al. [4] noted that a series of 20 cryostimulation treatments significantly reduced CRP protein values among obese subjects, while no significant changes were noted in subjects with normal body mass. This is interesting because obesity is a recognized pathophysiological factor causing chronic inflammation, which increases the likelihood of developing further disease entities of the metabolic syndrome. This also demonstrates that cryochamber treatments will not decrease the concentrations of selected cytokines per se, but only normalize their concentrations.
The activation of inducible nitric oxide synthase (iNOS) during inflammation in macrophages or muscle cells is thought to result in the release of large amounts of nitric oxide (NO). It is well known that NO is a major vasodilatory mediator and also inhibits the expression of proinflammatory cytokines [5]. On the other hand, NO may be a trigger for inflammation. Więcek et al. [6] subjected 20 men (mean age of 59) to a series of 24 WBC treatments, at a frequency of every other day. In their study, they demonstrated that a series of WBC treatments would increase the expression of iNOS, regardless of physical activity level. Więcek et al. [6], simultaneously with iNOS, examined the levels of CRP and interleukins, namely IL-6, IL-10, and IL-1β. They noted no changes in inflammatory markers. This shows that the body’s responses regarding inflammatory markers after exposure to cryogenic temperatures may be different. For clinical conditions that proceed with an increase in inflammatory markers, WBC allows them to decrease. For organisms with physiological concentrations, the treatments will have no effect.

2. Cryotherapy and Oxidative Stress and Skin

The theory of aging regarding the effect of reactive oxygen species (ROS) was proposed in 1956 by Denham Harman. He suggested that free radicals accumulate over time and are one of the major factors that contribute to the aging of the body [7]. This concept was the basis for the development of the free radical theory of mitochondrial aging (MFRTA) [8]. ROS are thought to be formed by electron leakage in the respiratory chain in mitochondria. This causes damage to the cytosolic components and the mitochondria themselves. A further consequence is the aging of the body. This theory assumed that ROS are the only source of mitochondrial damage, and it is impossible to block their formation and thus completely repair mitochondria and other subcellular components [9]. However, recently, this theory in relation to the whole organism has been questioned [10][11][12]. In spite of that, the free radical theory of aging holds true for the second largest human organ, the skin. There is a clear correlation between exposure to ROS from both extrinsic and intrinsic sources and the pro-aging effect [13]. Oxidative stress during aging reduces the expression of antioxidant enzymes, their concentration, or activity, including SOD (superoxide dismutase), CAT (catalase), and GPx (glutathione peroxidase). In addition, the total oxidative status [TOS] increases, while the antioxidant capacity (TAC) decreases [14].
The influence of WBC on the antioxidant status and activity of antioxidant enzymes was studied in healthy subjects, athletes, and patients with various disorders. Miller et al. [15] noted that a series of 10 WBC treatments resulted in an increase in total antioxidant status (TAS) in patients with multiple sclerosis. Wojciak et al. [14] demonstrated an increase in the GPx activity in erythrocyte and plasma TAC levels after the first WBC treatment in a group of older, physically active men. They also showed an increase in CAT activity after a single treatment in young, non-training individuals. Pilch et al. [16] observed a significant increase in CAT activity after a series of 20 WBC treatments in subjects with obesity. Sutkowy et al. [17], in a study involving young, healthy men, demonstrated an increase in the SOD and the GPx activity after a single WBC treatment. Using a series of treatments (at least 12 WBC treatments) resulted in an increase in SOD activity, and increasing the number of treatments to 24 potentiated this effect [16]. The SOD activity was also shown to increase after a series of 20 WBC treatments [18].

3. The Impact of Cryotherapy on Skin

The skin is responsible for many defense, secretory, and sensory functions [19]. It is designed to protect the human body against external harmful factors, at the same time ensuring contact with the external environment and recognizing its stimuli. In addition, the skin is equipped with immune cells and a number of receptors essential for the host’s defense and the maintenance of tissue homeostasis [20].
The human body is homeothermic, which ensures its proper functioning. In turn, the external temperature (measured on the skin) is dependent on the environment. The maintenance of relative thermal homeostasis is ensured by adipose tissue and hair, which do not allow excessive heat loss.
Skin temperature can be measured using a digital thermometer. An electrode is applied directly to the skin, so temperature measures reflect skin changes with heat lost rather than the direct effect of cold on the thermometer [21]. Another tool for assessing skin temperature is the Hanna Instruments HI-8751 telethermometer with an HI-765Ped factory-calibrated (ISO 9000) thermistor surface probe [22]. Cholewka et al. in their studies used thermography and contact thermometry. Thermography was performed with a Thermovision Camera AGEMA Type 470 and a Thermovision Camera A40 (Flir Systems Company, Danderyd, Sweden). The distance between the camera and the body needs to be approximately 1.0–1.5 m, depending on the height and size of the human. Contact thermometry was performed using thermocouples Ni-Cr-Ni-Al stacked to the surface of the body with a hypoallergic plaster [23].
In WBC, the temperature of the skin follows the low ambient temperature [24]. Exposing the skin to extreme cold causes significant fluctuations in the skin temperature, which leads to an increase in the activity of skin thermoreceptors and, consequently, to the stimulation of the thermoregulation center in the hypothalamus [25][26]. It was indicated that changes in skin temperature closely correlate with changes in subcutaneous and intramuscular temperatures [22][26]. However, Jutte et al. [27] showed that the variability of skin temperature is only responsible for 21% of the variability of the temperature in the muscle. In this research, the absolute value of temperatures was shown, therefore it cannot be directly compared with results in other papers. Nevertheless, the results of the studies by Jutte et al. [27] show that the relationship between skin temperature and the temperature of deep tissues is not clear.
The reaction to cold has two stages. In the first stage, sympathetic adrenergic fibers are stimulated, releasing NA. The speed of nerve conduction slows down and local blood vessels narrow [25][28]. In the second stage, there is a rapid expansion of blood vessels and tissue reperfusion. Such stimulation of microcirculation with increased reperfusion after limited blood flow in the narrowed vessels increases the supply of oxygen to cells and other nutrients, which will likely also improve the appearance of the skin. Such an action is to be expected with repeated exposure to low temperatures. It is indicated that the stimulation of microcirculation will support the penetration and distribution of medicinal or cosmetic preparations used immediately after the WBC treatment [29]. As indicated earlier, WBC has an inhibitory effect on the amount of ROS and stimulates the number of antioxidants produced by the body [14][15][17]. Therefore, the use of multiple cryotherapy treatments may bring effects similar to those observed after the use of cosmetics or nutricosmetics that improve the prooxidative-antioxidant balance [29][30].
With age, an accumulation of cellular damage leading to metabolic dysfunction and chronic inflammation is observed [31]. Aging cells are responsible for the appearance of wrinkles and morphological changes in elastin fibers [32]. They are unable to divide but remain metabolically active. They secrete numerous pro-inflammatory cytokines (including IL-6, IL-8), growth factors, chemokines, and proteases, known as the aging-associated secretory phenotype (SASP). It is shown that the number of SASP-expressing fibroblasts increases with age [33][34]. It has been also noted that in keratinocytes of aging skin, the secretion of IL-1α is higher, which may be related to the inflammation process occurring in these cells [35]. It contributes to a malfunction of whole skin tissue. The pro-inflammatory environment of the skin affects the reconstruction and damage of the extracellular matrix (ECM), thus disrupting the wound-healing process. Therefore, especially in the elderly, the inflammation process will affect the appearance and architecture of the skin and also the immune function of the skin [33].
Piotrowska et al. [36] showed the effect of a single systemic cryotherapy treatment on the improvement of skin hydration. As a result of high temperatures, the sweat glands secreted large amounts of fluids and electrolytes. Shamsuddin et al. [37] proved that the ion reabsorption capacity of the sweat gland is significantly lower at cool ambient temperatures compared to optimal. Therefore, it can be presumed that the eccrine glands, in response to extreme cold, will produce sweat slower, which will reduce water leakage from the extracellular space and, consequently, will improve the hydration of the stratum corneum. Skrzek et al. [38] also noted an improvement in the level of hydration after a one-time WBC treatment, but only in three out of eight measured locations (the chin contour, right cheek, and right lower limb). After applying a series of 10 treatments, Skrzek et al. [38] showed a decrease in the level of skin hydration in all measured locations, except for one (the forehead). This exception of the forehead may be due to a large amount of sebum secreted in this area. A significant difference in the cited works is the age of the participants and the number of treatments. Piotrowska et al. [36] investigated the effect of a one-time WBC procedure on skin features among women and men, whose mean age was 23.63 years. Skrzek et al. [38] studied middle-aged women (a mean age of 58.7) who underwent a single WBC treatment and a series of 10 treatments. With age, decreased vasoconstriction in the skin was observed during exposure to cold. Changes in skin blood flow reactions related to aging may contribute to thermoregulation disorders [39], which may have an impact on the results of the level of hydration in the respondents in the studies presented above. Therefore, the initial improvement in skin hydration demonstrated by Piotrowska et al. [36] could, as in the case of Skrzek et al. [38], be reversed under the influence of a series of treatments. However, this hypothesis would require further research to confirm it.
Kang [40] also noted an improvement in epidermal hydration in his research. After a series of treatments, the level of hydration in the group subjected to cryotherapy was 58% and was 53% in the control group. In his research, Kang [40] also noted the effect of cold treatments on the amount of sebum on the skin: 34% in the study group, while in the control group, the change was 27%. The authors indicated the presence of a clear correlation between the level of hydration and the degree of sebum secretion. In line with this observation, it can be concluded that in the study by Skrzek et al. [38], the level of sebum should decrease with the decrease in the level of hydration. However, the authors of the studies did not notice a decrease in sebum levels as a result of cryotherapy [38]. It may be related to the age of the probes and the activity of the sebaceous glands depending on the activity of the endocrine system [41].
The pH value of the skin is assessed by the presence of water on the surface of the skin. Changes in the skin microcirculation and the activity of sweat glands generated by cryogenic temperature will modulate the amount of water on the skin surface, which may imply changes in the acid–base reaction. Both Piotrowska et al. [36] and Skrzek et al. [38] suggest lowering the skin pH under the influence of WBC, but their results were not statistically significant. It is worth noting that, in both studies, the pH value was within the limits considered beneficial for the skin (in Piotrowska et al. [36], 4.0–6.00; in Skrzek et al. [38], 5.5–6.08).

This entry is adapted from the peer-reviewed paper 10.3390/cosmetics9050100

References

  1. Lubkowska, A.; Dudzińska, W.; Bryczkowska, I.; Dołęgowska, B. Body Composition, Lipid Profile, Adipokine Concentration, and Antioxidant Capacity Changes during Interventions to Treat Overweight with Exercise Programme and Whole-Body Cryostimulation. Oxid Med. Cell. Longev. 2015, 2015, 803197.
  2. Smolander, J.; Leppäluoto, J.; Westerlund, T.; Oksa, J.; Dugue, B.; Mikkelsson, M.; Ruokonen, A. Effects of Repeated Whole-Body Cold Exposures on Serum Concentrations of Growth Hormone, Thyrotropin, Prolactin and Thyroid Hormones in Healthy Women. Cryobiology 2009, 58, 275–278.
  3. Ziemann, E.; Olek, R.A.; Grzywacz, T.; Kaczor, J.J.; Antosiewicz, J.; Skrobot, W.; Kujach, S.; Laskowski, R. Whole-Body Cryostimulation as an Effective Way of Reducing Exercise-Induced Inflammation and Blood Cholesterol in Young Men. Eur. Cytokine Netw. 2014, 25, 14–23.
  4. Pilch, W.; Wyrostek, J.; Major, P.; Zuziak, R.; Piotrowska, A.; Czerwińska-Ledwig, O.; Grzybkowska, A.; Zasada, M.; Ziemann, E.; Żychowska, M. The Effect of Whole-Body Cryostimulation on Body Composition and Leukocyte Expression of HSPA1A, HSPB1, and CRP in Obese Men. Cryobiology 2020, 94, 100–106.
  5. Stanek, A.; Fazeli, B.; Bartuś, S.; Sutkowska, E. The Role of Endothelium in Physiological and Pathological States: New Data. Biomed. Res. Int. 2018, 2018, 1098039.
  6. Wiecek, M.; Szygula, Z.; Gradek, J.; Kusmierczyk, J.; Szymura, J. Whole-Body Cryotherapy Increases the Activity of Nitric Oxide Synthase in Older Men. Biomolecules 2021, 11, 1041.
  7. Harman, D. Aging: A Theory Based on Free Radical and Radiation Chemistry. Sci. Aging Knowl. Environ. 1956, 11, 298–300.
  8. Harman, D. The Biologic Clock: The Mitochondria? J. Am. Geriatr. Soc. 1972, 20, 145–147.
  9. Gruber, J.; Schaffer, S.; Halliwell, B. The Mitochondrial Free Radical Theory of Ageing–Where Do We Stand? Front. Biosci. 2008, 13, 6554–6570.
  10. Lapointe, J.; Hekimi, S. When a Theory of Aging Ages Badly. Cell. Mol. Life Sci. 2010, 67, 1–8.
  11. Buffenstein, R.; Edrey, Y.H.; Mele, J. The Oxidative Stress Theory of Aging: Embattled or Invincible? Insights from Non-Traditional Model Organisms. Age 2008, 30, 99–109.
  12. Bonawitz, N.D.; Shadel, G.S. Rethinking the Mitochondrial Theory of Aging: The Role of Mitochondrial Gene Expression in Lifespan Determination. Cell Cycle 2007, 6, 1574–1578.
  13. Rinnerthaler, M.; Bischof, J.; Streubel, M.K.; Trost, A.; Richter, K. Oxidative Stress in Aging Human Skin. Biomolecules 2015, 5, 545–589.
  14. Wojciak, G.; Szymura, J.; Szygula, Z.; Gradek, J.; Wiecek, M. The Effect of Repeated Whole-Body Cryotherapy on SIRT1 and SIRT3 Concentrations and Oxidative Status in Older and Young Men Performing Different Levels of Physical Activity. Antioxidants 2021, 10, 37.
  15. Miller, E.; Mrowicka, M.; Malinowska, K.; Mrowicki, J.; Saluk-Juszczak, J.; Kȩdziora, J. Effects of Whole-Body Cryotherapy on a Total Antioxidative Status and Activities of Antioxidative Enzymes in Blood of Depressive Multiple Sclerosis Patients. World J. Biol. Psychiatry 2011, 12, 223–227.
  16. Pilch, W.; Wyrostek, J.; Piotrowska, A.; Czerwińska-Ledwig, O.; Zuziak, R.; Sadowska-Krępa, E.; Maciejczyk, M.; Żychowska, M. Blood Pro-Oxidant/Antioxidant Balance in Young Men with Class II Obesity after 20 Sessions of Whole Body Cryostimulation: A Preliminary Study. Redox Rep. 2021, 26, 10–17.
  17. Sutkowy, P.; Woźniak, A.; Rajewski, P. Single Whole-Body Cryostimulation Procedure versus Single Dry Sauna Bath: Comparison of Oxidative Impact on Healthy Male Volunteers. Biomed. Res. Int. 2015, 2015, 406353.
  18. Lubkowska, A.; Dołegowska, B.; Szyguła, Z. Whole-Body Cryostimulation-Potential Beneficial Treatment for Improving Antioxidant Capacity in Healthy Men-Significance of the Number of Sessions. PLoS ONE 2012, 7, e46352.
  19. Sybilski, A. Skin–the Most Important Organ of Our Body. Let’s Take Care of It! Pediatr. Med. Rodz. 2012, 8, 375–379.
  20. Nguyen, A.V.; Soulika, A.M. The Dynamics of the Skin’s Immune System. Int. J. Mol. Sci. 2019, 20, 1811.
  21. Algafly, A.A.; George, K.P. The Effect of Cryotherapy on Nerve Conduction Velocity, Pain Threshold and Pain Tolerance. Br. J. Sports Med. 2007, 41, 365–369.
  22. Chesterton, L.S.; Foster, N.E.; Ross, L. Skin Temperature Response to Cryotherapy. Arch. Phys. Med. Rehabil. 2002, 83, 543–549.
  23. Cholewka, A.; Stanek, A.; Sieroń, A.; Drzazga, Z. Thermography Study of Skin Response Due to Whole-Body Cryotherapy. Skin Res. Technol. 2012, 18, 180–187.
  24. Darkenski, R.; Kazandjieva, J.; Tsankov, N. Skin Barier Function: Morpgological Basis and REGULATORY Mechanisms. J. Clin. Med. 2011, 4, 36–45.
  25. Herrera, E.; Sandoval, M.C.; Camargo, D.M.; Salvini, T.F. Motor and Sensory Nerve Conduction Are Affected Differently by Ice Pack, Ice Massage, and Cold Water Immersion. Phys. Ther. 2010, 90, 581–591.
  26. Kennet, J.; Hardaker, N.; Hobbs, S.; Selfe, J. Cooling efficiency of 4 common cryotherapeutic agents. J. Athl. Train. 2007, 42, 343–348.
  27. Jutte, L.S.; Merrick, M.A.; Ingersoll, C.D.; Edwards, J.E. The Relationship between Intramuscular Temperature, Skin Temperature, and Adipose Thickness during Cryotherapy and Rewarming. Arch. Phys. Med. Rehabil. 2001, 82, 845–850.
  28. Leppäluoto, J.; Westerlund, T.; Huttunen, P.; Oksa, J.; Smolander, J.; Dugué, B.; Mikkelsson, M. Effects of Long-Term Whole-Body Cold Exposures on Plasma Concentrations of ACTH, Beta-Endorphin, Cortisol, Catecholamines and Cytokines in Healthy Females. Scand. J. Clin. Lab. Investig. 2008, 68, 145–153.
  29. Sieron, A.; Cieslar, G.; Stanek, A. Cryotherapy: Theoretical Bases, Biological Effects, Clinical Applications; α-Medica Press: Bielsko-Biała, Poland, 2010.
  30. de Lima Cherubim, D.J.; Buzanello Martins, C.V.; Oliveira Fariña, L.; da Silva de Lucca, R.A. Polyphenols as Natural Antioxidants in Cosmetics Applications. J. Cosmet. Dermatol. 2020, 19, 33–37.
  31. Waaijer, M.E.C.; Parish, W.E.; Strongitharm, B.H.; van Heemst, D.; Slagboom, P.E.; de Craen, A.J.M.; Sedivy, J.M.; Westendorp, R.G.J.; Gunn, D.A.; Maier, A.B. The Number of P16INK4a Positive Cells in Human Skin Reflects Biological Age. Aging Cell 2012, 11, 722–725.
  32. Waaijer, M.E.C.; Gunn, D.A.; Adams, P.D.; Pawlikowski, J.S.; Griffiths, C.E.M.; van Heemst, D.; Slagboom, P.E.; Westendorp, R.G.J.; Maier, A.B. P16INK4a Positive Cells in Human Skin Are Indicative of Local Elastic Fiber Morphology, Facial Wrinkling, and Perceived Age. J. Gerontol. -Series A Biol. Sci. Med. Sci. 2016, 71, 1022–1028.
  33. Pilkington, S.M.; Bulfone-Paus, S.; Griffiths, C.E.M.; Watson, R.E.B. Inflammaging and the Skin. J. Investig. Dermatol. 2021, 141, 1087–1095.
  34. Campisi, J. Aging, Cellular Senescence, and Cancer. Annu. Rev. Physiol. 2013, 75, 685–705.
  35. Okazaki, M.; Yoshimura, K.; Uchida, G.; Harii, K.; Okazaki, M. Correlation between Age and the Secretions of Melanocyte-Stimulating Cytokines in Cultured Keratinocytes and Fibroblasts. Br. J. Dermatol. 2005, 2, 20–23.
  36. Piotrowska, A.; Aszklar, K.; Dzidek, A.; Ptaszek, B.; Czerwińska-Ledwig, O.; Pilch, W. The Impact of a Single Whole Body Cryostimulation Treatment on Selected Skin Properties of Healthy Young Subjects. Cryobiology 2021, 100, 96–100.
  37. Shamsuddin, A.K.M.; Kuwahara, T.; Oue, A.; Nomura, C.; Koga, S.; Inoue, Y.; Kondo, N. Effect of Skin Temperature on the Ion Reabsorption Capacity of Sweat Glands during Exercise in Humans. Eur. J. Appl. Physiol. 2005, 94, 442–447.
  38. Skrzek, A.; Ciszek, A.; Nowicka, D.; Dębiec-Bąk, A. Evaluation of Changes in Selected Skin Parameters under the Influence of Extremely Low Temperature. Cryobiology 2019, 86, 19–24.
  39. Charkoudian, N. Mechanisms and Modifiers of Reflex Induced Cutaneous Vasodilation and Vasoconstriction in Humans. J. Appl. Physiol. 1985, 109, 1221–1228.
  40. Kang, J.-H. The Comparison about The Effect of Thermotherapy and Cryotherapy on The Skin. Kor. J. Aesthet Cosmetol. 2013, 11, 281–288.
  41. Dąbrowska, A.K.; Spano, F.; Derler, S.; Adlhart, C.; Spencer, N.D.; Rossi, R.M. The Relationship between Skin Function, Barrier Properties, and Body-Dependent Factors. Skin Res. Technol. 2018, 24, 165–174.
More
© Text is available under the terms and conditions of the Creative Commons Attribution (CC BY) license; additional terms may apply. By using this site, you agree to the Terms and Conditions and Privacy Policy.
This entry is offline, you can click here to edit this entry!
Video Production Service
Feedback