Dr. Parvin Shafa | January 23, 2023
Saunas, steam rooms, and cold therapy (such as ice baths and cold showers) have been a popular source of self-care over the past several years. There has been more and more evidence supporting these practices for overall general health and even anti-aging, but little evidence has been proposed for skin specific benefits. This is a good time to emphasize that most things that improve your general health tend to have beneficial effects on your skin as well. In this discussion we will focus on skin specific points regarding these practices.
First we will talk about saunas. There has been emerging evidence of the many health benefits for sauna use. Recent evidence has displayed improved cardiovascular function with sauna use leading to decreased risk of cardiovascular disease, neurocognitive disease, and high blood pressure. This improved cardiovascular function has effects on the skin as well, as blood flow to the skin was noted to double during sauna use. From a common sense standpoint, increased blood flow to the skin allows for increased nutrition to the skin as the blood carries nutrients to every organ of the body. This study also displayed that regular sauna use created a more stable epidermal barrier function, increased hydration of the top most layer of the skin, and protective effect on skin pH levels.
Steam rooms on the other hand don’t have as much literature to support, but likely have the same health benefits. Steam rooms use wet heat as opposed to saunas which use dry heat. Therefore, it is thought that steam rooms have more effect on opening/unclogging your pores compared to saunas. Wet heat also penetrates the skin quicker than dry heat. This means that it could take less time in the steam room than it would take in the sauna for the heat to penetrate the body and to increase blood flow to the skin. Overall, until further research is performed with direct comparisons between saunas and steam rooms, I believe it is fair to consider them similarly beneficial for your health and to decide your choice of heat delivery based on your own preference.
In regard to cold baths, emerging evidence has also been showing benefits of cold therapy on overall health and anti-aging. Unfortunately, the effects of cold showers or cold baths haven’t been studied extensively for the skin specifically, but a few things can be deduced based on the information that we do have. It is a well established fact that hot showers are bad for your skin and lead to drier skin. Therefore taking cold baths in replacement of hot showers would make sense to be beneficial. Also, it is a well established thought that long showers also have a drying effect on the skin and harm the epidermal skin barrier. Cold showers are not easy to stay under, so I think it gives us the motivation we need to keep our showers brief and to the point. Cold showers have frequently also been reported to be soothing in patients with itchy skin so can be added as an adjuvant to treatment for those patients. Studies have shown that cold showers decrease stress levels and it can’t be emphasized enough how much stress negatively impacts general health and the skin.
From a disease specific standpoint. Studies have shown patients with psoriasis were noted to have a decrease in thick scale with regular sauna use. That doesn’t mean they had less psoriasis plaques, but the plaques that they did have had less scale in comparison. That being said, sauna alone would not be a sufficient treatment for psoriasis but may be something to consider in addition to traditional treatment. It is generally thought that sauna use may worsen or aggravate patients with atopic dermatitis or eczema due to the heat. I have heard contradicting statements in regards to this amongst various patients. It seems as though some of the evidence points towards a hydrating effect of sauna use where others have stated the heat causes flares of itchiness. Every individual is different in response, therefore, I think it is fair for patients with eczema to do a trial with regular sauna or steam room use and gauge how it affects their own individual skin. A lot of medicine has been trial and error, therefore I am a big advocate of trying things at an individual level. This leads to a very important point which applies to everyone but especially patients with eczema: immediately after rinsing off following sauna/steam room/cold bath use, moisturize all over with a cream based moisturizer to trap the hydration into your skin. This should be a vital step in everyone’s routine who engages in these practices. Few skin conditions should be noted to avoid or limit sauna/steam room use. These include patients with cholinergic urticaria, rosacea, or open/healing wounds. In that same token, patients with cold-induced urticaria or autoimmune conditions should stay away from ice baths/cold showers/etc. This discussion was just the tip of the iceberg in regards to these topics, so I’m sure we’ll be diving into this cold bath again soon.
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