Dermatologists frequently use cold, called cryotherapy, in the form of liquid nitrogen and dry ice to treat acne lesions. Doctors also use cold to treat a variety of other skin conditions, such as cancerous and precancerous lesions. If you’ve ever sprained your ankle, you also know that ice can help with soft tissue injuries as well.
Let's look at the science supporting the use of cold in medicine and then look at how you can use the ice in your freezer to help with acne as well.
Doctors recommend cold as a treatment primarily based on common sense and clinical experience rather than on scientific evidence, since not many studies have evaluated whether cryotherapy is effective or not. A 2008 study in Emergency Medicine Journal notes the results of a survey given to physicians regarding cryotherapy:
“A recent personal survey of Irish emergency physician practice indicated that 73% of consultants ‘always or frequently’ advocate the use of ice while only 7% ‘never’ use cryotherapy; 30% were ‘unsure’ if ice therapy is beneficial. Experience (47%) and common sense (27%) were the reasons most frequently cited for using ice, while 17% used scientific reasoning.”1
In other words, doctors continue to use cryotherapy because they experience it working on their patients.
What we can learn from cryotherapy for soft-tissue injuries: Scientists have performed several studies on the use of cold with soft-tissue injuries of the muscles, ligaments, and tendons. Based on what we learn from these studies, we can infer how cold might be of use in acne. Of the few existing studies that examine the use of ice or a cooling solution to treat soft-tissue injuries, some provide evidence that supports cryotherapy as an effective treatment, and some are inconclusive or show no benefit. But again, remember, doctors continue using and recommending cryotherapy because they see it working on their patients. This real-world, first-person experience is sometimes more reliable than the data from a limited amount of studies. However, to be thorough, let's look at the data from studies on cryotherapy for soft-tissue injuries:
According to a 2006 study in The American Journal of Sports Medicine, treating muscle injury in rats with a cooling solution reduced swelling, inflammation, and tissue damage.2 The solution in this study was a saline (salt water) solution at 8 degrees Celsius (46 degrees Fahrenheit) that was applied continuously for 6 hours to the skin over an injured muscle.
Several studies included in a 2007 literature review in the Journal of Periodontology indicated that applying ice after an injury slowed down cell metabolism and reduced blood flow, swelling, and pain and ultimately resulted in faster recovery.3
A 2008 review in Emergency Medicine Journal, which evaluated several studies that were performed on both humans and animals, found conflicting results:
- Of two clinical trials, “one [showed] supportive evidence for the use of a cooling gel and the other [did not reach] statistical significance.”
- Four animal studies demonstrated that “modest cooling reduced [swelling] but excessive or prolonged cooling is damaging.”
- Of two systematic reviews, “one…was inconclusive and the other suggested that ice may hasten return to participation [in activities].”
- Of all the studies reviewed, the authors noted, “Only one clinical trial, involving 74 patients, showed a definite benefit of cold therapy in reducing pain and disability. The animal studies do show reduced [swelling], but it is not yet known if that corresponds to faster clinical recovery.”1
From what we can assess based on the available evidence regarding soft-tissue injuries, cold appears to perform some beneficial functions, especially when applied in a correct manner.
Cryotherapy for Acne: There is only one study regarding how reducing skin temperature might help heal acne, but it shows that reducing temperature may in fact help reduce skin oil and thus reduce acne:
A 2015 study in the Journal of Investigative Dermatology applied extreme cold to the skin of both mice and humans to determine whether cryotherapy can help treat acne or not. The treatment cooled an area of skin to −10 degrees Celsius (14 degrees Fahrenheit) for 20 minutes or −15 degrees Celsius (5 degrees Fahrenheit) for two cycles of 10 minutes. This study found that the cold treatment reduced the production of sebum (skin oil), which in turn reduced acne lesions. The authors noted, “In humans, cooling to −10 or −15 °C for 20 minutes resulted in an approximate 20% suppression of sebum output that persisted for over 2 weeks.”4
It is impossible to cool the skin to these low temperatures at home using ice, and we wouldn't want to do that anyway because it could cause prolonged redness and skin damage unless properly supervised, but this study at least gives us a hint at how cold might work in reducing sebum production, which could help with acne.
Cryosurgery in the Treatment of Acne
Doctors frequently use cold in the form of a procedure called cryosurgery to treat acne. Cryosurgery uses extreme cold (liquid nitrogen or dry ice) to freeze an acne lesion for just a few seconds. This destroys the damaged cells within the lesion that cause redness and inflammation and promotes rapid healing of the lesion. Cryosurgery is an effective treatment for inflammatory acne lesions, including severe nodules and cysts, and is used sometimes even to treat acne scars.5
A 1999 study in the Australasian Journal of Dermatology noted that when using cryosurgery, “Papulopustular lesions require a 2–5 [second] single treatment, depending on their size. Acne cysts need a longer freeze time of 5–10 [seconds] and periodic treatment.”5
Again, it would be dangerous to use liquid nitrogen or dry ice at home in this manner, but since doctors commonly use the procedure and see results from it on their acne patients, we can see evidence mounting that cold can in fact help with acne.
Ice for Acne
As we have seen thus far, hard science tells us that cold is likely beneficial for soft-tissue injuries, and from the limited amount of evidence on the successful use of cold with acne, we can see it may also help with acne. This hard science, combined with decades of successful use of cryotherapy in dermatologist offices, leads us to deduce that cold in the form of simple, everyday ice may help acne as well.
Cold causes several physiological changes that result in reduced:
- Blood flow
- Metabolic speed (cells slow down their usual processes)
All of these physiological changes can be helpful in managing acne.
Ice and Acne How-To:
Spot treatment: This works best when you catch a pimple as it is first emerging. However, it can also help manage the pain and inflammation resulting from a full-fledged pimple. Place a single ice cube into a Ziploc®-type bag and gently hold it over the area to be treated for 5 minutes, twice a day. You may be surprised at how well this works, especially when you catch a pimple in its early stages.
Treating the entire face: This is a way you can help manage acne in an all-over fashion on a daily basis. Fill a Styrofoam cup with water and freeze it. Peel away the top ½ inch of Styrofoam and very gently move the ice around your entire face for 5–10 minutes. Remember to stay gentle because physical irritation can aggravate acne. Just very gently move the ice around without "smashing" it into your skin. You may do this up to twice per day, but even once a day may produce noticeable results. Note: When it comes to acne, it is important to avoid over-washing your skin. You should never wash more than twice per day. Since treating your entire face with ice like this gets your skin wet and is tantamount to washing your skin, treat the entire face with ice immediately before performing your morning and/or evening acne treatment regimen.