Does Cold Water Therapy Help Psoriasis? I Tried It to Find Out

By Claire Gillespie
Reviewed by Allison Truong, M.D.
March 11, 2021

I hate being cold. There are three blankets on our sofa… and they’re all mine. My husband and I fight constantly over the heating—I hike it up, he cranks it down. Give me the choice between a beach vacation, and a ski resort and I’ll be on the sand before you can say, “How hot is it?”

Basically, I’m the last person anybody would expect to take a cold water challenge. But I’ve done it. Or, rather, I’m doing it—cold water therapy is now just another part of my daily routine, like brushing my teeth or putting on SPF sunscreen.

Stories of using cold water for health and well‑being go way back to ancient Greek and Roman times. Ivi, the Greek goddess of youth, bathed in the curative waters of Patras. Hercules, the Roman god of strength and heroes, was known to bathe to regain strength after every feat. And don’t forget Jesus’s full-body baptism in the River Jordan. By the 17th century, cold-water bathing was used as a treatment for everything from bronchitis and constipation to nightmares and so-called “female complaints.”

But in modern times, cold water has only really been taken seriously as a therapeutic option in recent years. People are starting to practice it through adaptations like ice baths, daily cold showers, outdoor swims, and cold water immersion therapy. Research is starting to suggest that spending time in cold water could help with weight loss and depression, make people better able to deal with stress, lower the incidence and severity of colds during winter, and improve exercise performance.

On a cosmetic level, cold water tightens the pores and flattens hair follicles, making a final shower rinse with cold water good for the skin and the hair.

But it’s the association between cold water and inflammation that really interests me. I’ve had psoriasis for 25 years, and after stopping steroid use a few years ago, I’ve been laser-focused on what I can do to reduce inflammation in my body, rather than just treating my symptoms.

I also have depression—according to research, up to 25 percent of people with psoriasis do—and was fascinated by an episode of the BBC documentary The Doctor Who Gave Up Drugs. A young woman with depression alternated between a cold adaptation program one day and a swim in a lake the next. She’d been taking antidepressants for eight years; within four months, she was off them and managing her symptoms with regular lake swims. I wasn’t expecting a miracle cure, but I figured cold water couldn’t hurt and was worth a shot. It was exciting to try something that came with a guarantee of no side effects.

As with many “alternative” health therapies, research on the impact of cold water therapy on inflammation is conflicting, but the anecdotal evidence is strong. I decided it was time to try it for myself.

Google “cold water challenge” and you’ll get various different options. They’re all basically the same thing: You train your body (and mind) to withstand increasing periods of time in cold water. I decided to put my faith in a 61-year-old Dutch man who loves to sit, lie, do yoga, and chant in arctic conditions wearing nothing but Speedos. (He’s named Wim Hof, and he’s pretty amazing.)

Hof’s 20-day cold shower challenge is ideal for cold-fearing folks like me. There are increasing difficulty levels, from beginner to “Hoffer.” I went for the beginner level—I didn’t want to set myself up for failure from the outset.

At the beginner level, you start on day one with a 15-second cold shower and do that for a week. In week two, you increase it to 30 seconds. By week three, the goal is 45 seconds under the cold blast. The idea is that by week four, you’re able to endure a full minute under a cold shower. Hof recommends starting with a warm shower and turning the water cold at the end, doing this at least five times a week.

Day 1

I’m not going to lie—I wasn’t looking forward to this. Getting into cold water triggers a type of stress response that’s significant even at 68 degrees Fahrenheit (this temperature feels cold to most people, but not painfully so). It leads to increased heart rate and blood pressure, the release of stress hormones, and maybe hyperventilation in some people. Definitely not my ideal way to start the day.

Or so I thought. It wasn’t as bad as I thought—let’s face it, 15 seconds isn’t long, and by the time I’d got over the initial shock, my timer had gone off. And I don’t know if it was actually the purported therapeutic benefits of the cold water itself or just the sense of achievement, but I felt pretty energized for the rest of the day.

Day 3

The biggest surprise of this challenge was how quickly I became accustomed to the cold water at the end of my shower. After a few days, I realized that it was easier if my shower was warm to begin with, rather than hot. I found that if the water was lukewarm, I could take it even colder at the end.

According to scientists, as few as four immersions in cold water may diminish the stress response. This is important because, while we need to be able to react this way to certain situations where we’re genuinely in danger, what we really want is to avoid overreacting to the plethora of minor menaces that curse our days: traffic, Wi-Fi going down, a ripped grocery bag, and the like. By reducing our stress response, cold water helps us control our heart rate and blood pressure when things get tough or frustrating.

Day 8

The unthinkable has happened. I’m looking forward to my morning blast of cold water. I’m now on 30 seconds, and it’s just become part of my routine. By now, I believe there’s a real connection between my cold blast and improved energy levels—even on the days I wake up feeling groggy or unmotivated. I can’t say it’s made a difference to my psoriasis, but the skin on my face definitely seems a little brighter, and I haven’t made any other changes to my skincare regimen.

Day 17

By week three, my 45-second cold shower was doing good things. I felt less stressed in general, my skin had a definite glow, and my hair looked pretty shiny, too. I hadn’t noticed any huge changes to my overall health, but I wasn’t supposed to expect to after only 17 days. One morning, I turned the shower on after my husband had taken a scorching one, and it felt… wrong. Super-hot showers definitely don’t appeal to me at all any more.

Day 20

I’m at the end of the challenge, but not the end of my cold-shower habit. It’s still too early to say whether it will improve my circulation or boost my immunity (and I’m not in the market for weight loss or improved exercise performance), but I think—I think—the stubborn psoriasis plaques on my upper arms and the backs of my hands have faded. I’ll never know whether this is due to cold showers or one of the multiple other tools I have in my psoriasis management kit, but does it really matter? I plan to keep doing them all, with an open mind.

Important note: Due to lack of evidence-based data on cold water immersion and psoriasis, this regimen should not replace one’s current medications. Any initiation or discontinuation of treatments should be under physician guidance. This story is a personal anecdote of one person’s journey, and since each individual is different, your personal experience may be different from theirs. Certain conditions, such as cold urticaria may put patients at risk with extreme cold temperatures, and thus, adjunctive therapies like cold water immersion should only be attempted under physician supervision.