Atlas›Domain XII · Complementary, energy & biofield›Guide 150
Guide XII-150

Whole-body cryotherapy

A 26 · L 61 · M 1312 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: whole-body cryotherapy (WBC) as the US FDA described it in its July 2016 consumer update, and as "whole-body cryostimulation" is defined by the WBC Working Group of the International Institute of Refrigeration (IIR) in its 2025 contraindications position paper and the 2023 international-consortium scoping review (Legrand et al.). This guide sets out the psychotherapist's own work alongside the method: the psychotherapist does not perform, sell, prescribe or recommend cryotherapy. Sections 1–3 describe the method as its own organisations and regulators publish it. Section 4 covers the therapist's own work alongside it.

What it is. WBC exposes the body briefly to extremely cold, dry air or nitrogen vapour inside a purpose-built device. The sources describe two device families, which are often confused:

  • Whole-body cryotherapy/cryostimulation (WBC) proper. The whole body, head included, enters an enclosed cryochamber cooled by refrigerated air.
  • Partial-body cryotherapy (PBC) or "cryosauna". A can-shaped, open-topped cabin into which vaporised liquid nitrogen is injected. The head stays outside. The IIR-linked authors stress that PBC is often wrongly marketed as WBC. [source: Legrand et al. 2023; Capodaglio et al. 2025; FDA 2016]

Core idea of change, as proponents state it. A short, intense cold stimulus is said to trigger physiological responses. Spas and websites claim these improve circulation and metabolism, speed workout recovery and relieve joint and body pain. According to the FDA's summary, they also promote WBC for anxiety, depression, insomnia, migraine, fibromyalgia, multiple sclerosis, arthritis, asthma, Alzheimer's disease and weight loss. [source: FDA 2016] In the European medical tradition the IIR group presents WBC as a treatment first developed for rheumatic conditions and widely used in sports medicine for muscle injury and recovery. [source: IIR news, 2025] These are the proponents' claims. No method in this guide is presented as a treatment for any physical or mental disorder.

  • Regulatory status (US), one line: the FDA states that it has not cleared or approved any WBC device for treating any medical condition. [source: FDA 2016]
  • Evidence status, one line: France's Inserm (2019, commissioned by the Direction générale de la santé) found only modest, very short-term effects in methodologically weak studies. It also found genuine safety problems, and stated that cryotherapy cannot claim to treat cancers or serious somatic disease. [source: Futura-Sciences report of Inserm 2019] The French government's 2020 answer to a parliamentary question confirms that the Direction générale de la santé commissioned the review in 2018, that the July 2019 report found real safety problems, and that it recommended reserving the technique to health professionals for medical indications. [source: Assemblée nationale QE 26013, 2020]

For cold-water immersion, cold showers and other self-administered cold practices, see Domain X (cold practices).

2. Framework

2a. The method as its organisations describe it (what a client experiences)

  • Screening. In the medical cryostimulation model, a medical assessment is described as mandatory before exposure. It includes blood pressure and skin-temperature measurement and a check against a published contraindication list. The list guides screening but does not replace clinical judgement, and combinations of subclinical risk factors also count. [source: Capodaglio et al. 2025; Legrand et al. 2023] How rigorously commercial spas screen is [uncertain: not verified].
  • Preparation. The client wears protective clothing and cold-protection equipment. Dry gloves and socks matter: an injury lawsuit alleged that wet, previously worn gloves and socks were issued. [source: Courthouse News 2013, allegations] In the European chamber model there is a pre-chamber stage before the main chamber. [source: Legrand et al. 2023]
  • Exposure. The client stands in the cryochamber, or in the cryosauna with the head outside. The protocol the sources describe includes continuous observation through a window or camera and a security door for fast exit. [source: Legrand et al. 2023] Exposure parameters are deliberately not given in this guide.
  • Course. Clients often attend repeated sessions or buy memberships. [synthesis] The IIR group states that WBC prescribed for clinical conditions should be medically driven and delivered in a clinical setting. [source: Capodaglio et al. 2025]

2b. Who practises it

  • Medical and rehabilitation settings, especially in Europe: physicians and rehabilitation teams prescribe and supervise cryostimulation. [source: IIR news 2025; Capodaglio et al. 2025]
  • Sports medicine and team settings, for recovery. [source: IIR news 2025]
  • Commercial spas, gyms and franchises, usually with non-medical operators. In the US the treatment has been described as "largely unregulated". [source: NBC News 2015; CBS News 2015]
  • Training and accreditation. The IIR group states that facility accreditation and training curricula for WBC operators remain to be addressed. No recognised operator certification route is set out. [source: Capodaglio et al. 2025]

2c. Regulation and licensing in main jurisdictions

  • United States. The FDA has cleared or approved no WBC device for medical claims. [source: FDA 2016] At the time of a 2015 death, a news report stated that the FDA had no oversight of these treatments. [source: CBS News 2015] Oversight fell instead to state business-licensing, cosmetology and occupational-safety bodies. After the 2015 death, Nevada's cosmetology board shut the spa and fined it for lacking a business licence. State regulators closed its locations for lacking workers' compensation insurance. Nevada's Division of Industrial Relations then reviewed the safety of the technology itself. [source: NBC News 2015a, 2015b] Any rules adopted later in Nevada or other states: [uncertain: not verified].
  • France and the EU. A 2022 parliamentary question described two frameworks. If a device has a medical purpose, the medical-device rules apply. Otherwise the general rules for electrical appliances apply. In both cases the general product-safety obligation of the Consumer Code applies. [source: Assemblée nationale QE 44473, 2022] As summarised in 2019, no French rule restricted operating WBC cabins to a particular profession. [source: Futura-Sciences 2019] The government's 2020 answer, however, stated that WBC cabins are medical devices (Directive 93/42/EEC, then Regulation (EU) 2017/745 from 26 May 2020), that the Public Health Code limits the technique to registered doctors and physiotherapists (masseurs-kinésithérapeutes), and that medical use by anyone else is illegal practice; it announced no new measures. [source: Assemblée nationale QE 26013, 2020] For CE marking status in other EU states: [uncertain: not verified].
  • United Kingdom, Canada, Australia: [uncertain: not verified]. Check the national medical-device regulator, consumer-protection agency and workplace-safety regulator.

2d. Phases of the psychotherapist's alongside work [synthesis]

  1. Disclosure and recording. Ask routinely and record what the client uses and where.
  2. Understanding. Explore meaning, hopes and the client's explanatory model.
  3. Informed decision. Help the client weigh what the method claims, its regulatory status and their own values.
  4. Coordination. With consent, involve the client's doctor or prescriber for medical screening questions.
  5. Monitoring and risk response, including reporting.

These phases are not separate sessions. They are woven into ongoing therapy, usually across one to three conversations, then revisited when use changes. Move to the next phase when the client's use and their reasons are clear (1 to 2), when the client can state what they expect and how they will judge it (2 to 3), and when any medical question has been identified (3 to 4). Monitoring runs throughout. [synthesis]

3. Guiding principles

  • Curious, not judgemental. Ask about cryotherapy as you would about exercise or sleep habits. Clients disclose more when they do not expect disapproval. [synthesis]
  • Never perform, sell, prescribe or recommend. Do not endorse a provider or advise for or against sessions. Your role is the client's decision process and safety, not the procedure. [synthesis]
  • Attribute claims. Phrase health claims as "the spa says…" or "the FDA states…". Do not state them as fact or dismiss them. [source: FDA 2016 for regulatory status]
  • Medical screening belongs to doctors. The published contraindication lists are medical instruments. You flag possible concerns and route them to the client's physician. You never decide eligibility yourself. [source: Capodaglio et al. 2025] [synthesis]
  • Never advise on medicines. The IIR list includes current therapy with cardiotoxic or spasmogenic drugs as a temporary contraindication. Medication questions go to the prescriber or pharmacist. [source: Capodaglio et al. 2025]
  • Mental-health contraindications concern you. The IIR panel lists several permanent contraindications in your field: conditions that prevent informed consent or following session rules, dementia, exacerbation of psychotic or affective disorders, suicidal tendency, and alcohol or substance addiction. It lists claustrophobia as a temporary, subjective contraindication. [source: Capodaglio et al. 2025] Know these, and raise them with the client and, with consent, the doctor.
  • No substitution. The FDA warns that using WBC in place of proven treatments may mean a person fails to improve or gets worse. Keep evidence-based care for anxiety, depression and insomnia in place. [source: FDA 2016]
  • Autonomy without coercion. Adults may choose lawful wellness services. Support informed choice and avoid pressure in either direction. [synthesis]
  • Safety facts are not opinions. Asphyxiation, frostbite, burns and eye injury are regulator-stated risks. Share them plainly when relevant. [source: FDA 2016]
  • No conflicts of interest. Do not hold commercial ties to cryotherapy providers or refer clients to businesses you benefit from. [synthesis]
  • Children, pregnancy and dependent adults need extra care. Pregnancy is a temporary contraindication on the IIR list. Lack of informed consent is a permanent one. [source: Capodaglio et al. 2025]

4. Intervention inventory

All interventions below are the psychotherapist's own work. Unless a source is tagged, the procedures are [synthesis], built on the regulatory and consensus facts cited in sections 1–3.

4.1 Routine, non-judgemental enquiry and recording

  • Purpose / when: To learn whether the client uses cryotherapy or other cold practices, and where. Ask at intake and when the client mentions recovery routines, pain, sleep, mood "hacks" or spa memberships. [synthesis]
  • Steps:
    1. Ask an open question that includes cold practices among other self-care activities.
    2. Ask what kind of device it is: an enclosed chamber or a cabin with the head outside. Ask about the setting: a medical clinic, sports facility or spa.
    3. Ask how often they go and since when. Ask what they pay and whether they are on a membership. Ask what the provider told them it would do.
    4. Ask whether their doctor knows about it and whether any screening was done.
    5. Record the facts neutrally in the notes, including the client's stated reasons.
  • Example language (illustrative): "Some people use things like cold plunges or cryotherapy for stress or recovery. Is anything like that part of your routine?" "What does a session look like where you go? Was there any health check beforehand?"
  • Watch for: Embarrassment or defensiveness, which suggests the client expects judgement. Use that is escalating in frequency or cost. Use started as a replacement for treatment. A client who works at a cryotherapy business (see 4.10). Working signs: the client volunteers details and returns to the topic unprompted.

4.2 Exploring meaning, hopes, expectations and the explanatory model

  • Purpose / when: To understand what draws the client. Common draws are relief, a sense of control, identity (athlete, biohacker), community at a gym or studio, celebrity or influencer endorsement, or distrust of medication. Use this once use is known, and especially when cryotherapy is tied to mood, anxiety or sleep. [synthesis]
  • Steps:
    1. Ask what they hope cryotherapy does for them, in their own words.
    2. Ask how they think it works (their explanatory model) and where that understanding came from.
    3. Ask what they notice before, during and after a session: emotionally and in their body.
    4. Link it to the formulation. Is it a coping strategy, a form of exposure to discomfort, a social ritual, avoidance of other help, or part of a body-control pattern?
    5. Reflect back the values underneath, such as wanting agency, resilience or belonging.
  • Example language (illustrative): "What is it you're hoping the cold will do for you?" "After a session, what's different in how you feel? How long does that last?" "It sounds like it gives you a sense of being in charge of your body. That matters to you."
  • Watch for: Beliefs that it will "cure" depression or anxiety, or replace medication. Pursuit of extreme sensation as self-punishment or emotion regulation through pain. Weight-loss motives: the FDA notes weight loss among the marketed claims. [source: FDA 2016] Working signs: the client can distinguish what they feel from what was claimed.

4.3 Sharing regulatory and safety information (attributed, on request or when relevant)

  • Purpose / when: To fill information gaps, such as a belief that it is "FDA-approved", without debating the client. The FDA itself noted that consumers may wrongly believe WBC devices are cleared for medical treatment. [source: FDA 2016] Use this when the client asks, or when a misunderstanding affects a decision.
  • Steps:
    1. Ask permission to share information.
    2. State the source and the fact: the FDA says it has cleared no WBC device for any medical condition. It lists asphyxiation (especially with liquid nitrogen), frostbite, burns and eye injury as risks. [source: FDA 2016]
    3. Note the evidence status in one line: the French national review found modest, very short-term effects in weak studies. [source: Futura-Sciences 2019]
    4. Ask what the client makes of it. Do not draw the conclusion for them.
  • Example language (illustrative): "Would it be useful if I told you what the FDA has said about these devices?" "The FDA's position is that no cryotherapy chamber has been cleared to treat medical conditions. How does that fit with what you were told?"
  • Watch for: Feeling lectured, which leads to withdrawal; repair as in 5.5. Do not give a verdict on whether the client should go. Working signs: the client asks further questions or plans to ask their doctor.

4.4 Supporting an informed, values-based decision

  • Purpose / when: When a client is deciding whether to start, continue or stop, or is weighing cryotherapy against another treatment. No published decision aid specific to WBC is cited here. The steps below are general shared-decision-making practice. [synthesis]
  • Steps:
    1. Clarify the decision and the options, including doing nothing differently.
    2. Elicit what matters most to them: cost, time, safety, hoped-for benefit, the social side.
    3. Separate known facts (regulatory status, stated risks) from claims and from personal experience.
    4. Identify what the client needs to know from their doctor, such as whether any listed medical contraindication applies.
    5. Summarise and let the client decide. Record that the decision was theirs.
  • Example language (illustrative): "Let's lay out what you know, what you've been told, and what you'd still want to find out." "Whatever you decide, I'd like it to be a decision that fits what you care about."
  • Watch for: Pressure from a gym, team, partner or influencer. The client seeking your permission or endorsement; decline gently and return the decision to them. Working signs: the client can state reasons in their own terms.

4.5 Flagging mental-health contraindications

  • Purpose / when: The IIR consensus lists conditions in the psychotherapist's own field as contraindications. You are often the professional best placed to notice them. Use this when a client with any of the following uses, or plans to use, WBC: suicidal tendency, an exacerbation of a psychotic or affective disorder, alcohol or substance addiction, dementia or impaired capacity to consent or follow session rules (permanent contraindications), or claustrophobia (temporary and subjective, which may be managed after counselling and under supervision). [source: Capodaglio et al. 2025]
  • Steps:
    1. Tell the client, neutrally, that the European expert consensus lists their condition among reasons for medical review before cryostimulation.
    2. Encourage full disclosure to the screening doctor or provider.
    3. With consent, inform the treating physician or psychiatrist (see 4.6).
    4. With suicidal clients, fold this into the ongoing risk assessment and safety plan. Explore whether extreme-cold exposure has a self-harm meaning, following standard risk-assessment practice.
    5. Document the conversation and the client's response.
  • Example language (illustrative): "An international expert group on cryostimulation lists severe low mood with suicidal thoughts as a reason not to go ahead without medical review. Would you be willing to mention it to whoever screens you, or let me talk with your GP?"
  • Watch for: Concealment from providers. Cold exposure as self-punishment or risk-taking. Mania or psychosis driving escalating use. Working signs: disclosure to the doctor, a revised plan, and use folded into the safety plan.

4.6 Coordinating with the client's doctor or pharmacist (with consent)

  • Purpose / when: Medical screening, medication questions and new physical symptoms belong to the medical team. The FDA advises consumers to talk to their doctor before trying WBC or if already using it. [source: FDA 2016] The IIR consensus treats screening as mandatory, and its list covers cardiovascular, respiratory, endocrine, immunological, oncological, neurological, dermatological and ophthalmological conditions, as well as certain drug therapies. [source: Capodaglio et al. 2025]
  • Steps:
    1. Obtain explicit, specific consent for what you will share and with whom.
    2. Share only what is needed: that the client uses or plans to use cryotherapy, the type of device and setting, and any psychiatric contraindication you know of.
    3. Ask the doctor to review medical suitability and medications. Never comment on medicines yourself.
    4. Record the contact and outcome.
  • Example language (illustrative): "I'm not the right person to say whether this is safe with your heart condition or your medication. Your GP or pharmacist is. Shall we write down the questions to take to them?"
  • Watch for: A client who refuses all medical contact. Respect their autonomy, but record your advice and revisit it. Working signs: the client reports a medical review took place.

4.7 Responding to substitution for effective treatment

  • Purpose / when: The FDA warns that people who use WBC instead of proven treatments may fail to improve or may get worse. [source: FDA 2016] Use this when a client stops or delays evidence-based care for depression, anxiety, insomnia or a physical illness in favour of cryotherapy.
  • Steps:
    1. Notice and name the change without blame.
    2. Explore the reasons: side effects, cost, stigma, hope, persuasion.
    3. Separate the two decisions. Using cryotherapy does not require stopping other treatment.
    4. Route any medication change to the prescriber. Never advise starting, stopping or changing medication.
    5. Monitor symptoms with your usual measures and review them together.
  • Example language (illustrative): "You've been going to cryo more and you've stopped seeing your psychiatrist. Can we look at how that came about?" "Could cryo be something you do as well as, rather than instead of?"
  • Watch for: Worsening mood or relapse. Withdrawal symptoms after an abrupt medication stop; route these to medical care. With physical disease, liaise with the medical team. Working signs: the client re-engages with the prescriber.

4.8 Eating-disorder, body-image and compulsive-exercise screening

  • Purpose / when: Weight loss and "metabolism" are among the marketed claims. [source: FDA 2016] Use this when a client links cryotherapy to weight, shape, calorie burning or punishing exercise regimes. [synthesis]
  • Steps:
    1. Ask about weight, shape and eating concerns using your service's validated screening approach.
    2. Explore whether cold exposure functions as compensation or punishment.
    3. If an eating disorder is suspected, refer for medical assessment and follow eating-disorder pathways.
  • Example language (illustrative): "When you think about cryo and your body, is weight or burning calories part of it?"
  • Watch for: Restriction, compensatory behaviour, exercise compulsion. Note that the IIR list includes cachexia and electrolyte abnormalities among temporary contraindications. [source: Capodaglio et al. 2025] Working signs: the client discusses body-image concerns openly.

4.9 Health anxiety and somatic symptom presentations

  • Purpose / when: When a client's cryotherapy use is driven by health anxiety or persistent physical symptoms. Examples: repeated "boosting" to ward off illness, or chasing relief from somatic distress. Use established CBT approaches for health anxiety and somatic symptom disorder; see Domain II. [synthesis]
  • Steps:
    1. Formulate the role of cryotherapy: reassurance-seeking, safety behaviour or symptom checking.
    2. Work on health anxiety directly with the Domain II approaches, and agree experiments with the client.
    3. Keep medical review of new symptoms separate from anxiety work.
  • Example language (illustrative): "If you missed a session, what do you fear would happen?"
  • Watch for: Escalating frequency and distress when sessions are missed. Working signs: less urgency, flexible use.

4.10 Recognising and responding to acute risk and harm

  • Purpose / when: When a client describes symptoms after a session, or unsafe conditions at a facility. This includes clients who work at one.
  • Steps:
    1. Treat as medical and urgent: blistering, skin discolouration or pain after a session (possible cold burn or frostbite), sudden severe headache, neurological symptoms, confusion or memory loss, chest or abdominal pain. Direct the client to emergency or urgent medical care. Serious events reported after WBC include intracerebral haemorrhage, abdominal aortic dissection, transient global amnesia and an acute cerebrovascular event. [source: Legrand et al. 2023] Cold burns are documented, including one from a device malfunction. [source: MDedge 2019 report of JAAD Case Reports]
    2. Treat unsafe practice as a safety issue: someone using a nitrogen device alone or after hours, without an attendant, or with wet clothing. The FDA lists asphyxiation as a particular risk with liquid nitrogen. [source: FDA 2016] See the Harm account.
    3. Children: WBC is not cleared for any medical use. If you learn that a child is being exposed in unsafe conditions or kept from medical care, follow safeguarding procedures. Consent and assent concerns apply. [synthesis]
    4. Pregnancy is a temporary contraindication on the IIR list. Encourage a pregnant client to talk to her maternity care provider. [source: Capodaglio et al. 2025]
    5. Financial risk: look out for escalating memberships, debt and franchise or investment pressure. Explore these as you would any financial-harm risk. [synthesis]
  • Example language (illustrative): "Blistering after a session needs a doctor today. Can we sort out how you'll get seen?" "You mentioned staff use the chamber alone after closing. That worries me for their safety."
  • Watch for: Minimising injuries, shame, fear of losing a job. Working signs: the client obtains care and the conditions are reported.

4.11 Reporting routes

  • Purpose / when: After an injury, a misleading medical claim or unsafe workplace conditions. [synthesis]
  • Steps: Help the client decide whether and where to report. Reporting is usually the client's decision unless safeguarding duties apply.
    • US: the FDA's MedWatch programme, which takes voluntary reports from consumers, patients and health professionals on serious reactions and product problems with devices and other products, online, on Form FDA 3500B or by phone [source: FDA, Reporting Serious Problems to FDA]; the FTC for deceptive health advertising [uncertain: not verified]; state cosmetology or business-licensing boards; and the state occupational-safety agency for worker hazards. Nevada's cosmetology board and OSHA acted in 2015. [source: NBC News 2015]
    • France: the general product-safety framework applies. [source: Assemblée nationale QE 44473, 2022] For the reporting authority: [uncertain: not verified].
    • UK and elsewhere: the national medical-device regulator, the advertising regulator and the workplace-safety regulator. [uncertain: not verified]
    • Safeguarding authorities for children and adults at risk.
  • Example language (illustrative): "Would you like help working out who to tell about what happened? You decide whether to report it."
  • Watch for: Fear of retaliation, especially for employees. Working signs: the client makes an informed choice about reporting.

4.12 Supporting clients after injury or bereavement

  • Purpose / when: For clients injured in a session, and for family members or co-workers after a death. [synthesis]
  • Steps: Assess trauma symptoms, guilt ("I recommended it"), anger and grief. Offer evidence-based trauma or grief work. Support practical steps (medical, legal, reporting) without giving legal advice.
  • Example language (illustrative): "It makes sense that you keep going over it. Can we make room for what this has been like for you?"
  • Watch for: Complicated grief, PTSD symptoms, self-blame. Working signs: less intrusive rumination and re-engagement with daily life.

5. Handling problems

The sources do not address the therapist's alongside role. All guidance in this section is [synthesis] unless tagged.

  • Client becomes defensive ("you think it's nonsense"). Name your stance: you are not for or against it, and you want to understand it and keep them safe. Return to their hopes (4.2). Example (illustrative): "I'm not here to talk you out of it. I'm interested in what it does for you."
  • Client wants your endorsement or a provider recommendation. Decline warmly. Explain that you do not recommend or sell health products or services, and redirect to their doctor for medical suitability.
  • Client conceals use from the screening provider or doctor. Explore the fear of being refused or judged. Explain that screening exists because of documented serious reactions. [source: Legrand et al. 2023; Capodaglio et al. 2025] Respect the decision, record your advice, and revisit it.
  • Escalating, compulsive or self-punishing use. Formulate the function: emotion regulation through intense sensation, numbing, self-punishment, or body control. Work on the underlying pattern with the treatment for that presentation. Screen for self-harm and eating disorders (4.5, 4.8).
  • Stopping evidence-based treatment. Use 4.7. Do not turn sessions into a debate. Keep monitoring with routine outcome measures and share the data with the client.
  • Overwhelm or panic connected to the chamber. Claustrophobia is a recognised subjective contraindication. [source: Capodaglio et al. 2025] Do not set cryotherapy as an exposure task. If the client wants to work on claustrophobia, use standard exposure therapy for claustrophobia in its own right, with its usual consent and safety steps.
  • Rupture after sharing regulatory information. Acknowledge it ("I may have come across as preachy"). Ask what landed badly. Re-centre on the client's goals.
  • Group, team or employer pressure. This includes sports teams, gyms and workplaces that expect participation. Explore the client's freedom to decline and help them rehearse saying no. For athletes under team pressure, consider, with consent, involving team medical staff.
  • Financial pressure. Look for prepaid packages, memberships, franchise or investment pitches, or marketing in which customers recruit other customers. Explore costs against the client's values and budget. Signpost consumer-protection advice.
  • Client is an employee at a cryotherapy business. Explore workplace safety, including lone working and after-hours use, and the client's worker rights. Signpost the occupational-safety regulator. See the Harm account.
  • Therapist's own conflicts. Do not refer clients to businesses you have ties to, and do not promote cold practices you personally favour. Seek supervision if your own enthusiasm or scepticism is shaping sessions.

Harm account

What was actually done

  • Death in a nitrogen chamber, Las Vegas area, Nevada, October 2015. A 24-year-old woman managed a spa (Rejuvenice) that operated liquid-nitrogen cryotherapy chambers. She was found dead inside one of the chambers on 20 October 2015. [source: NBC News 2015b] Security video showed her locking the salon the night before. She had reportedly gone into the chamber alone, after hours, without assistance. A co-worker found her the next day. [source: NBC News 2015b; Fox News 2015] Investigators said she should not have been using the chamber after hours for personal use. [source: NBC News 2015b] The device's maker was reported as Juka; it did not respond to requests for comment. [source: CBS News 2015] She is not named here.
  • Frozen-arm injury lawsuit, Dallas, Texas. In a lawsuit reported in 2013, a woman alleged that a 2011 session at a whole-body cryotherapy business (named in the suit as Cryousa) left her arm frozen. She said she was issued wet gloves and socks that others had worn. She alleged that she then needed burn-unit treatment for third-degree burns and has lasting tissue and nerve damage. These are allegations reported from the complaint. [source: Courthouse News 2013]
  • Cold burn from a device malfunction, Philadelphia. A 71-year-old man developed stinging, redness and blistering the day after a session. The likely cause was a nozzle malfunction that let liquid nitrogen touch his skin. He was treated with medicines including corticosteroids and a burn cream. [source: MDedge report of O'Connor et al., JAAD Case Reports 2019]
  • Serious medical events in clinical reports. A 2023 international scoping review identified 16 adverse events. The serious ones were intracerebral haemorrhage during a first session in a woman with a history of ocular migraine, abdominal aortic dissection in a man with hypertension, transient global amnesia, and a near-occlusion of an internal carotid artery during a first session in a healthy young woman. [source: Legrand et al. 2023]
  • France. The 2019 Inserm review described burns, headaches and chronic cold urticaria among reported adverse effects. [source: Futura-Sciences 2019] A 2022 parliamentary question referred to numerous accidents, apparently increasing, especially in non-medical use. [source: Assemblée nationale QE 44473, 2022]

How it caused harm

  • Asphyxiation. Liquid nitrogen can displace oxygen, producing low oxygen levels, hypoxia and loss of consciousness. [source: FDA 2016] In the 2015 death, the Clark County coroner ruled that the cause was asphyxia, with unconsciousness followed by death. Oxygen levels were reported to have dropped to a small fraction of normal. [source: Fox News 2015] Lone use meant no one could raise the alarm or help her out.
  • Frostbite and cold burns. These come from direct contact with nitrogen (for example a malfunctioning nozzle), from wet clothing or gloves, and from exposure beyond safe limits. [source: FDA 2016; MDedge 2019; Courthouse News 2013]
  • Cardiovascular and cerebrovascular stress. The cold triggers abrupt rises in blood pressure and vascular responses. The serious events cluster in people with hypertension, migraine or vascular risk factors. This is why the consensus contraindication lists include uncontrolled hypertension and chronic migraine. [source: Legrand et al. 2023; Capodaglio et al. 2025]
  • Eye injury. The FDA lists this as a risk. [source: FDA 2016]
  • Indirect harm. Using WBC instead of proven treatment may mean a person fails to improve or gets worse. [source: FDA 2016]
  • Systemic contributors. The spa was unlicensed for its services. Its locations were closed for lacking workers' compensation insurance, and it was fined by the cosmetology board. The treatment was largely unregulated, and federal oversight was absent. [source: NBC News 2015b; CBS News 2015]
  • Most at risk: people using nitrogen devices alone; people with cardiovascular, cerebrovascular, cold-related immune or other listed conditions who are not medically screened; people wearing damp clothing; and workers who have access after hours. Underreporting is likely. [source: Legrand et al. 2023; Capodaglio et al. 2025]

Recognising it today

  • Marketing red flags: claims to treat depression, anxiety, insomnia, chronic disease, arthritis or weight problems; calling the device "FDA-approved" for medical use (the FDA says none is cleared for these claims); celebrity or athlete endorsement in place of evidence. [source: FDA 2016]
  • Operational red flags:
    • no health screening, or only a waiver in place of medical screening;
    • no attendant watching throughout;
    • nitrogen cabins used alone, after hours or by staff for personal use;
    • damp or shared gloves and socks;
    • no visible means of fast exit;
    • a business that cannot show local licences;
    • a "WBC" that is in fact a nitrogen cryosauna with the head outside. [source: NBC News 2015b; Courthouse News 2013; Legrand et al. 2023] [synthesis for the list]
  • How the medical version differs: in the European medical model, a physician prescribes cryostimulation after mandatory screening against a published contraindication list (including psychiatric items). It is delivered in a clinical setting with continuous monitoring and a fast exit. [source: Capodaglio et al. 2025; Legrand et al. 2023]
  • In a colleague's practice: a therapist who recommends or sells cryotherapy, refers clients to a business they are tied to, or frames it as treatment for mental disorders. [synthesis]

What to do instead and how to help those harmed

  • Instead: for the mental-health aims that are marketed (anxiety, depression, insomnia), the client continues or begins evidence-based psychological and medical care. Physical complaints go to the client's doctor. Clients who still choose cryotherapy are encouraged to tell their doctor and get screened, as the FDA advises. [source: FDA 2016] For self-administered cold practices, see Domain X.
  • Assessment of affected clients: physical injury always goes to medical care first. Then assess for trauma symptoms, health anxiety, chronic pain, and grief and guilt in families and co-workers (4.12).
  • Ethical duties: never perform, sell or recommend the procedure. Avoid conflicts of interest. Document advice and consent to share information. [synthesis]
  • Reporting and legal:
    • Support reporting to device, consumer and licensing regulators and to occupational-safety agencies (4.11).
    • Safeguarding duties apply to children and adults at risk.
    • Refer to legal advice for compensation questions; do not give legal opinions. [synthesis]

Sources

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