Sitting in an ice bath for three minutes a day, five days a week, is an unconventional treatment that the no-nonsense Holby City character, Dr Jac Naylor, is unlikely to have endorsed.
But actress Rosie Marcel, who played the heart surgeon in the popular BBC drama for 16 years, is a devotee of the freezing dips to tackle the pain caused by her rare autoimmune condition.
‘I go numb when I’m in the ice bath – but you quickly get used to it,’ says Rosie, 46, who lives in Hertfordshire with her husband, Ben, 41, who owns a gym, and their daughter, Beau, eight.
‘When I get out of the ice bath my skin’s bright red. But then the endorphins and dopamine kick in – and I feel incredible.’
Rosie takes ice baths to ease the symptoms of Behcet’s disease, an agonising immune condition that causes painful red lumps all over the body.
Actress Rosie Marcel, who played the heart surgeon in Holby City for 16 years, takes ice baths to tackle the pain caused by her rare autoimmune condition
Behcet’s syndrome, as it’s also known, is caused by an over-reaction of the immune system, thought to be due to a combination of genetic, immune and environmental factors. As well as swollen lumps, symptoms can include painful mouth and genital ulcers, stiff and painful joints, eye inflammation (resulting in red eyes and blurred vision) and hypersensitive skin.
Treatments include steroids, immunosuppressants and biologic drugs (made from human or animal proteins, which reduce inflammation), to ease symptoms.
In Rosie’s case it causes outbreaks of ‘painful hard, red lumps’ all over her legs, ‘ranging in size from a 5p piece to a tennis ball’ as well as ‘loads of mouth ulcers’.
First diagnosed with the condition in her 20s, she had been taking immuno- suppressants for nearly 20 years, but with side-effects such as an increased risk of infections (Rosie says she was constantly ill), she decided to try out ice baths after reading about the potential benefits on social media.
Traditionally used for centuries in Scandinavia and Russia for their ‘healing’ properties, ice baths have become a social media trend, popularised by Wim Hof, an endurance athlete who once held the Guinness world record for swimming under ice.
Hof argues that cold water and deep breathing can bring a host of benefits, including speeding up metabolism to boost weight loss.
Rosie takes ice baths to ease the symptoms of Behcet’s disease, an agonising immune condition that causes painful red lumps all over the body
Ice baths – literally bathtubs full of icy water ranging from 0c to 15c – are available in gyms and spas, but can also be bought for home use. Some people resort to filling wheelie bins with ice, according to social media sites.
But while ice-bathing may promote feelings of elation and wellbeing, can it really benefit your health? And what about the risks?
The scientific evidence for their benefits is far from conclusive.
Certainly, when it comes to muscle recovery, the case is stronger, and elite athletes such as runners and footballers have long used cold-water immersion therapy (including ice baths and cold-water swimming) after intense training sessions – it helps ease muscle inflammation.
A review of 17 trials (in which the water temperature was 15c or lower) by the prestigious Cochrane group concluded that the practice did reduce muscle soreness — but said more research was needed as to its safety.
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Pharmacist Ben Merriman says: ‘When the balance of fungal cells which naturally live on our skin is upset – for example, when our feet get too hot and moist over a sustained period – it creates the perfect environment for fungi to grow, causing athlete’s foot (symptoms include itchiness, especially between the toes, and flakiness or softening of the skin). There are two main medical treatments: antifungals made with azoles (such as clotrimazole) or terbinafine. They work slightly differently but ultimately stop the fungal cells growing.
‘Any cream alone will not work without good foot hygiene: this means drying feet properly, wearing non-synthetic socks and keeping toenails short to reduce risk of infection. Both products here contain clotrimazole – I’d be happy using either, though the generic version is better value for money.’
Another, more recent, review published last year in the journal Sports Medicine, found cold-water immersion therapy was effective after high-intensity interval training (HIIT) among people deemed physically active or involved in sport. Those using it reported better muscle power and less soreness 24 hours after exercising than those who just rested. Researchers noted that colder temperatures after HIIT might be more effective at removing the enzyme creatine kinase, a marker of inflammation.
Beyond muscle repair, a 2022 review of 194 studies of cold-water swimmers, ice swimmers and ice-bath users found they experienced a range of health benefits including potential weight loss, reduction of blood fats and better control of blood sugar levels.
The researchers suggested one reason for this might be because cold water activates the body’s stores of ‘good’ brown fat, which burns energy in the form of fat to keep the body warm, and helps regulate blood sugar and fat metabolism. (By contrast, white fat, which makes up the greatest proportion of fat in your body, stores energy as fat.)
One of the review’s authors, Professor James Mercer from the University of the Arctic Circle in Troms, Norway, told Good Health that it was hard to draw definite conclusions as there was so much variability between the studies.
Although the people he meets who use cold-water therapy all ‘swear by’ its benefits, he adds: ‘The jury is still out in terms of the science behind cold-water immersion and more high-quality research studies are needed’.
Any health benefits may stem from the body’s response to the cold, explains Dr Mark Harper, a consultant anaesthetist at Brighton and Sussex NHS Trust, and the author of Chill: The Cold Water Swim Cure.
He says: ‘What happens initially is that your body tries to protect itself against the cold, so all the blood vessels supplying the skin, close up, and the body instead concentrates on providing warm blood to the vital organs.’
He adds that inflammation levels drop over time as the body adapts to cold-water immersion therapy.
Separately, cold-water swimming is being trialled as a potential treatment for depression.
Led by Dr Harper, the study – which is under way at Portsmouth University – will compare outdoor swimming with standard therapy for depression in 400 volunteers over two years.
The results of the study, which is being funded by the National Institute for Health and Care Research, the research funding arm of the NHS, are expected in 2026.
Although the exact mechanism is not yet clearly understood, cold-water therapy does seem to trigger an increase in white blood cells, part of the immune system, explains Professor Mercer, who has studied temperature regulation in the human body for 50 years.
‘I go numb when I’m in the ice bath – but you quickly get used to it,’ says Rosie Marcel, 46 (pictured)
Dr Fadi Jouhra, a consultant cardiologist at St George’s University Hospital and the Harley Street Clinic in London, says the fact cold-water immersion stimulates production of immune cells – particularly interleukin-6, B and T cells – could help with auto-inflammatory conditions, such as Behcet’s, by reducing inflammation.
Although he stresses there are currently no trials to support this, and he can’t yet recommend it based on the science, he adds: ‘Behcet’s is a very difficult condition to treat, so if you can get relief in this way, it might be worth a try if you don’t have any heart conditions.’ (This is because the heart may struggle to cope with the sudden increase in blood pressure and heart rate caused by cold-water immersion.)
Rosie started having cold showers last year after Holby City ended. She was so pleased with the results, she bought an ice bath. ‘I’d say ice baths improved my Behcet’s symptoms by 95 per cent,’ she says.
‘Maybe it’s partly the placebo effect, but I’m so much better. Now if I get any lumps on my arms or legs, they are smaller and go away around 75 per cent quicker than they did before.
‘I’m also significantly healthier – I get the occasional cold, but it never lasts long.’
But experts agree it’s too early to recommend cold-water therapy, and there are potential risks.
Dr Heather Massey, a senior lecturer in sport health and exercise science at Portsmouth University, says that although some people may experience health benefits from cold-water immersion, ‘the level of evidence isn’t sufficient to recommend it’.
The downsides include ‘very painful, cold, numb and swollen hands and feet’, and worse – ‘people have had cardiac arrests going into cold water as well as strokes. In most cases those concerned had an underlying heart or other medical condition, and while some may be aware of their condition, others may not’.
Dr Massey advises checking your health status with a doctor before trying an ice bath.
Having another person on hand when you experiment with cold-water immersion may be a good idea if you feel unsure, ‘so that if you get into difficulty, there are people on hand to support you’.