Are cold plunges and saunas safe for kids? What parents need to know about the benefits and risks

In late 2019, Kevin MacDonald noticed that his twin 16-year-olds, Allie and Lexi, seemed sad and uninterested in schoolwork. He decided to buy an infrared sauna for the family after seeing research on the potential mental health benefits. For MacDonald’s family, the purchase has paid off. “It’s been therapeutic for the kids in dramatic ways,” he says.

As more adults have been incorporating saunas, cold plunges and other hot and cold therapies into their wellness routines, increasingly, they’re encouraging their kids to do the same.

Emerging research suggests these therapies offer physical and psychological benefits for adults. But experts warn that kids’ systems for regulating internal temperature are still developing: “So whatever risks you have in adults will be amplified by an order of magnitude,” says Francois Haman, a professor of biology who researches thermal physiology at the University of Ottawa.

“We must be mindful that teens have specific requirements and concerns that need to be addressed, both physically and emotionally,” says pediatrician Dr. Elizabeth Henry.

Here, Haman, Henry and other experts share their views on the potential benefits of hot and cold therapy for kids, and and how parents can help them stay safe.

What are the benefits of hot and cold therapy?

Sauna bathing may increase feel-good brain chemicals such as dopamine and serotonin, and may also lead to improvements in heart health and chronic pain. Sauna use may increase blood circulation, helping to reduce blood pressure and speed recovery from physical activity. So far, though, studies have looked only at the effects of sauna in adults. Caroline Smith, director of Appalachian State University’s Thermal and Physiology Laboratory thinks these benefits may apply to kids, though more research is needed.

As with heat, cold exposure and immersion can trigger a psychological high, Haman says. “You actually feel good once you come out of the cold,” he tells Fortune. But he says he’s seen no compelling evidence of other benefits touted by wellness influencers, such as detoxification and building healthy brown fat.

Henry, the pediatrician, sees potential for both the heat and cold. “Teens want to take advantage of how these modalities can promote their well-being,” she says. 

During the pandemic, MacDonald joined his daughters in the sauna every morning, and he saw how their self-esteem and discipline grew as they routinely faced and conquered the heat. They became more engaged in school, despite the challenges of remote learning. He attributes this improvement at least in part to their sauna regimen. “Honestly my children progressed better in their schoolwork than pre-pandemic,” MacDonald says.

Do kids benefit from hot and cold therapy?

Any benefits for kids must be stacked against the risks, as their developing bodies make them more vulnerable to extreme conditions. “Especially under age eight, kids have difficulty in regulating their temperatures,” Henry says.

In very warm environments, younger kids’ core temperatures rise more quickly because they sweat less and have smaller bodies, among other important differences from adults, Smith says. These factors increase the odds of a life-threatening heat stroke. What’s more, because fat heats up faster than muscle, children of higher weights and lower fitness levels may be at an increased risk, Smith says.

Another consequence of kids’ smaller size: They cool more rapidly in cold temperatures, especially in water below 50 degrees Fahrenheit. “The risks are much higher than adults who have double or triple the mass,” Haman says. Dangers include hypothermia, trench foot, cardiac arrest, frostbite, and drowning.

As teenagers grow and become more adult-like, they have fewer age-specific physical vulnerabilities for both cold and heat. However, Henry notes, their brains are continuing to mature. “Older teens look like adults, but their brain is still under construction,” which may lead to impulsive decisions. Combine this factor with peer pressure, and “they may stay in the cold plunge longer than they should,” she says.

Managing the risks

Parents should be aware of the perils and supervise their child’s hot and cold therapy. With the right knowledge, parents can help their kids strike a balance between confronting healthy challenges and managing the risks.

MacDonald, who directs a spa at Claremont Hotel in Berkeley, Ca., understands the risks and emphasizes safety with his daughters, such as warming up gradually and avoiding extreme temperatures. Although MacDonald prefers traditional Finnish saunas, he chose an infrared sauna for the family because it’s less hot. He was concerned the kids might be tempted to try the Finnish version at extreme temperatures.

In his infrared, he started his daughters with sessions only a few minutes long, ultimately limiting them to 25 minutes, 125 degrees Fahrenheit. His approach tracks with Smith’s advice for teens to start using the sauna with short time windows and cooler temperatures, increasing the intensity gradually as they become accustomed to the heat over several sessions, and always keeping sessions shorter and less hot than the maximum length and temperature recommended for adults.

MacDonald is careful to ensure the twins are well hydrated before and after sauna use. In the heat, Smith says, dehydration makes controlling internal temperatures even harder, upping the chances of heat illness.

Haman says kids should avoid cold plunges under 50 degrees Fahrenheit unless they’re guided by a credible professional, someone who was trained by an academic research institution and is appropriately focused on safety precautions for children—not Wim Hof instructors. While cold showers are okay, “kids should never cold plunge for longer than two minutes,” he says. If they do, it’s essential that they wear 5 millimeter neoprene gloves and socks to protect hands and feet from the cold. 

Parents should have honest conversations with their teens about the risks and safety measures, Henry says. When teens use these therapies to promote their health and well-being, it should always be guided by adults—but supervision doesn’t have to be the point. “Parents can use this as an opportunity to actually make it a family affair,” Henry recommends. “That would be a great way to frame it.”

Families can bond and learn to overcome healthy challenges together, MacDonald says. He doesn’t let Allie and Lexi post sauna selfies on social media because, he tells them, “that’s not why we’re doing this.” The true lesson of the sauna is that “what they define as discomfort really isn’t that big of a deal,” MacDonald says. “Doing hard things makes them feel capable.”