Therapearl® was designed by a doctor to be safe and therapeutically effective, but there are some conditions which may increase the risk of frostbite. Check with your doctor if you think one of these may apply to you. People who are taking beta blockers, which decrease the flow of blood to the skin, are particularly susceptible. Also at risk are smokers, individuals with diabetes, peripheral neuropathy, local limb ischemia, arteriosclerosis, cold urticaria, hypertension, rheumatoid arthritis, paroxysmal cold hemoglobinuria, or Raynaud’s phenomenon. A low body fat percentage, most commonly found in athletes and the elderly, also increases the risk of frostbite. Additionally, people suffering from exhaustion, dehydration or malnutrition or who have consumed alcohol should also be careful when using Therapearl® 3-in-1 packs.