Devices, systems, and techniques are configured for cooling tissue during recharge of an implantable medical device (IMD) battery. In one example, a method includes charging, by an inductive charger, a rechargeable battery of an implantable medical device (IMD) within a patient, wherein the IMD comprises a housing that houses the rechargeable battery, and wherein a primary coil of the inductive charger is positioned above a region of skin of the patient proximate to the IMD. The example method further includes cooling, by a heat exchanger, the region of skin below a normal ambient surface temperature of the region of skin, wherein the heat exchanger is interposed between the primary coil and the region of skin.