Hot Baths During COVID-19 with Fever
You should avoid hot baths when you have COVID-19 and are running a fever, and instead use lukewarm or cool water for bathing and hand hygiene.
Water Temperature Recommendations
The available guideline evidence specifically addresses water temperature in the context of COVID-19 hygiene practices:
Lukewarm or cold water is recommended over hot water to avoid skin irritation and physiological stress. Water temperatures above 40°C (104°F) can damage the stratum corneum through lipid fluidization, leading to increased skin permeability and irritation 1.
Water temperature does not affect pathogen removal, so there is no benefit to using hot water for hygiene purposes during COVID-19 infection 1.
Physiological Concerns with Hot Baths During Fever
When you already have an elevated body temperature from COVID-19:
Hot baths raise core body temperature further, which can exacerbate hyperthermia when you're already febrile 2, 3.
Fever serves as an evolved defense mechanism that augments immune cell performance and induces stress on pathogens. However, this doesn't mean artificially raising body temperature further through external heat is beneficial 4.
Distinguishing fever from heat-induced hyperthermia becomes difficult when external heat sources are applied, potentially complicating clinical assessment 2, 3.
Practical Bathing Guidance
For personal hygiene during COVID-19 with fever:
Use lukewarm water (below 40°C/104°F) for bathing and showering 1.
Keep bath duration brief to minimize heat exposure and conserve energy when ill.
Ensure adequate hydration before and after bathing, as fever already increases fluid losses 2.
Monitor for dizziness or weakness during bathing, as fever combined with warm environments can cause orthostatic symptoms.
Alternative Comfort Measures
Instead of hot baths for symptom relief:
Lukewarm compresses can provide comfort without excessive heat exposure 1.
Allow fever to run its course unless it becomes dangerously high (>40°C/104°F), as fever reduction has not been shown to improve survival in infections 4.
Paracetamol is preferred over NSAIDs if fever reduction is necessary for comfort 5.
Important Caveats
The evidence base specifically addressing bathing during COVID-19 fever is limited, with most guidance focusing on hand hygiene water temperature 1.
Medical personnel wearing PPE in hot conditions face different considerations and require specific cooling strategies, but this doesn't apply to patient bathing 2.
If you experience severe symptoms, difficulty breathing, or persistent high fever, seek medical attention rather than attempting self-management with bathing 1.