A woman in a towel lies face up on a massage table

T hinking of heading to a spa? Be cautious: The massage you enjoyed in your 30s could do some damage in your 80s, and risking an infection for a pedicure may no longer seem worth it.

But that doesn’t mean pampering is off-limits. Here’s the lowdown on popular spa offerings so that you can keep indulging in self-care safely. If you’re unsure about any treatment, consult your doctor first.

Facials

Never had a facial? Now may be the perfect time to try one.

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An aesthetician will clean, massage, and apply lotions to your face and neck. “Older adults tend to have drier skin, and a facial can help moisturize it,” says Patricia Farris, M.D., a dermatologist in Metairie, La., and clinical associate professor at the Tulane University School of Medicine in New Orleans.

While facials are safe for most, skip them if you have overly dry, cracked skin on your face or neck, because some products may be irritating. And head to a dermatologist instead of a spa if you’re considering treatments such as a chemical peel, which can cause an infection or scarring if not done properly, Farris says. 

Saunas and Hot Tubs

Heat may be problematic.

“High temperatures may raise the body temperature and pulse, redirecting blood from the vital organs to the skin for cooling,” says John Osborne, M.D., Ph.D., a cardiologist in Dallas. “This also can lead to low blood pressure and even cause fainting.”

Skip hot tubs and saunas if you have poorly controlled high blood pressure or low blood pressure, angina, or heart disease.

Healthy older adults, however, may benefit from them. Some research has shown that regularly spending time in a sauna, for example, is associated with lower blood pressure and a reduced risk of heart disease and sudden cardiac death.

But if you choose to soak or sweat, be cautious. “Don’t drink alcohol or take medications that make you drowsy beforehand, and never go in alone,” Osborne says.

Also make sure to stay hydrated, limit your time to 15 minutes, and be careful getting into and out of a hot tub. A 2009 study found that slips and falls and overexposure to high temps were the top causes of hot-tub injuries for people 60 and older. And to reduce the risk of infection, make sure the tub is clean and chlorinated. 

Manicures and Pedicures

Manicures are generally safe at any age as long as the salon is clean and uses sterilized tools and disinfected footbaths. Technicians who use tools that aren’t sterilized can cause fungal and bacterial infections, and even spread diseases such as hepatitis C.

Pedicures may be a problem for some older adults. If you have decreased sensation in your feet, whether from diabetes or another condition, you might not be able to feel whether the water is too hot or whether you’re getting nicked, says Alan Bass, D.P.M., a podiatrist in Manalapan, N.J., and a spokesman for the American Podiatric Medical Association.

Poor circulation or any condition that affects your immune system can also make spa pedicures dangerous because both increase the time it takes for an infection to heal. People with these types of conditions may want to consider using a podiatrist for nail care, Bass suggests. 

Massages

A massage can reduce stress, heart rate, and blood pressure; increase circulation; and help ease aches. It’s even recommended as a complementary therapy in the treatment of certain diseases. But that doesn’t mean all types are safe for everyone, says Angela Barker, a licensed massage therapist and the owner of Premier Massage Plus in Milton, W.Va.

“For example, if you’re taking an anticoagulant, you shouldn’t get a deep-tissue massage,” she says, “and you should never be massaged near a surgical or recent injection site.”

People with osteoporosis may need to be cautious. Ask your doctor whether a massage is safe for you. And always check a therapist’s certification. Use the “find a massage therapist” link at the American Massage Therapy Association’s website to find one.

Editor’s Note: This article also appeared in the September 2019 issue of Consumer Reports On Health