Managing Hygiene and Self Care During Severe Symptoms

Why this matters

Hygiene and self-care are rarely discussed in the context of chronic illness, which can leave people feeling alone with something that affects daily life significantly during flares. There’s no failure in finding these tasks hard when severely unwell.

Why self-care becomes difficult during severe symptoms

Fatigue, pain, joint stiffness, and reduced mobility all make tasks that are ordinarily automatic considerably harder. The energy cost of showering, dressing, or preparing food can be disproportionate to what’s available. For some people, the cognitive load of managing multiple tasks at once, or simply standing long enough to complete them, is the barrier. Skin sensitivity, photosensitivity, or active rashes can also make standard products or routines uncomfortable or harmful.

Adapting rather than abandoning

The goal during difficult periods is a reduced but sustainable version of self-care, not the full routine or nothing. Sitting rather than standing for tasks where possible, using a shower chair, breaking washing into smaller steps with rest between, or switching to dry shampoo on days when a full shower isn’t manageable all reduce the energy cost without abandoning hygiene entirely.

Warm rather than hot water tends to be better tolerated during skin flares. Fragrance-free, gentle products reduce irritation. Laying out everything needed before starting a task means fewer trips and less standing time.

Food and nutrition

Preparing food is often one of the first things to become difficult during a severe flare. Simple, no-cook or minimal-cook options, batch cooking during better periods and freezing portions, and accepting help with meals where available all reduce the burden without compromising nutrition entirely. Staying hydrated is easier to maintain than eating when severely unwell and is worth prioritising.

Asking for and accepting help

During severe flares, asking someone to help with personal care or household tasks isn’t a failure of independence. It’s an appropriate response to a temporary reduction in capacity. Identifying in advance who could help, and what specifically would be most useful, makes it easier to ask when needed rather than having to work it out in the middle of a difficult period.

What you could do

• Keep a small kit of adapted self-care essentials, such as dry shampoo, gentle wipes, and easy-to-open products, accessible for difficult days
• Identify the minimum self-care that feels necessary for wellbeing and focus energy there when capacity is limited
• Track flare patterns over time so periods of reduced capacity can be anticipated and prepared for
• Discuss your goals with occupational therapists and physiotherapists who can help you manage your household tasks and activities of daily living

This article is for general information purposes only and doesn’t constitute legal, financial or benefits advice. For advice specific to your situation, please speak to a qualified professional or contact an organisation such as Citizens Advice, who may be able to assist you further.

References:

‘Epidermal barrier dysfunction in atopic dermatitis’ (2009) https://doi.org/10.1038/jid.2009.133

'Occupational therapy addressing the ability to perform activities of daily living among persons living with chronic conditions: a randomised controlled pilot study of ABLE 2.0' (2021) https://doi.org/10.1186/s40814-021-00861-9

‘Patients' perceptions of fatigue in rheumatoid arthritis: overwhelming, uncontrollable, ignored’ (2005) https://doi.org/10.1002/art.21450