If you’ve ever watched Naked and Afraid on the Discovery Channel, you’ve wondered about the hygiene on the show. Twenty-one days is a long time without a shower and soap. Obviously, they generally do fine, and it seems as if hygiene is downplayed on the show. It always gets me thinking, though. What kinds of issues would arise in that type of survival situation? How would I mitigate the atrocity of no soap?

First, let me start by saying that not having soap in that three-week period might not be as bad as you might guess. As long as you had water to clean with, you might be fine. In using your hands to scrub all of those 2,000 body parts, you remove debris and dead skin. This may keep the pores from clogging up to a certain degree and prevent inflammation in the pores of your skin. Some of these pores can have pustules and look infected, but usually don’t progress in that direction.

Nature’s Soap

Making soap in a survival situation is possible, but time-consuming.

Some of you might be thinking about making soap from hardwood ash and animal fat. The ash wouldn’t be that difficult, and the animal fat would take luck and skill to acquire. But say you’re adept and lucky. It can take some time to make bar soap — time that you might not be afforded in a survival situation. You could, however, mix the fat and ash in a pan that you cooked the animal in. It’d be great for washing the pan; however, the basic (pH) nature of lye from the ash might be irritating to someone with sensitive skin. It’d feel like a bad sunburn or worse. [See RECOIL
OFFGRID Issue 30 about making soap from scratch.]

Buffaloberries are a natural source of saponins. Source: Lazarus000 / Wikimedia Commons (CC BY-SA 4.0)

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For a field-expedient solution, it’s possible to crush the berries or roots of certain plants that contain natural compounds called saponins — soapberry (aka buffaloberry), soapwort, yucca, and creosote, to name a few. Upon mixing with water, these substances produce a frothy lather that was used historically as soap or shampoo. For more information, refer to our article on this topic.

Areas of Concern

Because most of the smelly parts on our body are also the most sensitive areas, and safely producing soap in the field may not always be viable, you'd be better off just using water on your body. You’ll notice on Naked and Afraid that the participants are almost always given an opportunity to find water. It may not always smell the best, but it’s available to make potable. I’m sure that a secondary reason is for bathing. You’ll also notice that the contestants don’t have rolls of fat like many of those in our citizenry. One of the problems with obesity is that the overlapping intertriginous areas are moist, hot, and rub against each other. These places, such as under the breasts, under belly fat, between the buttocks, and in the groin are common areas that are affected by poor hygiene and heat, and a foul smell can emanate from these areas. If left untreated, these areas can sometimes open up to create small wounds that may become infected by bacteria.

To treat these moist areas, air is probably the best weapon. Lying down and allowing the breeze to blow across those hard-to-reach areas will assist with keeping them dry and enable the areas to heal better.

Corn starch can assist in keeping certain areas dry that may be prone to fungal buildup.

If you happen to be near a corn field, you could grind corn into flour and apply it to the areas. Again, this takes time and effort, probably more effort than is worth the time. And while corn flour isn’t exactly the same as corn starch, it may be good enough to keep the affected areas drier. We usually recommend corn starch in our convenient environment if zinc oxide products aren’t available. Apply this twice a day and wash, then dry, each time before application.

Another issue is that these warm, moist areas are ideal places for yeast to grow. This is what contributes to the funky smell that emanates from these intertriginous areas. Besides the smell, there may be redness, itching, peeling or cracked skin, and perhaps even small blisters. Although this isn’t life-threatening, it’s uncomfortable and you could also be susceptible to secondary infection when the skin breaks down. Hopefully your diet has been high in garlic to help boost your immune system. If you happen to find some wild garlic, you could either eat it or make a paste and apply it to the affected area. Let it sit for a few minutes, then rinse it off. You could do this twice a day.

If you had a stockpile of apple cider vinegar, you could pour half a cup into a bathtub full of water, and soak. You could also try an apple cider vinegar compress by soaking a natural fiber cloth in the apple cider vinegar, then placing it on the affected areas for 15 minutes at a time. Do this twice a day until the area is healed. If there’s infection in a wound, this is also a good remedy.

Oral Health

Apple cider vinegar can also be used to make toothpaste. Use a ½ tablespoon of the vinegar with 1 tablespoon of baking soda, and add water to make a paste. Dental hygiene is often overlooked, but is super important to maintain healthy gums. Once the gums deteriorate, infection can settle in. The gums can be painful, red, swollen, and may even bleed. The teeth can also become painful due to infection, making it difficult to eat and makes a person pretty miserable. If there are no ingredients to make toothpaste, take a small branch from a pine tree (about the size of a pencil) and fray the ends. This can serve as a makeshift toothbrush. [Refer to “Off-the-Grid Dentistry” in Issue 27 for more information on dealing with dental problems when medical help will be unavailable for the foreseeable future.]

Female Hygiene

Ladies, urinary tract infections are also something that can bring misery in a survival situation. Symptoms of a urinary tract infection can include urinary frequency, burning with urination, incontinence, and fever. With poor hygiene, and with poor hydration, this can be a real possibility. Without the benefit of toiletries, you’ll need to search for nature’s bidet, like a babbling brook. Anything that you can do to wash away the particulate matter will help minimize chances of infection. Finding edibles to help your immune system (e.g. garlic, spinach, citrus fruits) can help in general. Edibles that can act as natural antibiotics (e.g. honey and Echinacea) may help, but shouldn’t replace your stockpiled antibiotics. And be sure to stay hydrated.

Menstruation is another potentially troublesome issue in an austere setting. This was somewhat of a challenge for the military after Sept. 11, as the number of women in combat had increased. The idea was to suppress menstruation rather than accommodate hygienic practices that’d interfere with combat roles. There are options for menstrual suppression; however, these will require advanced planning. Your doctor can discuss a hormonal rod implant that provides contraception for around three years. An intrauterine device (IUD) can also be placed by a physician and stay in place up to five years.

Menstrual cups can be another method to assist that time of the month in austere conditions.

For shorter term options, an intramuscular injection of hormone every 90 days is available. The end goal for these types of options is to stop menstruation from occurring. If that isn’t an option for you, menstrual cups are available. Check out Eryn Chase’s article in Issue 21 of RECOIL OFFGRID for an excellent discussion on wilderness hygiene. Edibles that contain progesterone include soy, broccoli, kale, cabbage, and ginkgo, to name a few, but the reality is that even though these contain very small amounts of the hormone, it’s not likely it’ll be strong enough to affect the menstrual cycle.

Above: Ginkgo biloba tablets and certain vegetables contain progesterone, which can aid in managing menstruation during situations where conventional methods are unattainable.

Conclusion

Hygiene in a survival setting may not seem like a priority early in the chaos and is often ignored due to other pressing issues in the dire environment (i.e. water, fire, shelter, food, and safety). Keep in mind that taking a few minutes to wash up and brush your teeth in those early days can prevent misery as the event draws out into weeks. Women will have extra issues to contend with, and planning may be the best remedy. The old adage of “an ounce of prevention is worth a pound of cure” applies here. Take some time to take care of your hygiene before minor problems become more of a pressing need.

About the Author

David L. Miller, DO, FACOI is an internist in private practice for 20 years. His experiences away from the office have included time as a fight doctor in regional MMA events and as a team physician for 10 years at a mid-major university in the Midwest. Currently, he serves as the lead medical instructor for the Civilian Crisis Response team based out of Indianapolis.

Written by Dr. David Miller