People with high blood pressure, heart conditions, severe skin issues, open wounds, or infectious diseases, plus pregnant women, young children, and those with tattoos (depending on the onsen's rules) should generally avoid or exercise extreme caution with onsen, as the heat and minerals can strain the body, exacerbate conditions, or violate cultural norms. Always check with a doctor and the specific onsen's policies before bathing.
You should avoid bathing in an onsen if you have certain symptoms depending on the quality of the spring water. Be aware of the contraindications according to the quality of the spring water. if you are elderly and have dry skin. Your symptoms may become worse depending on the quality of the spring water.
Many people report feeling dizzy or nauseous after their first few times after going to an onsen, and this is usually because of dehydration or overheating from staying in too long.
Health concerns
Despite its relaxing nature, hot spring bathing can be demanding, and bathers should take care not to overdo it, especially people with high blood pressure and other health conditions. The bath water tends to be hot, and taking in all that heat can be taxing.
Those who have diabetes, high blood pressure and high cholesterol should not bathe in hot springs exceeding 40°C or alternate between hot and cold water, it said.
Of course, whether it's in hot springs, sento, or their home bathtub, Japanese bathe at least once a day. As for how often Japanese go to onsen, that depends on the person. Beppu citizens sometimes go as many as three times a day. But no matter how many times we go, our relationship with onsen is unique and deep.
No, you cannot wear underwear in a traditional onsen; full nudity is required in the bathing area, as clothes, swimsuits, and underwear are prohibited to maintain hygiene, though some unisex or modern onsens might allow swimsuits or cover-ups, so checking rules beforehand is best. You'll typically strip in the changing room, shower thoroughly before entering the hot springs, and use a small towel for modesty when walking or placing on your head, not in the water.
Persons with medical history of heart disease, circulatory problems, diabetes or blood pressure problems should obtain their physician's advice before using hot tubs. Persons taking medications which induce drowsiness, such as tranquilizers, anti-histamines or anti-coagulants, should not use hot tubs.
You Got Too Hot
The Problem: Staying in hot water for too long stresses your entire body. This leads to a fast heartbeat, dehydration, and that dizzy feeling. Your body is basically waving a white flag. The Fix: Keep the water temp under 41∘C.
The frequency of bathing shall be at most 1-2 times per day, and when people get used to Onsen, they can enjoy 2-3 times per day. Duration of bathing depends on the temperatures of water, but generally it shall be around 3-10 minutes at one time, and can be extended to 15-20 minutes if you get used to it.
Onsen (especially onsen towns) can smell because of sulfur or other minerals in the water. This can smell like rotten eggs or other unpleasant odors. It is usually pretty easy to tell if it is the onsen water that is the source of the smell.
Stay on the safe side
But people with unstable chest pain (angina), poorly controlled high blood pressure, or other serious heart issues should avoid them. "People who are in their 70s and older whose blood pressure is on the low side also should be extra careful," says Dr. Hutter.
The "Japan 5-minute rule" refers to extreme punctuality, meaning you should arrive 5-10 minutes before a scheduled time, as being exactly on time is considered late, demonstrating respect and reliability, a concept sometimes called "5-minute prior action" (５分前行動). It highlights Japanese culture's emphasis on preparedness, where trains are so precise that delays over 5 minutes get official notes, making being early a crucial part of business and social etiquette.
In recent years, Japan is seeing a rise in infections due to Legionella bacteria in hot spring baths. The airborne bacteria are said to spread more quickly in a hot environment between 40°C and 45°C (104°F and 113°F). They are also more prevalent in baths that circulate water or create bubbles.
The Japanese 80% rule, known as "Hara Hachi Bu", is a Confucian principle advising people to stop eating when they feel about 80% full, not completely stuffed, to support health and longevity. This practice encourages mindful eating, helps prevent overeating, and is linked to lower rates of illness and longer lifespans, particularly observed in Okinawan centenarians. It involves slowing down during meals, listening to your body's fullness cues, and appreciating food as fuel rather than indulging to the point of discomfort.
Even more common in hot tubs is Legionella pneumophila, a bacterium that can cause Legionnaires' disease, a pneumonialike lung infection that is potentially serious, particularly for those ages 50 and older. Symptoms of Legionnaires' disease include: Cough. Shortness of breath.
People can get Legionnaires' disease or Pontiac fever from hot tubs when they breathe in mist that contains Legionella. People can be exposed to Legionella in hot tubs when these bacteria get into water systems and grow (increase in numbers).
1. Arrive early. Punctuality is not just polite in Japan—it's expected. Here, being on time means arriving five to 10 minutes early (especially for restaurant bookings), strongly aligning with the culture of reliability and courtesy.
The washlet can replace toilet paper completely, but many users opt to use both wash and paper in combination—although use of paper may be omitted for cleaning of the vulva. Some wipe before washing, some wash before wiping, some wash only, and some wipe only—each according to their preference.
Japanese couples tend to detach sexual pleasure from family life. They feel satisfied with their partner in their role as a wife or husband, but they do not expect the maintenance of their joint sexual intimacy over time.
The "3 Date Rule" in Japan refers to the cultural tendency to make a formal love confession (kokuhaku) on or around the third date, marking the transition from casual dating to an official couple, often after building trust with lighter activities like meals or walks, and it's considered a crucial step for clarifying relationship status before deeper intimacy, though it's a guideline, not a strict law.
The leading cause of death in Japan is consistently cancer (malignant neoplasms), accounting for about 30% of all deaths, followed by heart disease, cerebrovascular diseases (stroke), and pneumonia, with aging-related conditions like Alzheimer's also rising due to Japan's aging population. While cardiovascular diseases (heart disease, stroke) are significant, cancer has been the top killer since the 1980s, with lung, stomach, and colon cancers being prominent.
Rice Tips. Rice is sacred in Japan and leaving uneaten rice or even morsels of rice in a rice bowl are frowned upon. While visitors will be forgiven, if you don't plan to finish your rice, ask for small portions, decline rice or make an effort to eat every rice morsel.