Spa nudity can cause some anxiety and confusion, especially if you're going for the first time, but there are some pretty simple rules for spa destinations in and around the United States when it comes to getting naked.
The question most first-time spa guests ask is whether or not the massage therapist will see their body naked. Most resort spas and destination spas in Canada, Mexico, the United States, and the Caribbean stipulate that your therapist must cover your body with a sheet or large towel during your appointment and that only the part of the body that is being worked on is exposed.
Another concern is a fear of one's body being judged, but since massage therapists are professionals who are used to dealing with all kind of bodies, they're only interested in what's going on with your muscle tissue.
Some people, on the other hand, feel completely comfortable without clothing and wonder why there has to be a sheet or towel over their body during the massage. However, while those people may not feel like the situation is sexual, pulling the sheet back or asking the therapist about it is usually a prelude to unwanted advances and should be avoided.
Places for Full Nudity at Spas
If you're not shy about getting naked at the spa, there are plenty of naturist resorts and clothing-optional spas spread throughout the United States, South America, and Europe (as well as most other places in the world), each with varying degrees of comfort around the naked body.
You can find a more relaxed attitude towards nudity at some hot springs or mineral springs spas with co-ed tubs, like Ten Thousand Waves in Santa Fe, New Mexico, or Esalen in Big Sur, California. However, you still shouldn't expect any nudity in the treatment room; even the Palm Springs clothing-optional resort Sea Mountain uses draping during a massage at its spa.
European spas are considerably more relaxed about nudity, both in the treatment room and in co-ed Sauna Worlds, a spectacular collections of saunas, whirlpools, and ice rooms, often part of hot springs. In German spas, adults of all ages enjoy themselves in the nude without being self-conscious, which is quite different from the vibe in American spas, where even sitting in a co-ed lounge with a man can be uncomfortable for some women.
Treatments That Require Nudity
When it comes to services that require to be fully nude, options are fairly limited in the United States. However, most body treatments like a salt glow or a Vichy shower do require full nudity in order to fully exfoliate and treat your pain. However, most spas offer disposable panties for the body treatment, which are sometimes optional, though some places do request you wear them.
Spas may request you wear a swimsuit or disposable briefs during hydrotherapy treatments, which is especially true with men as women are often allowed to choose. However, if you've developed a close professional relationship with your therapist, you may be able to take this treatment nude.
Additionally, full resort spas in the West typically have steam rooms, sauna, and hot tubs in separate men and women's changing areas. In these areas, you can go nude, wrap yourself in a towel, or wear a swimsuit, but you'll want to bring a towel to sit or lie on in the steam or sauna for sanitation purposes.
One final "treatment" that some "spas" domestically and abroad offer that require nudity is the "happy ending," which includes a sexual release at the end of a full-body massage. Legitimate spas don't offer these services, so asking for one from a licensed therapist, especially in America, is a serious breach of spa etiquette.
Nudity at the Typical American Spa
When it comes to getting a full-body massage (without a happy ending), you'll most likely need to fully strip before your therapist can work on you. You are generally asked to change into a robe and slippers in the locker room before entering the treatment room. However, since some day spas and chains like Massage Envy don't have locker rooms, you may have to disrobe in the treatment room and slip under the sheet.
At the time of your appointment, the massage therapist will ask you about areas of concern and give you clear instructions about getting on the table—robe off, where to hang it up, face up or down—and then leave the room. The therapist will give you time to get on the table, then knock and ask if you're ready before entering.
Generally, you are nude during the massage but always covered with sheets when the therapist is not working on that part of the body. When it's time to turn over, the therapist will hold up the sheet and looks away so you're covered as you switch to laying on your other side.
You can wear underwear if you're uncomfortable with complete nudity, but this means the therapist can't work the large muscles of the gluteus maximus and hip attachments, which are often problematic areas, especially for older patients.
However, since massage relies on relaxation to work out muscle tension, whatever you're comfortable with is what you should do. If you're nervous about spa nudity, you can always start with a facial, where the esthetician is only touching your head, arms, shoulders, and sometimes feet. There are also styles of massage where you stay fully clothed like Thai massage and reflexology or the classic mani-pedi option instead.