My 14 year old stepdaughter has always had a hygiene problem every since she was a small child. Since she has been old enough to bath and clean herself, she has pretty much chosen not too. She doesn't wipe herself..at all..when she does "#2" or when she urinates. During a shower or bath, she will only sit or stand in the water and if she does wash, it is her hair and face only. We used to be able to do more about the problem when she was younger because we would supervise her baths or showers to make sure that she cleaned herself. Now that she is a teen, we don't see that as being realistic so there really isn't much that we know to do. She does see a psychologist regularly, as well as seeing others at different times too. Her psychologist ruled out different mental disorders, ruled out sexual abuse, etc. but has no idea why she is practicing such poor hygiene. She isn't around anyone who uses poor hygiene. She has to see a gynecologist regularly as well because her poor hygiene causes her to keep vaginal bacterial infections. This is killing her Dad and I because we constantly worry about her health due to this issue. She says that she just "doesn't want too bath or clean herself" and that "it is just too much work to be clean". We have tried more techniques than you can imagine but we still have no luck. It is a bad situation all the way around because her unpleasant odor bothers us, our families, and her friends at school. How can we help her?
This is unacceptable behavior for some one her age particularly because it is causing infection. Start by having her parents sit down with the current psychologist and explain that this cannot continue and what contract with her can you all devise. Next, speak to her pediatrician about this and have a long visit in case there really is abuse or early sexual behavior that is of concern. Finally, she may need a developmental evaluation to be sure that poor social contact (read Asperger's Syndrome) is not a consideration. Best wishes with this difficult situation. Lead by example at home. A final thought is to explore camp or situations where she is out of the house and observing her peers hygiene. Sometimes it works.
Wayne Yankus, MD, FAAP
expert panelist: pediatrics