A fever, a cold coming on, a stomach bug, sunburn, too much sun or too much wine: whether to keep a massage booking, answered from a pathology textbook for massage therapists with its page numbers — including the popular claim it will not make, that massage flushes out toxins.
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You booked a massage for tomorrow afternoon, and tonight you are pink from the beach, or running a temperature, or one glass of wine past sensible. Should you still go? The answers on this page are not ours. They come from Ruth Werner's A Massage Therapist's Guide to Pathology, 5th edition, a textbook written to teach massage therapists what to do when a client arrives unwell, and every answer carries its page number so you can check it. We are Nghê Prana, a riverside hotel and spa on the Thu Bồn in Hội An. What we add is what each answer means for the treatments on our own menu.
| If you have… | Massage? | What the textbook says | Page |
|---|---|---|---|
| Sunburn: pink, sore, no blisters | Wait until it stops hurting, usually 2–3 days | A first-degree burn; "the only exception might be very mild sunburn" | 52–53 |
| Sunburn with blisters | No | A second-degree burn | 52–53 |
| Cramps after a hot day | Yes, after drinking | Massage "along with rehydration" eases heat cramps | 288 |
| Headache, dizziness, heavy sweating after the sun | No: water and shade | Heat exhaustion; "fast hydration is the best recourse" | 288 |
| A fever of 38.3°C or more | No | Fever rules out massage that asks the body to adapt | 288 |
| A cold coming on | Better not | It may make you sicker; anecdotal, "no rigorous research" | 325 |
| The flu | No, until the worst has passed | Highly contagious | 326 |
| A stomach bug, still active | No | "Unlikely to be comfortable"; can spread on surfaces | 363–364 |
| Fully recovered from any of these | Yes | "The same benefits from massage as the rest of the population" | 288, 364 |
| Drunk | No, move the booking | "Clients who are intoxicated … need to reschedule" | 170 |
| One glass of wine with dinner | A judgment call | "One glass of wine is different from a fifth of vodka" | 173 |
| A hangover | The textbook is silent | Our reading is below | — |
| A graze, a scratched bite, a new tattoo | Yes, but not on it | Broken skin "is a red flag" | 20 |
Page numbers are the printed pages of the 5th edition (Lippincott Williams & Wilkins). Where a row says no, Werner's reasons come down to two: a massage asks the body to respond — her phrase is "an adaptive response" — at a moment when it is busy with something else, and some illnesses pass from guest to therapist to the next guest. The case for each row follows.
Werner classes sunburn as a first-degree burn: red, painful, without blisters, and usually healed "in 2 to 3 days", sometimes with flaking and peeling (p. 52). Most burns "contraindicate massage when they are acute—not just for pain but also for infection risk", and "the only exception might be very mild sunburn" (p. 53). If your sunburn has blistered, it is a second-degree burn in her terms (p. 52), and the answer is no; a pharmacy or a doctor is a better next stop than a spa.
On our menu, that rules out more than you might expect. The oil massage, all three body scrubs, the hot stones, the warm herbal compresses of the Vietnamese massage, the herbal steam and the jacuzzi each rub, heat or soak the skin, and sunburned skin wants none of the three. If only your shoulders caught the sun, a foot massage (450,000₫ for 60 minutes) never goes near them. The one item on our menu made for sunburn is the aloe vera treatment, and it is sold only inside Package 4, "To Looking Your Best!": 1,440,000₫ (about US$55) for three hours, with a facial massage and a manicure and pedicure; our spa packages page does the arithmetic on it. If all you want is the aloe, three hours is more than a burn needs, and waiting is cheaper. Our body scrub page explains why a scrub waits too.
Werner separates overheating into three stages (p. 288). Heat cramps come from the water lost to sweat, and on these she is positive: "massage along with rehydration is an excellent way to move fluid back into the muscle bellies." So after a long hot day, drink first and then book something without heat, such as the oil massage or a foot massage, rather than hot stone, herbal compress, steam or jacuzzi. Heat exhaustion is the next stage: heavy sweating, headache, light-headedness, sometimes fainting. For that her answer is "fast hydration", not a massage table. Heat stroke is the last: body temperature around 40°C, sweating that can stop, and a person who "may become confused or delirious". That is an emergency, not a spa question; the ambulance number in Vietnam is 115.
Werner counts 38.3°C (101°F) or more on a thermometer under the tongue as a fever, and her ruling is that fever "contraindicates any massage that requires an adaptive response that may challenge a body while it is fighting a pathogenic invasion"; the therapist, she adds, "must take pains not to pick up a new infection" (p. 288). Susan Mumford's The Massage Bible, written for massage at home, opens its list of reasons not to massage with the same two: "an infection" and "a temperature" (p. 13). Werner allows that very light touch may help someone with a fever sleep, which is care at a bedside, not an hour in a spa. And she is just as clear about afterwards: a person who has "fully recovered from a fever with no lingering complications" can enjoy massage like anyone else. So if you have a temperature, move the booking, not the idea.
For a cold, Werner labels her evidence carefully. "Anecdotal reports suggest" that a vigorous circulatory massage while a cold is taking hold may leave you sicker than if you had waited, and that massage during recovery can make symptoms briefly worse before shortening the recovery; "no rigorous research has been published on this issue" (p. 325). We repeat her hedge because it is the honest state of the evidence. Her advice is to delay vigorous work until the acute phase has passed. The flu is simpler: it is "highly contagious", and she prefers to delay a session until the acute phase is over (p. 326). One practical point of our own: lying face down with a blocked nose is miserable, so if you come in at the tail end of a cold, tell the therapist before you lie down.
A stomach upset can happen on any trip, and Werner notes that "traveler's diarrhea" is almost always caused by E. coli or C. jejuni bacteria (p. 363). Her reason for saying no while it is active is more practical than alarming: the client "is unlikely to be comfortable" — an hour on a table, away from a bathroom — and infectious forms "may also be communicable if surfaces are contaminated" (p. 364). Most cases clear "within 2 or 3 days". The larger risk is dehydration, which is one more reason to skip the heat treatments for a day or two after. Once you are well, book as normal.
In her section on chemical dependency, Werner is brief: "Clients who are intoxicated at the time of a massage need to reschedule" (p. 170). She gives the reason and the grey area a few pages later: current alcohol use contraindicates massage "mainly because of the risk of overtaxing a liver that is already occupied", and it "can be a judgment call, based on the level of intoxication (one glass of wine is different from a fifth of vodka)" (p. 173). A glass of wine with dinner before an evening massage is a conversation, not a refusal. The morning after is a gap: the textbook does not discuss hangovers, so what follows is our reading, not hers. A hangover usually arrives with thirst and a headache. The heat treatments add heat to a body already short of water, so drink first and choose something without heat — the oil massage, or the back, neck and shoulder treatment at 490,000₫ for 60 minutes. What a massage will not do is flush the alcohol out, which brings us to toxins.
It is one of the most repeated lines in spa marketing: massage releases toxins, so drink plenty of water afterwards to flush them out. Werner does not support it. The idea that massage eases soreness by clearing lactic acid is "probably inaccurate", because lactic acid's role in muscle soreness "is no longer generally accepted"; and on toxins, "to date, no research shows evidence of significant changes in toxic excretions after massage" (p. 59). She is equally frank on the other side: people report recovering better after massage, but "the mechanisms for how this might be accomplished have not been identified". So we will not tell you a massage has detoxed you, and we will not tell you it has cured a hangover.
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Drink water after a massage by all means. Hội An is hot and humid for much of the year, and if you have just had a fever, a stomach bug, too much sun or too much wine, you are likely short of water for those reasons. That is the reason to drink, and it is reason enough; nothing needs washing out.
Werner calls it the one cardinal rule for skin: when the skin is not intact, the client is "a walking invitation to infection", and open, broken, scabbed or oozing skin "is a red flag" (p. 20). Mumford's list says the same for massage at home: don't massage over cuts or a rash (p. 13). Both rules are about the spot, not the whole body. A bicycle graze on a knee, a scratched mosquito bite or a new tattoo that is still healing does not cancel a massage; it means the therapist works around it, with no oil and no scrub on it. Mark it "avoid" on the consultation form's body map and it will be.
Before the day, message or call the spa and we will move your booking; we would rather lose a booking than work on you when the textbook says wait. On the day, the consultation form you fill in before the visit asks what to focus on and what to avoid. If something has changed since — a temperature this morning, a sunburn from yesterday — say so when you arrive. Nobody will talk you into a treatment.
If one of you is unwell and the other is not, the well one can book alone. The couple spa — two tables side by side in our private couple's room, with the jacuzzi after at 300,000₫ each for 30 minutes — keeps for a day when you are both better.
We are a hotel spa, not a clinic, and our therapists do not diagnose. Werner's book is a textbook for massage therapists; we quote it because it answers, with page numbers, the questions guests ask us, not because it is a protocol we follow line by line or a substitute for a doctor. If you are unsure whether you are well enough, a pharmacist or a doctor is the right person to ask. For chest pain, confusion or collapse, call 115.
Nghê Prana Riverside Hotel & Spa, Hẻm 384 Nguyễn Tri Phương, Cẩm Nam, Hội An, Đà Nẵng 51312 — on the Thu Bồn, a few minutes from the Old Town. Phone or WhatsApp +84 896 687 961, or email sales.nghehotel@gmail.com. An hour's notice is enough; walk-ins are welcome when a therapist is free. You do not need to be staying with us.
Cautions from Ruth Werner, A Massage Therapist's Guide to Pathology, 5th ed. (Lippincott Williams & Wilkins), pp. 20, 52–53, 59, 170, 173, 288, 325–326 and 363–364, and Susan Mumford, The Massage Bible (Sterling, 2009), p. 13; page numbers checked against the printed pages on 26 September 2026. Where the textbook is silent, as on hangovers, we say so and label our own reading. Prices read from our live spa menu on 26 September 2026. We are a hotel spa, not a clinic; nothing here is a diagnosis.
23 rooms on the quiet south bank of the Thu Bồn River, ten minutes by bicycle from the Ancient Town and a world from its noise.
Book your stayWait until it stops hurting — usually two or three days. Ruth Werner's A Massage Therapist's Guide to Pathology (5th ed.) classes sunburn as a first-degree burn that usually heals in 2 to 3 days (p. 52) and says most burns contraindicate massage while acute, "the only exception might be very mild sunburn" (p. 53). A blistered sunburn is a second-degree burn: no massage. At Nghe Prana, skip oil massage, body scrubs, hot stone, herbal compress, steam and the jacuzzi on burned skin; a foot massage (450,000₫ for 60 minutes) stays away from burned shoulders.
Not with a fever: Werner counts 38.3°C (101°F) or more under the tongue as a fever and says it contraindicates any massage that requires an adaptive response (p. 288). With a cold coming on, better not: anecdotal reports suggest vigorous massage as a cold takes hold may make you sicker, though Werner notes no rigorous research has been published on it (p. 325). Flu is highly contagious; delay until the acute phase has passed (p. 326). Once fully recovered, massage is fine.
Not while drunk: Werner writes that clients who are intoxicated at the time of a massage need to reschedule (p. 170), though one glass of wine is a judgment call (p. 173). The textbook does not discuss hangovers. Our reading: a hangover usually comes with thirst and a headache, so drink water first and choose a treatment without heat, such as the oil massage or the back, neck and shoulder treatment (490,000₫ for 60 minutes). A massage will not flush alcohol out of your body.
There is no evidence that it does. Werner writes that the claim massage removes lactic acid is probably inaccurate, and that to date no research shows significant changes in toxic excretions after massage (p. 59). Drink water after a massage because Hoi An is hot and you may be short of water, not to flush anything out. Nghe Prana makes no detox claim for any treatment.
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