Puberty changes bring new challenges for all children and youth. They may notice that overnight they have oily hair, smell bad, and start getting pimples.

Hygiene is important for health (e.g., teeth cleaning to prevent cavities and gum disease) but also for social reasons such as smelling and looking good. Good hygiene and self-care is considered a positive social quality and can help us feel good about ourselves.

Children and youth with disabilities may need extra support to follow hygiene rules and routines. They may struggle reading social cues and knowing when to fix a hygiene issue such as smelly breath. Also, if a youth has a physical disability they may need extra help with personal care.

 Although parents are likely the main educators when it comes to hygiene and self-care, service providers can make a difference when they reinforce the messages given by parents. Service providers are in a unique position to support both parents and children/youth through the process of puberty. Consistent messages from both parents and service providers can make great impact when it comes to the management of hygiene and self-care.


Hayley is 10 years old. Her parents have recently noticed that she is beginning to show signs of puberty including body odour, underarm hair, and some signs of breast growth. They are worried as they have to give Hayley lots of support and reminders with very basic self-care, such as cleaning her teeth and brushing her hair. Hayley has not received any sexuality education, so has not been introduced to the concept of puberty and the changes that will be happening soon, such as menstruation.

Managing Hygiene and Self-Care

Parents and service providers can work with children and youth to teach them how to take care of their body during puberty. It’s helpful for them to hear the same messages from different people.  Here are some key tips for self-care as they relate to different parts of the body.

Hygiene Diagram

Hover a body part definition for more info

Hygiene Diagram
Face Facial Hair Underarms Legs Feet Pubic Hair Genitals Breasts Teeth Nose Hair


Wash face morning and night as skin gets oily during puberty; use a mild soap or face wash. If pimples and acne are a problem, visit a doctor for advice.

Facial Hair

Males grow facial hair during puberty. It can be shaved with shaving gel/foam and razor or electric razor.


Hair grows under arms during puberty. Armpits get sweaty, so wash and use deodorant or antiperspirant to smell fresh. Be sure to wear a clean shirt. Some people may choose to shave under their arms. If they do, they should ask for help.


Leg hair is normal and does not need to be removed although some people do not like to have hairy legs. Ask for help before removing leg hair. Razors and gel/foam, waxing and creams should be used carefully.


Wash feet and change socks every day. Use nail clippers (you may need help using them) to cut toenails and fingernails.

Pubic Hair

Pubic hair is normal and does not need to be removed. Ask for help before removing pubic hair. Razors and gel/foam, waxing and creams should be used carefully.


Penis – Wear cotton underwear as this allows the skin to breathe and keeps moisture away from the body. Change underwear every day. If the penis is not circumcised (small flap of skin has not been removed), pull back the foreskin gently to wash. It is normal to have erections where the penis gets bigger and hard. Erections can be embarrassing when they happen in front of people. You can sit down if this happens, so that the erection is less noticeable. A wet dream is when a small amount of sticky white fluid comes out of the penis while sleeping; this is normal.

Vagina and vulva – Wear cotton underwear as this allows the skin to breathe and keeps moisture away from the body. Keep this area clean by showering or bathing every day or so. Use mild soap to keep this area healthy. During menstruation use pads or tampons and change them every few hours. Bleeding will last several days every month. It’s very important to shower or bath every day during this time.


Females wear bras to be comfortable as breasts grow. Males may notice some breast growth during puberty but this is usually temporary.


Brush teeth at least twice a day, use toothpaste and floss. Visit the dentist at least once a year for a check-up.


Use a tissue to blow your nose. Don’t forget to wash your hands after.


Wash hair using shampoo in either the shower or bath. Some people wash their hair every day, some less often. Brush hair morning and night to keep it looking good.

Good to know

Children and youth who do not identify with the sex they were given at birth may find puberty very difficult. Although they may not identify as male or female (sex assigned at birth) the body changes they experience will follow a typical path of development. They will need support recognizing that their changing body needs care no matter which gender they identify with or their gender expression.

Hygiene Routine Chart

Using a hygiene routine chart can help your youth stay on track and make healthy habits.

Make a chart (like the one below) that shows the tasks. Put them in the order that works best for your family. Some families find the morning too busy for bathing, so showers are taken in the evening. Use pictures or photos as visual reminders of what comes next and check them off as they are completed.


 Learning healthy habits takes time and practice. As your youth grows they may not want to have help from adults in the shower or bathroom. Both parents and service providers can take time to review hygiene with them and develop ways to check if those routines are being followed. Patience may be needed if they do not meet all of the tasks all of the time.

Managing menstruation

 Girls may begin to have periods as early as 8 years old, up until age 16. Managing menstruation can be difficult for girls with a disability and they may have fears about how to cope, whether or not it will hurt, and who to talk to.

Here are some practical tips for parents and service providers to support youth through the process.

  • Talk about having a period as a normal and healthy part of growing up.
  • Explain why females have periods: “your body is getting ready to change into a woman.”
  • Use simple language: “the blood flows out of your vagina, the opening between your legs. It is similar to the blood when you cut your finger or have a nose bleed.”
  • Show what to do including where to find the pads, how to use them, and dispose of them in the garbage. Practice with lots of different products and give choices about the type of pads.
  • Explain what to do if blood gets on underwear or pants. For example, “keep back up underwear or clothes in your backpack just in case you get blood on your underwear or pants.”
  • Talk about fears and concerns. Mention that different types of emotions (e.g., sadness or moodiness) are normal. Talk about feelings and discuss coping strategies (e.g., listening to music, doing some gentle stretching, or getting extra sleep).
  • Discuss other practical strategies for managing menstruation, for example, “don’t wear white clothing when your period is due as this can lead to embarrassment if bleeding starts.”

Good to know

  • Having a period is a normal and healthy part of growing up. However, for some, periods can be painful and difficult to manage. Many people have cramping. If that cramping interferes with everyday life, such as going to school, it is important to talk to a doctor.
  • On average about 2-3 tablespoons of blood are lost during a period. Many people think they lose more. If bleeding seems to be very heavy (a maxi pad is soaked in less than an hour) talk to a doctor.


Be aware of your child’s cycle and help them prepare. For example, have pads and clean underwear in a cosmetic purse to keep at school. (You may need to let other caregivers, teachers, etc. know also.) There are apps that you can download for free to track the cycle or use a calendar.

Self-Care and Sexual Health beyond puberty

As youth get older they may move from the care of a pediatrician to a family doctor. Regular check-ups and screening are important as they transition into adulthood.

  • Healthcare providers may perform a pelvic exam to examine a female’s reproductive organs. To learn more about having a first pelvic exam, see  SexualityAndU.ca.
  •  A Pap test checks for changes in the cells of the cervix. If any cell changes are found, they should be followed closely. If needed, cell changes can be treated so that cancer does not develop. Current guidelines recommend a Pap test for females who are 25 years of age or 3 years after first sexual activity, whichever is LATER.
  • All breasts have a certain amount of ‘lumpiness’ so people should know what feels normal for them and if something does not feel right, talk to a healthcare provider. A clinical breast exam performed by a healthcare provider can help detect changes early.
For more detailed examples of how to teach hygiene skills, see lesson plans on teachingsexualhealth.ca.
For more detailed examples of how to teach about menstruation, see lesson plans on teachingsexualhealth.ca.