The Old Dirty Business of Cruise Ship Massage Therapy Practice

Going on a cruise should mean enjoyment and relaxation. You don’t have to cook and someone cleans your room and makes your bed. What could be better? Perhaps a massage?  Well many cruise lines have that covered too, depending on your personal standards!

Massage and spa appointments are fairly typical services amongst consumers who take cruise vacations. As of 2026, there’s no specific data that shows what percentage of cruise passengers book massage or spa appointments; however, cruise ship spas are regularly full during sea days. As such, a massage appointment is fairly coveted, and consumers generally accept what they are provided, even when it’s not the best. In this article, it's important to point out that I am not singling out any particular cruise line, but instead reviewing general cruise line massage practices that are common amongst almost all cruise ship brands and spas.

Most cruise lines booked 50-minute massage appointments on the hour, every hour as standard practice for years. Unfortunately, during COVID, we experienced a significant reduction in practicing massage therapists which might have eased employment standards and gruelling schedules.

For many years, the spas in cruise companies got away with anything and everything, between charging exorbitant prices for massage appointments to costly upgrades that were not disclosed until checkout, where embarrassed passengers paid whatever was charged seeing they agreed to the upgrade while half conscious during their spa appointment. There’s been a lot of unethical and dirty massage industry business on cruise lines.

Another peculiar cruise ship practice for the massage industry is the lack of knee or ankle bolsters.  I’ve personally cruised a variety of different cruise line companies, and I believe the lack of bolsters amongst almost all cruise lines stems from a number of factors including:

1. A bolster is significantly more expensive than a rolled up towel which is commonly used in place of a bolster.

2. Cruise ships lack space. A bolster is slightly bulky and takes up valuable space in a treatment room.

3. Bolster upholstery can peel and become unsightly, especially when not used properly, such as covering it with a new cover with each massage appointment. This requires replacement and greater equipment costs.

4. Massage bolsters are not a one size fits all commodity. come in various sizes, and some clients might like a smaller or larger bolster, which makes it even more difficult to stock all different types of bolster sizes.

The dirty practice of bolstering has become, massage therapists are rolling up towels and reusing these with every client, to avoid laundry expenses.  This could be a clean practice if the massage therapist placed their rolled towel UNDER the client’s bottom sheet draping.  But unfortunately, most therapists place rolled towels directly under a client's ankles or knees, if they use any bolstering at all. The rolled towel is considered “contaminated” once it contacts a client’s skin, and should be laundered instead of reused.  This is the dirty element of using rolled towels for bolstering during massage.  These rolled towel bolsters should either be placed under other draping, or immediately laundered if it touches the client’s skin.

In my cruise ship massage appointment today which spirited me to write this article, I asked the massage therapist to provide an ankle bolster before she left the room.  She agreed to do so, and then pulled out a filthy rolled up towel and placed it top on the pristine towels which really showed how dirty it was! In the picture below, you can see the dirty towel rolled up when compared to the clean rolled up towel.

The therapist had two towels rolled up together that had been reused so many times, that the towels were now becoming grey in color.  When I told her I didn’t want these filthy reused rolled towels as my bolster, she then rolled a single clean towel for my bolster which was inadequate in height.  So while my new rolled towel bolster was smaller and flatter than the therapist’s regular one, at least it was clean and there was less chance of developing an infection from coming in contact with something that had such obvious filth.

On another note, when I told her I didn’t want the rolled up dirty towel to be used as a bolster, she put that filthy rolled up towel right back from where she took it instead of placing it in a place to be laundered.  It is my guess those filthy rolled towels will undoubtedly be used for other unknowing clients, if the client receives any bolstering at all, given I wasn’t provided anything until I asked for one.

Massage therapists have been using large rolled up towels for decades as knee and ankle bolsters; however, the expense of laundering those towels would cost more than a regular knee/ankle bolster (pictured above is a 6 inch 3/4 bloster). So how could a business with minimal space keep their expenses low while properly supplied?  The answer in the cruise industry is they reuse towels as bolsters, and that creates a real sanitation problem when the massage therapist places a towel bolster in direct contact to a client’s bare legs.

While it’s okay to use the same rolled up towel in place of an ankle or knee bolster, it must be used properly. It’s important to remember to place the rolled up towel underneath the clean table drape, so that the rolled up towel is not coming into contact with each client.  Also, if the client sweats through the table drape, or if a spa product such as a body scrub leaks through the bottom draping onto the rolled towel bolster, then it should be laundered and replaced, to avoid sanitation issues such as odor causing bacteria to form, or worse.

You Don't Always Get What You Pay For in a Cruise Ship Spa

Balinese massage is often described as a blend of bodywork techniques that could include acupressure, deep tissue massage, skin rolling, plucking or flicking, lighter massage strokes including tapotement, stretching, aromatherapy and other applications. Overall, a balinese massage is supposed to leave a client relaxed and refreshed at the end of the session. I recently scheduled a balinese massage on a cruise ship, and the therapist provide a regular Swedish massage instead, which was entirely comprised of effleurage and kneading strokes. When I asked the therapist how they thought their balinese massage was different from a regular Swedish appointment, they responded they didn’t know and they just did what their school taught them to do. Unfortunately the balinese massage was twenty euro more expensive than a Swedish, so lesson learned, sometimes you don’t always get what you pay for in a cruise ship spa.

While most of my recent cruise ship spa experiences have been positive, this article was based on a few bad experiences over several different cruise lines, where dirty or unethical practices seemed to be commonplace for their industry. Cruise massage does not have to be dirty business with proper procedures and application.  To learn more about appropriate massage therapy practices, please register for more training with us at: https://ceinstitute.com