Is It Better Not to Wear Underwear?

There is no blanket medical recommendation to wear or skip underwear. For most people, going without is perfectly fine and can even reduce moisture buildup and skin irritation in the genital area. Whether ditching underwear improves your comfort or health depends on your body, your clothing, and what you’re doing at the time. The question is less about a single right answer and more about understanding the trade-offs for different situations.

Why Going Without Can Help

The genital area is one of the warmest, most enclosed regions of the body. Underwear adds another layer of fabric that traps heat and moisture against the skin. For people prone to yeast infections, jock itch, or general irritation, that extra layer can make things worse. Yeast and many bacteria thrive in warm, damp environments, so anything that keeps the area drier and cooler can reduce the odds of an overgrowth.

This is especially relevant overnight. When you’re sleeping, you’re not moving much, and the groin area stays pressed against fabric for hours. Sleeping without underwear lets air circulate, which helps moisture evaporate rather than sit against the skin. Many gynecologists suggest this as a simple first step for patients dealing with recurrent vulvovaginal irritation. It’s low-effort and costs nothing.

During the day, going commando under loose-fitting pants or skirts achieves a similar effect. The key factor isn’t really the presence or absence of underwear itself but rather how much airflow reaches the skin. A pair of loose cotton boxers may breathe almost as well as wearing nothing, while tight jeans without underwear can still trap plenty of heat.

Thongs, Briefs, and Infection Risk

A persistent belief holds that thong underwear increases the risk of urinary tract infections or vaginal infections because the narrow strip of fabric could transfer bacteria from the anal region forward. It sounds logical, but the research doesn’t support it. A survey study published in the Journal of Obstetrics and Gynaecology Research compared infection rates in thong wearers versus non-thong wearers and found no significant difference in urogenital infections over the previous twelve months. Thong use was not an independent predictor of any urogenital infection in the study.¹

That doesn’t mean thongs are ideal for everyone. People who find thongs uncomfortable or who notice chafing or irritation are better off switching styles. But the fear that a thong will give you an infection just by virtue of its shape isn’t well founded. The more meaningful variables are the fabric the underwear is made from, how tightly it fits, and how long you wear it before changing.

Underwear and Male Fertility

For men, the underwear question takes on a different dimension because of scrotal temperature. Sperm production is sensitive to heat, which is part of the reason the testes sit outside the body in the first place. Anything that raises scrotal temperature, even modestly, can affect sperm quality over time. This has led to a long-running debate about boxers versus briefs for men trying to conceive.

A study in the Central European Journal of Urology measured scrotal skin temperature in men wearing standard underwear versus a specially designed cooling garment. The median scrotal temperature during the control period was about 35.3°C, compared to about 34.6°C with the cooling underwear, a statistically significant difference.² That gap of roughly 0.7°C might not sound like much, but scrotal temperature operates in a narrow window where even small shifts matter for spermatogenesis.

Going without underwear entirely, or wearing loose boxers, tends to keep scrotal temperatures lower than snug briefs do. For men who aren’t actively concerned about fertility, this difference is unlikely to matter day to day. But for those who are trying to conceive and have borderline sperm parameters, switching to looser underwear or going commando when practical is one of the easier lifestyle adjustments to try. It won’t fix a serious fertility issue on its own, but it removes one variable that’s working against you.

When Underwear Itself Causes the Problem

Sometimes the irritation people attribute to “needing to go commando” is actually a reaction to something in the underwear itself. Contact dermatitis from underwear elastic is a well-documented phenomenon. A study in the Archives of Dermatology described six patients who developed allergic reactions to the elastic in their undergarments. Patch testing showed they weren’t reacting to the raw rubber components or to new elastic. The allergic response only occurred after the elastic had been washed with bleach, which chemically altered a rubber accelerator compound in the waistband material.³

This is a useful example because it shows that the problem isn’t always the underwear per se but the combination of the materials and how you care for them. If you have persistent redness, itching, or a rash along the waistband or leg openings, the culprit may be a chemical reaction between your detergent or bleach and the elastic rather than the fabric against your skin. Switching detergents or avoiding bleach entirely can sometimes solve the issue without needing to ditch underwear altogether.

Other common irritants include synthetic dyes, fragrances in laundry products, and certain finishes applied to fabric during manufacturing. Underwear sits against some of the most sensitive skin on the body, so it’s one of the first places contact allergies show up. If you’ve been going commando because underwear always seems to irritate you, it may be worth experimenting with unbleached, undyed cotton pairs washed in fragrance-free detergent before concluding that you simply can’t wear them.

Fabric and Microclimate

The material your underwear is made of changes the conditions against your skin more than most people realize. A study comparing two types of underwear fabrics during moderate exercise and recovery found meaningful differences in how temperature and humidity behaved in the clothing microclimate. During the recovery period after walking in cold conditions, one fabric retained significantly more warmth and humidity close to the skin than the other.⁴ In practical terms, what you’re wearing next to your skin continues to affect moisture and temperature even after you’ve stopped sweating.

Cotton is generally recommended for everyday underwear because it absorbs moisture and allows more air to pass through than most synthetics. However, cotton also holds onto moisture once it gets wet, which is why it’s less ideal during heavy exercise. Synthetic moisture-wicking fabrics pull sweat away from the skin and dry faster, making them better for workouts but potentially worse for sitting around all day if they don’t breathe well.

If you exercise frequently and don’t want to go commando during workouts, the fabric choice matters more than whether you’re wearing underwear at all. A well-fitted pair of moisture-wicking briefs during a run will likely keep you drier than a pair of cotton briefs that ends up soaked. But after the workout, changing into clean, dry underwear promptly, or going without while you recover, is more important than the fabric type.

Children and Tight Clothing

The question of underwear and genital health also comes up in pediatric contexts, particularly regarding vulvovaginitis in young girls. This is one of the most common reasons prepubertal girls visit a gynecologist, and hygiene practices play a significant role. A study on personal hygiene and vulvovaginitis in prepubertal children found that over a third of the affected children wore tight clothing.⁵ Tight underwear and clothing can restrict airflow and trap warmth against sensitive tissue that, in prepubertal girls, lacks the protective estrogen-influenced environment that develops after puberty.

Pediatricians frequently recommend loose-fitting cotton underwear for children, with changes after swimming, sports, or any activity that produces dampness. In some cases, particularly at night, allowing a child to sleep in just a nightgown without underwear is suggested as part of managing recurrent irritation. The principle is the same as for adults: reducing trapped moisture reduces the conditions that encourage irritation and bacterial overgrowth.

Situations Where Underwear Earns Its Keep

Going commando isn’t always the more comfortable or hygienic choice. There are plenty of scenarios where underwear does genuine work.

During menstruation: Underwear provides a base layer for pads, liners, and period underwear. Even with a menstrual cup or tampon, a liner catches backup leaks, and wearing nothing underneath an outer garment during your period is impractical for most people.
During vigorous exercise: Running, cycling, and other high-movement activities generate friction. Without a snug base layer, skin-on-skin or skin-on-seam rubbing can cause chafing, particularly along the inner thighs and groin folds. Compression-style underwear or cycling shorts reduce this friction considerably.
With rough or structured clothing: Jeans, wool trousers, or garments with interior seams that sit against the crotch can irritate skin directly. Underwear acts as a buffer between those rougher materials and sensitive tissue.
In shared or public environments: Trying on clothing at a store, using shared gym equipment, or wearing rental garments like wetsuits all involve situations where a barrier layer is practical for hygiene.

The point is that underwear isn’t inherently bad for you and going commando isn’t inherently superior. Each has a place depending on the circumstances.

Common Misconceptions Worth Clearing Up

One popular claim is that wearing underwear to bed “suffocates” the genitals. The language is dramatic, but the grain of truth is simply that an extra layer of fabric reduces airflow, which is only a problem if moisture is getting trapped for extended periods. If you sleep in loose boxers or breathable cotton underwear and you don’t experience any irritation, you are not harming yourself. The “never wear underwear to bed” advice is most useful for people who already have symptoms like itching, discharge, or recurrent infections. For everyone else, it’s a preference.

Another misconception is that going commando is less hygienic because discharge or sweat ends up directly on outer clothing. In reality, genital discharge is a normal bodily function, and whether it lands on underwear or on the inner surface of your pants doesn’t change your health outcomes. What changes is laundry logistics: outer garments are usually washed less frequently than underwear, so going commando may mean you need to wash pants and skirts more often to keep things fresh.

There’s also a belief that men should always wear supportive underwear during exercise to prevent testicular torsion or hernias. Testicular torsion is a medical emergency caused by the spermatic cord twisting, and it’s related to anatomy, not to what you’re wearing. Inguinal hernias similarly develop due to structural weaknesses in the abdominal wall. Supportive underwear can make vigorous activity more comfortable by reducing bouncing and friction, but it’s not preventing these conditions from occurring.

What About Bacterial Vaginosis and Yeast Infections Specifically

Bacterial vaginosis and vulvovaginal candidiasis (yeast infections) are among the most common reasons women consider going underwear-free. Both conditions are influenced by the vaginal microbiome, and anything that shifts the local environment, such as increased warmth, moisture, or pH changes, can tip the balance toward an overgrowth of the wrong organisms.

There isn’t a randomized controlled trial showing that removing underwear prevents BV or yeast infections. The recommendation to wear loose, breathable clothing and to sleep without underwear comes from clinical experience and the basic microbiology of what these organisms need to proliferate. It’s a reasonable, low-risk intervention that clinicians suggest alongside other measures like avoiding douching, using unscented products, and changing out of wet swimsuits promptly.

For recurrent yeast infections specifically, the evidence points to a combination of factors: immune status, antibiotic use, hormonal shifts, and local conditions in the vulvovaginal area. Underwear choice is one of the more controllable variables. If you’re dealing with recurrent infections, switching to cotton underwear during the day and going without at night is a sensible starting point, though it likely won’t be sufficient on its own if other contributing factors are in play.

Underwear After Surgery or During Recovery

Post-surgical contexts add another layer to the decision. After cesarean sections, abdominal surgeries, or procedures in the groin area, underwear that sits on or near the incision site can cause irritation, pressure, or friction against healing tissue. Many people find that going without underwear or wearing very high-waisted or very low-rise styles that avoid the incision line entirely improves comfort during recovery.

Hospital staff often recommend loose-fitting undergarments that don’t compress the surgical site, and some patients opt for underwear designed with cutouts or lower panels specifically to accommodate abdominal incisions. The key consideration is avoiding anything that creates sustained pressure or rubbing on a wound. Once the incision has healed and the skin has regained its normal resilience, normal underwear choices can resume.

Similarly, after gynecological procedures, clinicians sometimes advise avoiding tight underwear for a period of days to weeks, depending on the procedure. The rationale is the same: minimizing irritation and allowing the area to heal without unnecessary compression. In these situations, “better not to wear underwear” isn’t a lifestyle philosophy but a temporary clinical recommendation.

The Practical Bottom of the Drawer

If you’re not dealing with any symptoms, the decision to wear or skip underwear is largely personal. Some people find going commando more comfortable, some feel exposed without a base layer, and both groups are making perfectly fine choices from a health standpoint. The situations where skipping underwear offers a genuine health benefit are fairly specific: recurrent vulvovaginal infections, contact dermatitis from underwear materials, nighttime airflow for people prone to irritation, and keeping scrotal temperatures lower during fertility efforts. Outside of those scenarios, the best underwear strategy is whichever one keeps you dry, comfortable, and not thinking about your underwear at all.