Rethinking Hygiene: Can We Be Too Clean?
A scientist goes without a shower for five years and tells about his experience, and the lessons he learned.
Clean feels so good! You step out of the shower feeling refreshed and clean, ready to face the day. Why would a Yale scientist ask, “Is showering overrated?” (Medical Xpress). Five years ago, Dr. James Hamblin stopped taking showers. Yikes! Just the thought would make you keep your social distance without government mandates!
But after a lot of research and experience, Hamblin thinks showering is overrated. He wrote a book that was just published, Clean—The New Science of Skin and the Beauty of Doing Less (Riverhead, 2020). He’s not asking anybody to follow his example, but maybe he has a point or two.
The book is the result of five years of deep research that took Hamblin on a journey through soap factories, microbiology labs and the Manhattan offices of one of the world’s most popular high-end skin care companies. Along the way he talked to dermatologists, allergists, immunologist, aestheticians, Amish people, theologians and even scam artists. Hamblin spends considerable time in the book explaining the history, science and socio-cultural factors associated with cleanliness from Roman baths and germ theory to the value of popular modern-day skin care products like “Glass Skin Refining Serum” and “Matcha Pudding Antioxidant Cream.” In presenting the facts, Hamblin remains neutral. Like personal nutrition, financial investments or religion, what people ultimately choose to do is their decision, he says.
Somehow, most people got by for thousands of years without beauty creams, shampoos and soaps. The fact is, we are each and every one a community of organisms that live inside us (the microbiota) and on our skin. Hamblin points out that the most vigorous scrubbing does not remove them all. Maybe it can even do harm. He recalls the cavalier attitude people had years ago about antibiotics, assuming that bacteria in our gut are bad and we would be healthier by cleaning them out. That was not wise, it turned out; we need to work in harmony with our gut microbiota, because they help us digest our food and protect us from pathogens. Is something similar happening with the organisms that make peace with us on our skin?
Like the gut microbiome, it is not as simple as identifying one particular microbe on our skin that prevents a particular disease. It seems to be about proportions of populations and balance, more like an orchestra of effects. But there are absolutely correlations between eczema flares, acne, psoriasis and instances where people experience shifts in the biofilms on their skin. We’re just beginning to understand how to identify those patterns and what to do with them. Clearly the microbes on and in our skin are very important to us. Yet ways of optimizing that ecosystem are far from fully understood.
Hamblin is not recommending people dispense with their preferred habits for hygiene. He did find for himself, however, that his skin microbiota adjusted when he stopped washing everything off. Surprisingly, the rancid body odor that repels others faded away after awhile. “That’s not to say I don’t smell, but the microbe populations on my body don’t produce that classic body odor smell they always did. My girlfriend tells me I smell “like a human”‘ – whatever that means!
Modern deodorants didn’t really emerge until the last century and it just doesn’t seem logical that evolutionarily, our bodies would become obscenely offensive to other humans within 12 hours if we did not use all these modern applications and products. I gradually weaned myself off these things. I’m not saying it is the best approach for everyone. But it works for me. A lot of reaction I hear from people is that if they stop showering, their skin and hair gets greasy and they feel awful. But it’s like training for a marathon. You can do it, but you have to have patience and go slow. Gradually your body adopts. The theory is these microbial populations on your skin change and eventually establish a healthy equilibrium.
His theory about skin balance does not require Darwinism; it could represent a designed equilibrium just as well. Hamblin readily admits that more research is needed in this area, but he notes that the Amish “have low rates of allergic and inflammatory conditions,” probably because they get a lot more exposure to farm animals and dirt. It recalls the Edward Jenner’s observation that farm women had a natural immunity to smallpox due to their exposure to a milder form of the disease in cowpox. Like a good scientist, Hamblin is just asking questions:
The bottom line is that we need to do a better job discerning science from marketing and focus on effective evidence-based hygiene. To do that, we need to help people understand what is scientifically beneficial, what is elective, what is driven by cultural or beauty preferences and what is simply marketing. All of our cultural and personal preferences are valid, but they are not necessarily helping us to stay alive or prevent the spread of infectious disease.
No one needs to radically change their habits, but it might be wise not to wash all our microbial helpers completely down the drain.
Hamblin’s work supports the “hygiene hypothesis” explored by other scientists (search CEH), that asserts that we can do ourselves harm by being too clean. At The Conversation on August 4, Avril Rowley, a specialist in primary education, wrote about “Muddy knees and climbing trees: how a summer playing outdoors can help children recharge.” Her focus is more on the mental health benefits when kids play outdoors, and how sunshine is healthy:
More exposure to sunlight also increases synchronicity to the natural – or circadian – rhythms of the day. This means that as it gets later in the day, children’s brains start to release the hormone melatonin which encourages drowsiness in preparation for sleep.
On top of this, exposure to sunlight builds vitamin D in the body – an important vitamin for maintaining strong bones and preventing chronic diseases.
Another article from NC State says that children also need solitary time in nature. Outdoor social activities like camping are good, but solitary time like fishing and hunting can help children feel more connected with nature and learn to love and respect the environment. How bad can dirt and exposure to nature be when humans have lived outdoors for most of history? The human body is part of an ecosystem with many players, most with roles to play in good health. It makes sense that we are healthiest when we work together in harmony.
Was Pig-Pen the wise character in the Peanuts cartoons? Rest assured; I, for one, will not be stopping showers or the use of soap. Nor should you, especially if you work in an office environment. The first lesson of this article is to ask questions; why do we behave the way we do? We might find that a habit makes sense, and should be continued. But popular behaviors about beauty products may be more marketing than science. The personal care industry makes a fortune on getting us to believe that all germs are bad and must be washed off, and then cleansing products must be applied on the skin. Then people get psoriasis, eczema and other maladies. Who knows? Maybe those microbial passengers on our skin would help us out if we “live and let live.” Most surprising from Hamblin’s experience that the rancid B.O. that grosses us all out seemed to fade away after Hamblin dispensed with deodorant.
A second lesson is what I have dubbed the “Eden Principle” which could be stated, “If something was not necessary in the Garden of Eden, then the burden of proof is on the claimant to say it is necessary now.” There are people who argue that we need coffee enemas for health. OK, so where does it say that Adam and Eve needed those? Obviously there are things we do need now that were not needed then, like surgeries for cancer and eyeglasses or hearing aids when those become necessary, because we live in a cursed world without the original balance. The Eden Principle, however, provides a simple rule of thumb to raise questions when marketers insist that you have to have their product for good health. Make them prove it. It might save you money.
The Bible extols cleanliness in many places. The Mosaic Law has many instances of washings, both of the bodies of priests, and the washing of sacrifices and utensils. Naaman was ordered to wash in the Jordan seven times, and came up clean (although not because of the dirty river water, but by God’s power). Mikvahs have been found all over Israel, and baths were popular all over Greece and Rome. Swimming is mentioned in the Bible. Humans are not ordered to roll in the dirt, like horses do, but some exposure to dirt is not a bad thing. In short, cleanliness is seen as a generally desirable thing; often it appears as a metaphor for washing away iniquity. But the proverb “Cleanliness is next to godliness” is not found in the Bible. Sweat and dirt during hard work has its place, too. Moderation, balance and recognition that God’s creation was initially complete at the beginning make sense even today.