In The Era Of Hygiene, ‘Clean’ Author Makes The Case For Showering Less

“[physician and health reporter James] Hamblin’s new book, Clean: The New Science of Skin, is a documentary survey of this pre-dawn moment in our understanding of the skin microbiome.

[Emily Vaughn] Your book sets out to challenge some cultural norms about hygiene. What types of cleansing do you think are overdue for reexamination, and which are critical?

[James Hamblin] There’s a distinction between “hygiene” and “cleansing rituals” that’s especially important in this moment. “Hygiene” is the more scientific or public health term, where you’re really talking about disease avoidance or disease prevention behaviors. Removal of mucus, vomit, blood feces … any behavior that signals to people “I am thoughtful about not transmitting diseases to you, and I’m a safe person to be around.” That would include hand-washing, brushing your teeth, cleaning of open wounds, even mask-wearing. I don’t think any of that stuff is due for questioning.

But a lot of the other things that we do are class and wealth signifiers — like combing your hair or whitening your teeth or wearing deodorant — which actually have nothing to do with disease avoidance or disease transmission. They’re really much more of a personal or cultural preference. And that’s where people are experimenting with doing less.

[Emily Vaughn] Why do you think that some of these cultural practices deserve to be reexamined?

[James Hamblin] So many reasons. We’re spending a lot of money (or at least we were pre-pandemic, I don’t have new data) on products and practices in this enormous industry-complex of self-care, skin care, hygiene and cosmetics — which is barely regulated, which is a huge and important part of people’s daily lives, which people worry a lot about, which people get a lot of joy from, which people bond over, which people judge, and which causes a lot environmental impacts in terms of water and plastic.

And there’s the emerging science of the skin microbiome. Being clean [has historically] meant removing microbes from ourselves, so it’s an important moment to try to clarify what, exactly, we’re trying to do when we’re doing the hygiene behaviors. [..]

[Emily Vaughn] You wrote that you think we’re at the edge of a radical reconception of what it means to be clean. What do you mean by that?

[James Hamblin] That’s harder to answer now because I don’t know how the current moment is going to change things. But I believe there’s a shift in the very near future upon us, similar to what we saw with the gut microbiome.

Twenty years ago, the idea of kombucha, and probiotics, and trying to have a healthy biome in your gut were really fringe hippie concepts. And now we’re doing clinical trials of fecal transplants. It’s very mainstream to think about your microbiome. People are being more conscious about things like antibiotic overuse because they don’t want to potentially disrupt the gut microbiome. That has been a really radical shift.

And something like that [for] the skin would be even more radical in terms of the effect on our daily lives, and consumer behaviors and spending, because a lot of what has been done traditionally [in terms of hygiene] is predicated on eradicating microbes. [..]

[Emily Vaughn] What’s the danger of that fine line [between drugs and beauty products here, which makes it very hard for consumers to know]?

[James Hamblin] Most likely these products are not doing anything. Because there’s so little regulatory oversight on this type of product, we don’t even know for sure that they contain what they claim to contain. And if they were significantly changing your skin microbes, I would want to be extremely careful that there was indeed evidence to back up that that change was good and worth making.

I think a lot of people buy products like this thinking, “It can’t hurt, right?” And I would suggest keeping in mind that if something can help, that it can hurt.”

Full article, Vaughn E. Shots: Health News from NPR 2020.9.26