An Argument For The Benefits Of Not Bathing

IRA FLATOW: This is Science Friday. I’m Ira Flatow. These days, now that I’m working from home, my morning shower routine is really the only thing that gets me feeling like the day has begun. I mean, one day to the other feels like all one day, right? So without the daily ritual, I risk kind of feeling unmotivated and unclean.

But for some, staying home during the pandemic has them rethinking their hygiene routines, including not showering.

JAMES: Hey, there, Sci Fri. I want to say that I do shower less often, which I think is a good thing. And I don’t wear deodorant as often as I used to.

MARGARET: I’m showering less because I don’t go so many places. I also changed my hair routine to using baking soda and apple cider vinegar. I’m very happy with the results. My hair is soft and feels even more clean.

Thanks to listeners James from Denver and Margaret from California for sharing their stories with us via the Science Friday VoxPop app. If the idea of not showering every day makes you feel icky, how about not showering for years? Writer James Hamblin says he stopped showering five years ago. Imagine the gook and the grime caked on the skin after all that time. Not to mention the smell. But no, Hamblin says his skin has never been better, thanks to his healthy, well-functioning skin microbiome. So, joining us now to talk about the benefits of not showering and the future of medicinal products for our skin is James Hamblin, staff writer for The Atlantic, author of the new book, Clean, The New Science of Skin.

James, welcome to Science Friday.

JAMES HAMBLIN: Thank you so much for having me.

IRA FLATOW: I have to admit that this is a strange topic to be talking about right now, with all the focus on handwashing and sanitizing. But you were questioning the benefits of these hygiene rituals for years, before the coronavirus hit. Your first line in the book is actually how you stopped showering five years ago. When and why did you stop showering?

JAMES HAMBLIN: Yeah, it’s something that I have been dabbling with for a very long time. And I started working on the book years ago. So I should say, I never stopped washing my hands. That’s very important. That is an evidence-based behavior that saves lives. And that’s not part of anything I’m questioning here. And I still occasionally rinse off with water. But showering in the traditional sense– washing your hair, using a bunch of body wash, using moisturizers and deodorants and anything else– has gone away.

And that came together in my life for complex reasons, part of which was just reporting on the science of it, on the skin microbiome, which, about five years ago, I started seeing a lot of scientific papers on just how many microbes were all over us, very similar to what’s in our gut. And that kind of made me question what is the point of a lot of what I thought was good and necessary. And what of it could possibly be left behind and save time and money and water and plastic bottles and just simplify things.

IRA FLATOW: You have a medical and public health background, so tell us why using soap and other products on our skin, they don’t help us very much, as much as we think they do?

JAMES HAMBLIN: Well, it’s a tool, like anything else, like a medication or like a hammer. On your hands, it’s an excellent tool. And if you have something grimy or greasy, you know, some oil on your skin, that you need to get off, soap is a great tool for that. But just like everything in medicine and health, more doesn’t mean better. And just because it’s good on your hands doesn’t mean it’s good everywhere. If you suggest to someone that they put hand sanitizer all over their entire body, you would find that ridiculous. And I think of soap similarly.

I think most people probably have fine, healthy relationships to showering. But there are also people who overwash and strip the oils from their skin to a degree that dermatologists recommend that they cut back.

IRA FLATOW: The first thing that people talk about– I’m sure you’ve been asked this– the first thing that people want to know is, how much do you smell after not washing for five years?

JAMES HAMBLIN: Yeah, that is a concern. I wash. I rinse off. I just don’t use soap on my body or shampoo on my hair or deodorant. I think– it’s a gradual process. So everyone that has the experience of having gone a day or two or three without showering, and people– that’s the gut reaction, is, yeah, I know what that’s like. I feel gross. I look gross. I smell gross. Doesn’t work for me.

But in my experience– and I’m far from alone on this. Everyone who has gone the minimalist route, it happens gradually. You just sort of wean yourself off. Either people are taking shorter showers using less products, using fewer products, using less of those products. And over time, over the course of months and years, your body just sort of adapts. And the idea, at least, is that you are reaching a steady state with the oils that your skin is secreting, the microbes living on your skin, wherein you just sort of– the whole environment is less volatile. So you do smell. Humans naturally smell. But you don’t smell objectionable. You don’t have a classic body odor-type smell.

IRA FLATOW: Let’s talk about the microbes on our skin. Because you’re right that, like the microbes that fill our guts, the microbes on our skin rarely cause disease. If anything else, they may help protect us from disease. Tell us more about that.

JAMES HAMBLIN: Yeah, I think it’s a similar concept. And this is very much emerging science. But the basic theory is that– I always used to think, if there are germs on your skin, microbes, you just want to get them off. And then the point of showering is to just remove them all, as many as possible. And once we got this sequencing technology to begin to learn about the microbiome, we saw that the skin is never without microbes. There are many, many microbes all over us all the time.

And so, the point can’t be to sterilize ourselves. You’d have to bathe in iodine, something like that. And even right when you got out, you’d be repopulated again. So, similar to the gut microbiome, we don’t know how to do that exactly, but you ideally want a diverse, harmonic, well-balanced system in you. And we do know that simply trying to eradicate the microbes in your gut or on your skin categorically is not the best approach.

IRA FLATOW: And so that’s why you say we’re overwashing ourselves. We’re too concerned with having these microbes on our skin, when we don’t realize that some microbes are good for us.

JAMES HAMBLIN: Yeah, I think not everyone is overwashing, certainly. But that we should think more strategically about it. It’s like saying, we’re taking too many medications. Obviously, many people are taking medications that are lifesaving and important to them. And we just need– many of us could be more strategic about why exactly we’re doing what we’re doing, and are our hygiene practices really necessary, or are they things that if we don’t enjoy them, if they don’t bring us joy, could we do less or go without?

IRA FLATOW: Let’s talk about efforts to turn bacteria on our skin into drug delivery systems.

JAMES HAMBLIN: Yeah, that’s one of the exciting things. Toward the conclusion of the book, I tried to figure out where this is all going. We have basically had the idea for 100 years that you just want to get all the microbes off your skin. Now we’re just starting to understand that maybe the goal should be to have a healthy balance of non-disease-causing microbes on your skin.

So how do you do that? And some people are– this is not supported by evidence yet– but selling skincare products that are labeled as probiotic or prebiotic, similar to the products you see for the gut. And drug companies are actually working on selling what would technically be probiotic, bacterial creams or sprays, topical drugs that are essentially genetically modified bacteria that can deliver drugs like you might want to help you modify, say, eczema, such that– and this is all still very hypothetical– but that if the skin is populated with these microbes, they would stick around longer and deliver an active compound to the skin in a way that would make the person not have to be constantly reapplying something.

IRA FLATOW: But we’re talking about GMO bacteria here. How do you convince people?

JAMES HAMBLIN: Yeah. When you talk to people who have lived with severe eczema or other inflammatory skin conditions, there’s a lot of frustration right now. People are pretty open-minded to approaches, because we have really not proven able to cure eczema, acne, psoriasis, things that for some people are major deals in their life. And so, the science is not there yet to say that this will definitely happen, but the basic concept of shifting our microbes, of trying to shift the ecosystems, repopulate, move things around, is a conceptual change in how we will approach these diseases that is exciting.

IRA FLATOW: Is there any evidence that we are washing away some of the beneficial bacteria that might be overcoming some of these skin illnesses you’re talking about?

JAMES HAMBLIN: I think it is more likely that what we’re doing when we aggressively wash– and people who are fighting bad acne, as I have, tend to get into cycles of just really doing more and more, using more products, and washing and washing– is you’re at least changing the amount of oil that’s on the skin, which serves as sort of soil that feeds the microbes, on which they live. So when you change that, you change the ecosystems. You’re never getting all of the microbes off of you, but you can shift their balances and change the soil in which they grow. And we know that changes in the proportions of microbes do correlate with flares of these skin conditions.

IRA FLATOW: Is it possible that the biome on our skin is also interacting with the microbiome that’s inside our gut?

JAMES HAMBLIN: Nothing would surprise me at this point.

IRA FLATOW: I mean, you’d think you might be exchanging them back and forth, right? We wash our hands. We wipe ourselves after we touch our mouths. We go to the bathroom. We exchange bacteria all the time. You would think that somewhere, there’s some sort of conversation going on.

JAMES HAMBLIN: Yeah. Yeah, I think that’s totally possible. And one of the things that we overlook, often, when we’re talking about skin health, is we tend to think that it has to be addressed or created with topical products or by doing things that are modifying just the skin itself. But we know that when people change their diets, when you’re feeling less stressed, when you are sleeping better, these things affect the functioning and appearance of our skin. So it is really all one complex, dynamic system, the body.

IRA FLATOW: There’s a scary part in the book that I had not heard about, and that’s something called a super fungus, you write, that “no one even knew existed until a decade ago, but has emerged as one of the CDC’s top concerns.” Candida oris– did I pronounce that correctly?

JAMES HAMBLIN: Yeah, that was something that was starting to get a fair amount of attention for being picked up in the bloodstreams of people just before the pandemic of coronavirus. And now has kind of taken a back seat. But the idea that we– this is not to suggest that the microbes that populate our skin are good or bad or that we should give up on trying to identify and eliminate the disease-causing ones. But that the microbes evolve as we are taking more antibiotics and we are trying to treat things, and new pathogens are arising constantly. And so it’s an area of science where, unfortunately, we can’t just say skin microbes are good or bad. And there will always be new challenges. And we’ll have to be vigilant.

IRA FLATOW: I’m Ira Flatow. This is Science Friday from WNYC Studios. In case you’re just joining us, we’re talking with James Hamblin, staff writer for The Atlantic, and author of the new book, Clean, The New Science of Skin. And this is a great read. It’s got all kinds of historical stuff about soaps and the evolution of the soap industry. I didn’t ever realize how far back soap goes and how the meaning of what it means to be clean has changed over the years. And you say that the skin care industry is growing, not shrinking. So why do you expect people will eventually discover the benefits of doing less with their skin?

JAMES HAMBLIN: I’m not certain we will. The industry has successfully sold us more and more products and grown year over year for a long, long time. In the middle 20th century, it was just normal for a family to just have one bar of soap that would do everything for every member of the family. And now showers and bathrooms are lined with many, many different products. And we have products segmented by gender and age and skin type and what colors and scents we like.

The shift that’s happening recently is that people are wanting products that are milder or have fewer ingredients or more quote, unquote natural. So it does seem like– these are often expensive, luxury products. And the fact that people are investing in them means that the industry grows. But it doesn’t mean that people are taking the same clear cut the forest approach to the skin that we were in recent years.

IRA FLATOW: Do you think that COVID-19 and people who have changed their habits due to being at home all the time, and changed their cleanliness habits– washing, showering, whatever– do you think these things will last past the pandemic?

JAMES HAMBLIN: I wouldn’t be surprised. I think it’s a time when people are being more vigilant about where they’re direct their breath and how we’re covering our faces, and not going out when we’re sick, and washing our hands. And that is the sort of thing that is really important. We should’ve been doing all along. The idea of being on an airplane with someone who’s coughing right next to you is terrifying right now. And that probably should have been the case before, that we just stayed home when we were sick. And we were really vigilant about handwashing in the way that we are now.

And at the same time, people are working from home. They’re feeling comfortable discarding a lot of the practices that they might have been doing just because they felt it was necessary in order to go to the office or because everyone does it. So that includes showering. And people getting to a place where they’re really just doing what they find to be beneficial to them.

IRA FLATOW: Well, I have to tell you that after reading your book– I’ve been reading it for about a week– and I have changed my showering habits.

JAMES HAMBLIN: You have?

IRA FLATOW: I have. I mimicked something that you said in your book, in that people were washing only their private parts and leaving the soap off their large major areas.

JAMES HAMBLIN: Yeah. And once we start talking about those things, it turns out, that’s kind of what a lot of people do. The billboards, with people whose bodies are fully lathered from head to toe, are made to sell us soap. And when you get down to it, a lot of people are just the armpits, groin, maybe the feet.

IRA FLATOW: The book is called Clean, The New Science of Skin. James Hamblin, staff writer for The Atlantic and author of the book. You can check out an excerpt of the book on our website, ScienceFriday.com/clean. James, good luck with the book, and thank you for taking time to be with us today.

JAMES HAMBLIN: Thank you so much for talking with me.

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