DEAR DOCTORS: I saw where a doctor wrote a book about what happened to his skin when he stopped bathing for a few years. He said our skin has a microbiome, and he wanted to learn more about it. Is that the same thing as the gut microbiome? What does taking a bath have to do with it?
DEAR READER: You're referring to an unusual and fascinating multiyear experiment conducted by Dr James Hamblin, a US physician with a speciality in public health. A lecturer at the Yale School of Public Health, Hamblin became curious about how daily showers and baths, along with the array of skin lotions and potions people use, affect the skin microbiome. His five-year quest to learn more involved giving up the daily soap-and-hot water showers that are the standard in the United States today, and the use of all personal care products.
Needless to say, this unusual self-experiment generated headlines. And although they suggested Hamblin abstained from all personal hygiene, that's not exactly true. Hamblin writes that he continued to regularly wash his hands with soap to protect against viral and bacterial pathogens, and he followed basic hygiene practices by rinsing off with water. He admits a certain amount of body odour was involved, but says it wasn't too off-putting. He also writes about beneficial changes to his skin that resulted from these new bathing practices. He said his skin became more supple and less oily, and that he experienced fewer flares of eczema, a form of chronic skin inflammation.
At the crux of all this, as you point out, is the human skin microbiome. That is the collection of bacteria, viruses, fungi and microscopic creatures living on the exterior surface of our bodies. Research shows they contribute to the health of our skin and our bodies. And, yes, this is the same basic principle involved in the gut microbiome.
It turns out that each person hosts a unique array of skin microbes, and that these core colonies are formed by the time we are toddlers. They feed on oils and other secretions emitted by the skin and the dead skin cells that slough off as new skin is formed. The skin is a tough environment. It's not surprising that the soaps, chemicals and abrasives routinely used in bathing can have a direct and immediate effect on the skin microbiome, and perhaps have an adverse effect on its natural balance.
A daily bath or shower has become a given in our culture. For many people, it is the standard of proper hygiene. But historians tell us daily bathing became possible, and then increasingly common, with the advent of modern plumbing at the turn of the 20th century.
While it isn't necessary to go to the no-showers extreme that Hamblin did, you can make small adjustments to help preserve your skin microbiome. Don't over-wash, which removes oils needed to feed your microbe friends. The overuse of abrasives can literally strip beneficial microbial colonies from the skin. You can also protect your skin from within by eating a balanced diet, staying hydrated and getting regular exercise. Universal Features Syndicate
Dr Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health.
