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6 things science is revealing about your skin and hygiene
Unfortunately, "less is better" is not a catchy marketing slogan.
- For his new book, "Clean: The New Science of Skin," physician James Hamblin didn't shower for five years.
- Soap is a relatively simple concoction; you're mostly paying for marketing and scent.
- While hygiene is important, especially during a pandemic, Hamblin argues that we're cleaning too much.
A few months ago, James Hamblin made a splash when announcing he hadn't showered or used much soap in five years. The physician, Yale public health lecturer, and staff writer at The Atlantic experimented on himself as research for his latest book, "Clean: The New Science of Skin."
Hygiene rituals are as old as recorded civilization. While Muslims and Hindus created elaborate cleaning rituals, European Christians thought bathing increased your chances of falling ill thanks to miasma theory. For centuries, changing your linen shirt supposedly bestowed cleanliness—not soap and water. Many Christians during this era only had one bath in their entire lives: baptism.
While easy to shake your head in disbelief, Hamblin points out that many current hygiene and skincare rituals have moved us too far in the opposite direction. You certainly want to wash more than yearly, yet our expensive rituals may be more harmful than helpful.
Modern hygiene and skincare is also a time suck. As Hamblin points out, if you spend a half-hour showering and applying products every day, you'll devote over two years to showering-related activities over the course of a century-long life.
In his previous book, "If Our Bodies Could Talk," Hamblin investigated numerous body myths. In "Clean," he focuses on our largest organ. Skin is an environment unto itself. What follows are six important lessons in his book, ranging from hygiene practices to capitalistic greed.
As Hamblin notes in the introduction, abandoning soap doesn't apply to washing your hands, especially during a pandemic. As a physician, he performs this ritual multiple times a day.
Doctor hasn’t showered for five years | Today Show Australia
An obsession with soap might be creating allergies
In the quest to protect our children against bacteria, we might inadvertently create lifelong allergies. An uptick in peanut allergies is indicative of this trend. Our skin is the first line of defense against disease, and it knows how to protect itself. In fact, the organisms and bacteria that live on our skin are doing important work; the more we wash them away, the more susceptible we become to foreign invaders.
Nut allergies might only be one consequence of overwashing. Allergic rhinitis, asthma, and eczema might in part be caused (or provoked) by too many antibacterial soaps (or soap in general). As Hamblin writes, "Soaps and astringents meant to make us drier and less oily also remove the sebum on which microbes feed."
Your skin is crawling with mites
Speaking of foreign invaders, skin science verifies an old Buddhist idea: there is no self. As Hamblin puts it, "Self and other is less of a dichotomy than a continuum." In fact, "you" are a collection of organisms and bacteria, including Demodex. A half-millimeter in length, these "demon arachnids" are colorless and boast four pairs of legs, which they use to burrow into the skin on our face.
Yes, all of our faces.
While these mites were originally discovered in 1841, it wasn't until 2014 that a group of researchers in North Carolina used DNA sequencing to understand their impact. Though you might recoil at the suggestion, it turns out that these critters potentially act as natural exfoliants. While housing too many of these mites results in skin disease, your face is their home. If not for them you might be even more susceptible to breakouts and infections.
Think unchecked capitalism is bad? Thank soap.
Soap is chemically simple. Combine fat and alkali to create surfactant molecules. The fat can be animal- or plant-based—three fatty acids and a glycerin molecule create a triglyceride. Combine this mix with potash or lye, apply heat and pressure, and wait for the fatty acids to rush away from the glycerin. Potassium or sodium binds to fatty acids. That's soap.
You actually pay for scent and packaging. In 1790, the first patent in history was approved for an ash processing method that produced soap. It wasn't an immediate hit; the balance was off. Too much lye resulted in a lot of burnt skin. A century passed before companies convinced Americans regular washing was necessary. Thanks to ingenious marketing—we still have radio-inspired "soap operas" today, though barely—soap became a must-have. A luxury became a common good.
As with everything capitalism, a little doesn't generate much revenue. Marketers convinced the public that a lot was needed. As Hamblin phrases it, "Capitalism sells nothing so effectively as status. And if a little bit was good, a lot would be better." Soap infected mainstream consciousness. Soon, we needed a lot of everything, all thanks to simple chemistry.
A little baby is reaching out of a bath tub to get at a tablet of Pear's soap. The drawing is entitled 'He won't be happy till he gets it'! (1888)
Photo by Hulton Archive/Getty Images
The skincare industry is almost entirely unregulated
Hamblin tried another project for this book: he launched a skincare line. One day he went to Whole Foods and purchased raw ingredients: jojoba oil, collagen, shea butter, a few other things. After mixing them in his kitchen, he ordered glass jars and labels from Amazon. In total, he spent $150 (which included his company website) to launch Brunson + Sterling. He then posted two-ounce jars of Gentleman's Cream for $200 (on sale from $300!).
Hamblin didn't sell any jars, but that wasn't the point. At an expo, he noticed one-ounce jars of SkinCeuticals's C E Ferulic selling for $166, even though that topical acid is no more effective at improving health than eating an orange. Collagen is another hype machine. Drinking collagen does nothing for your skin as it's broken down by enzymes in your digestive tract. Even still, plenty of companies claim it gives you glowing skin even though the charge is rubbish.
Even more incredibly, Hamblin didn't have to report any ingredients to the FDA. He also didn't need to note its effects or provide evidence of safety. He simply needed to apply for a business license. The FDA can't even make him (or anyone) recall products. The government's safety system relies on a code of honor—and there are plenty of businesses that are less than honorable.
Marketing and hype. Thanks, soap.
The ongoing joke about the happiness one derives from finding Clorox wipes in the supermarket will be with us for some time to come, as the CEO announced they won't have enough supply until 2021. That said, do we need to Clorox everything? Probably not, Hamblin suggests. In fact, for Clorox to work, you have to leave it on the surface for about 10 minutes.
"The product isn't 'killing 99.9% of germs' in the way that anyone actually uses it—a quick wipe-down."
Hamblin suggests regularly wiping down your countertop with soap and water. Regularly killing germs isn't the healthiest practice. Similar to antibiotics, overuse makes cleaning products ineffective. Hamblin continues, "some chronic conditions seem to be fueled by the fact that so many of us are now not being exposed to enough to the world."
The takeaway: read beyond what's posted in bright shiny letters on the cover of cleaning products. And consider using them less than you might think you need.
Animals smell. You're an animal.
The soap advertisements that kicked off modern marketing relied on one concept: B.O. We think of body odor as a given, but that too is an invention. Our feet "smell" thanks to Bacillus subtilis. This bacteria has potent antifungal properties. Shoes weren't available for most of history, a period in which smelly feet bestowed a strong evolutionary trait. As Hamblin writes, we didn't evolve to smell, we evolved in harmony with protective microbes that we just happen to find unpleasant.
While a number of players in the wellness and skincare industries likely have good intentions, so much of what is sold is unnecessary, and even damaging. The marketing machine makes us feel "less than" in order to sell us products that complete us. As Hamblin concludes, evidence-based companies would take an opposite approach to skincare and hygiene: less is more. As that will never produce million-dollar companies, we continue to sacrifice health in the name of branding.
Stay in touch with Derek on Twitter and Facebook. His new book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."
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The COVID-19 pandemic is making health disparities in the United States crystal clear. It is a clarion call for health care systems to double their efforts in vulnerable communities.
- The COVID-19 pandemic has exacerbated America's health disparities, widening the divide between the haves and have nots.
- Studies show disparities in wealth, race, and online access have disproportionately harmed underserved U.S. communities during the pandemic.
- To begin curing this social aliment, health systems like Northwell Health are establishing relationships of trust in these communities so that the post-COVID world looks different than the pre-COVID one.
COVID-19 deepens U.S. health disparities<p>Communities on the pernicious side of America's health disparities have their unique histories, environments, and social structures. They are spread across the United States, but they all have one thing in common.</p><p>"There is one common divide in American communities, and that is poverty," said <a href="https://www.northwell.edu/about/leadership/debbie-salas-lopez" target="_blank">Debbie Salas-Lopez, MD, MPH</a>, senior vice president of community and population health at Northwell Health. "That is the undercurrent that manifests poor health, poor health outcomes, or poor health prognoses for future wellbeing."</p><p>Social determinants have far-reaching effects on health, and poor communities have unfavorable social determinants. To pick one of many examples, <a href="https://www.npr.org/2020/09/27/913612554/a-crisis-within-a-crisis-food-insecurity-and-covid-19" target="_blank" rel="noopener noreferrer">food insecurity</a> reduces access to quality food, leading to poor health and communal endemics of chronic medical conditions. The U.S. Centers for Disease Control and Prevention has identified some of these conditions, such as obesity and Type 2 diabetes, as increasing the risk of developing a severe case of coronavirus.</p><p>The pandemic didn't create poverty or food insecurity, but it exacerbated both, and the results have been catastrophic. A study published this summer in the <em><a href="https://link.springer.com/article/10.1007/s11606-020-05971-3" target="_blank">Journal of General Internal Medicine</a></em> suggested that "social factors such as income inequality may explain why some parts of the USA are hit harder by the COVID-19 pandemic than others."</p><p>That's not to say better-off families in the U.S. weren't harmed. A <a href="https://voxeu.org/article/poverty-inequality-and-covid-19-us" target="_blank" rel="noopener noreferrer">paper from the Centre for Economic Policy Research</a> noted that families in counties with a higher median income experienced adjustment costs associated with the pandemic—for example, lowering income-earning interactions to align with social distancing policies. However, the paper found that the costs of social distancing were much greater for poorer families, who cannot easily alter their living circumstances, which often include more individuals living in one home and a reliance on mass transit to reach work and grocery stores. They are also disproportionately represented in essential jobs, such as retail, transportation, and health care, where maintaining physical distance can be all but impossible.</p><p>The paper also cited a positive correlation between higher income inequality and higher rates of coronavirus infection. "Our interpretation is that poorer people are less able to protect themselves, which leads them to different choices—they face a steeper trade-off between their health and their economic welfare in the context of the threats posed by COVID-19," the authors wrote.</p><p>"There are so many pandemics that this pandemic has exacerbated," Dr. Salas-Lopez noted.</p><p>One example is the health-wealth gap. The mental stressors of maintaining a low socioeconomic status, especially in the face of extreme affluence, can have a physically degrading impact on health. <a href="https://www.scientificamerican.com/index.cfm/_api/render/file/?method=inline&fileID=123ECD96-EF81-46F6-983D2AE9A45FA354" target="_blank" rel="noopener noreferrer">Writing on this gap</a>, Robert Sapolsky, professor of biology and neurology at Stanford University, notes that socioeconomic stressors can increase blood pressure, reduce insulin response, increase chronic inflammation, and impair the prefrontal cortex and other brain functions through anxiety, depression, and cognitive load. </p><p>"Thus, from the macro level of entire body systems to the micro level of individual chromosomes, poverty finds a way to produce wear and tear," Sapolsky writes. "It is outrageous that if children are born into the wrong family, they will be predisposed toward poor health by the time they start to learn the alphabet."</p>Research on the economic and mental health fallout of COVID-19 is showing two things: That unemployment is hitting <a href="https://www.pewsocialtrends.org/2020/09/24/economic-fallout-from-covid-19-continues-to-hit-lower-income-americans-the-hardest/" target="_blank" rel="noopener noreferrer">low-income and young Americans</a> most during the pandemic, potentially widening the health-wealth gap further; and that the pandemic not only exacerbates mental health stressors, but is doing so at clinically relevant levels. As <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413844/" target="_blank" rel="noopener noreferrer">the authors of one review</a> wrote, the pandemic's effects on mental health is itself an international public health priority.
Working to close the health gap<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDc5MDk1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTYyMzQzMn0.KSFpXH7yHYrfVPtfgcxZqAHHYzCnC2bFxwSrJqBbH4I/img.jpg?width=980" id="b40e2" class="rm-shortcode" data-rm-shortcode-id="1b9035370ab7b02a0dc00758e494412b" data-rm-shortcode-name="rebelmouse-image" />
Northwell Health coronavirus testing center at Greater Springfield Community Church.
Credit: Northwell Health<p>Novel coronavirus may spread and infect indiscriminately, but pre-existing conditions, environmental stressors, and a lack of access to care and resources increase the risk of infection. These social determinants make the pandemic more dangerous, and erode communities' and families' abilities to heal from health crises that pre-date the pandemic.</p><p>How do we eliminate these divides? Dr. Salas-Lopez says the first step is recognition. "We have to open our eyes to see the suffering around us," she said. "Northwell has not shied away from that."</p><p>"We are steadfast in improving health outcomes for our vulnerable and underrepresented communities that have suffered because of the prevalence of chronic disease, a problem that led to the disproportionately higher death rate among African-Americans and Latinos during the COVID-19 pandemic," said Michael Dowling, Northwell's president and CEO. "We are committed to using every tool at our disposal—as a provider of health care, employer, purchaser and investor—to combat disparities and ensure the <a href="https://www.northwell.edu/education-and-resources/community-engagement/center-for-equity-of-care" target="_blank" rel="noopener noreferrer">equity of care</a> that everyone deserves." </p><p>With the need recognized, Dr. Salas-Lopez calls for health care systems to travel upstream and be proactive in those hard-hit communities. This requires health care systems to play a strong role, but not a unilateral one. They must build <a href="https://www.northwell.edu/news/insights/faith-based-leaders-are-the-key-to-improving-community-health" target="_blank" rel="noopener noreferrer">partnerships with leaders in those communities</a> and utilize those to ensure relationships last beyond the current crisis. </p><p>"We must meet with community leaders and talk to them to get their perspective on what they believe the community needs are and should be for the future. Together, we can co-create a plan to measurably improve [community] health and also to be ready for whatever comes next," she said.</p><p>Northwell has built relationships with local faith-based and community organizations in underserved communities of color. Those partnerships enabled Northwell to test more than 65,000 people across the metro New York region. The health system also offered education on coronavirus and precautions to curb its spread.</p><p>These initiatives began the process of building trust—trust that Northwell has counted on to return to these communities to administer flu vaccines to prepare for what experts fear may be a difficult flu season.</p><p>While Northwell has begun building bridges across the divides of the New York area, much will still need to be done to cure U.S. health care overall. There is hope that the COVID pandemic will awaken us to the deep disparities in the US.</p><p>"COVID has changed our world. We have to seize this opportunity, this pandemic, this crisis to do better," Dr. Salas-Lopez said. "Provide better care. Provide better health. Be better partners. Be better community citizens. And treat each other with respect and dignity.</p><p>"We need to find ways to unify this country because we're all human beings. We're all created equal, and we believe that health is one of those important rights."</p>
A study by UK archaeologists finds that longbows caused horrific injuries similar to modern gunshot wounds.
- UK archaeologists discover medieval longbows caused injuries similar to modern gunshot wounds.
- The damage was caused by the arrows spinning clockwise.
- No longbows from medieval times survived until our times.
Battle of Agincourt.
The angle of entry into a cranium found during the excavation at a medieval Dominican friary in Exeter, England.
Credit: Oliver Creighton/University of Exeter
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Vegans and vegetarians often have nutrient deficiencies and lower BMI, which can increase the risk of fractures.
- The study found that vegans were 43% more likely to suffer fractures than meat eaters.
- Similar results were observed for vegetarians and fish eaters, though to a lesser extent.
- It's possible to be healthy on a vegan diet, though it takes some strategic planning to compensate for the nutrients that a plant-based diet can't easily provide.
Comparison of fracture cases by diet group
Credit: Tong et al.<p>The results showed that vegans were especially vulnerable to hip fractures, suffering 2.3 times more cases than meat-eaters. Vegetarians and pescatarians were also more likely to suffer hip fractures, though to a lesser extent.</p><p>One explanation may be that non-meat eaters consume less calcium and protein. Calcium helps the body build strong bones, particularly before age 30, after which the body begins to lose bone mineral density (though consuming enough calcium through diet or supplement can <a href="https://ods.od.nih.gov/factsheets/Calcium-Consumer/" target="_blank">help offset losses</a>). Lower bone mineral density means higher risk of fracture.</p><p>Protein seems to help the body absorb calcium, <a href="https://www.bonejoint.net/blog/did-you-know-that-certain-foods-block-calcium-absorption/#:~:text=Historically%2C%20nutritionists%20have%20warned%20that,may%20increase%20intestinal%20calcium%20absorption." target="_blank" rel="noopener noreferrer">when consumed in normal levels</a>. The recent study, along with past research, shows that people who don't eat meat tend to have lower levels of both protein and calcium. When the researchers accounted for non-meat eaters who supplemented their diets with calcium and protein, fracture risk decreased, but still remained significant.</p>
Credit: Pixabay<p>Another explanation is body mass index (BMI). Non-meat eaters tend to have a lower BMI, which is associated with higher fracture risk, particularly hip fractures. In the new study, vegans with a low BMI were especially likely to suffer hip fractures. That might be because having more body mass provides a cushioning effect when people fall.</p><p>Still, the study has some limitations. For one, White European women were overrepresented in the sample. The researchers also didn't collect precise data on the type of calcium or protein supplementation, diet quality or causes of fractures.</p><p>Another complicating factor: Producers of vegan products, such as plant-based milk, are increasingly fortifying foods with nutrients like calcium and protein, so modern vegans are potentially at lower risk of deficiency.</p><p>The researchers wrote that their findings "suggest that bone health in vegans requires further research."</p>