GOOD READS BOOK REVIEW

Clean: The New Science of Skin The downside of cleaning, moisturizing and deodorizing our bodies

BY CHARLES R. MEYER, MD

nless I awaken in a tent in the Bound- explains, really aren’t important since ary Waters, which hasn’t happened for “Part of the appeal of skin care is that it is Uquite a while, I take a shower every explicitly not about rational argument but morning. It is not quite a punctuation to about artistry, autonomy, enjoyment, and the day, more like the capital letter at the personal expression. “ beginning of a sentence. The warm water Hamblin builds a case that all this clean- feels good and I thought I was being hy- ing, whether for beautification or therapy, gienic— until I read the opening sentence may not be necessary. He investigates of preventive medicine physician and At- the skin microbiome with its billions of lantic writer James Hamblin’s book Clean: bacteria present since birth and asks what The New Science of Skin: “Five years ago I function they serve. His answers include stopped showering.” This triggered a flash- competition for other organisms such as back to early days in my practice when I fungi, emission of chemicals which cause saw a farmer from Loretto, Minnesota who sometimes objectionable odors but may said he needed to walk across the road to serve an important evolutionary or sexual access his neighbor’s well for his water and purpose, and stimulating and maintain- who stated that he was “old fashioned” and ing our immune system. He questions only bathed once a week. You could tell. whether attempting to decrease the popu- Much of Clean is an entertaining, some- lation of the biome with soaps, cleansers times humorous, exploration of human at- Clean: The New Science Of Skin and antibiotics is wise and offers multiple titudes toward their perplexing epidermal By James Hamblin, MD, MPH opinions from scientists affirming that it is Published July 2020 by Riverhead Books, 2020 covering. People in the developed world not. That attitude is going commercial as want their skin to be wrinkle-free, rash- skin care companies jump on the probiotic free and, impossibly, germ-free and capi- Dirt not only looked bad it also smelled, and prebiotic bandwagon, such as Dove’s talist initiative has catered to those desires which suggested infection and, in a pitch campaign to care for your baby’s micro- with soaps, creams, peels, lasers and botox, to medicalize cleanliness and soap, Life- biome using their product that promotes generating a multibillion-dollar skin-care buoy forever changed the lexicon of stink prebiotic moisture or AOBiome’s probiotic industry. Hamblin traces the history of the and claimed its soap would eliminate dan- sprays to “re-colonize” your skin biome. obsession with staying clean to the 1853 gerous B.O. Primed with hexachlorophene Eventually, Hamblin endorses a new repeal of the soap tax in England, which and promising to kill germs, Armour’s Dial concept of clean, not the “ineffable state” reversed society’s antipathy to bathing advertised “fresh around the clock” and we have pursued for years, but rather a frequently. Spurred by a belief that dirt was stopping odor before it starts and in three balance of “targeted hygiene” and an “ac- disgusting and that the blackness of dirt years overtook Lifebuoy as America’s most tive life in a safe environment.” His recom- carried suspect racial overtones, English popular soap. Abandoning Dial and all mendations could be summarized as bathe and American cultures clamored for more other soaps, Hamblin dismisses concerns less—although wash your hands after ways to wash and were rewarded with about not showering and B.O. as worry- using the toilet; avoid skin creams, cleans- Sunlight soap from Lever Brothers, Gold ing too much about not offending others ers and deodorants; and walk in the park. Dust Washing Powder from the Fairbanks rather than avoiding a health hazard. After reading Clean, I will keep using my Company and Pears soap, which ran an ad Contemporary skin-care pitches have soap to tend to my B.O. and stick with my stating “The first step towards lightening focused on “clean beauty” with an allu- morning ritual—but maybe making it a bit the white man’s burden is through teaching sion to an undefined purity to strive for. shorter. MM the virtues of cleanliness. Pears soap is a Shelves of exfoliants and moisturizers Charles R. Meyer, MD, is the former executive potent factor in brightening the dark cor- promise beautiful skin with vague expla- editor of Minnesota Medicine. ners of the earth as civilization advances.” nations of mechanism which, Hamblin

MARCH/APRIL 2021 | MINNESOTA MEDICINE | 27