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Hand Washing: Is it damaging our skin?

What is all the hand washing doing to our skin?

     Even people who were serious germaphobes before the pandemic are likely going through more soap and antibacterial wash than usual these days. We all are.

     Showering is almost certainly on the rise too, given that one of the more aggressive protocols people adopted to protect themselves from COVID-19 was hopping into hot water and lathering up the moment they got home. Most people’s skin, obviously, is drying out, but I wondered if it went further. What is all this washing up doing to the many bacteria that call our skin home?

     Although most research on the human microbiome (the flora on and inside our bodies) is focused on our gut, the skin is also lousy with bacteria and fungi—over 1,000 separate species, many of which are good for us. So how do we get rid of the bad, infectious bugs and viruses (not just SARS-CoV-2) without washing away the ones that are beneficial to human health?

     Dating back to when germ theory was first established, it was quickly discovered that hands are how we transmit infectious particles, so you have to wash them. Although you can disturb the microbiome even when you wash with just water, what we do know about the skin biome is that it is relatively stable when you become an adult.

Even after showering, our microbiome is pretty good at re-establishing itself. However, in my opinion, it is not necessary to shower each day and most studies on the skin’s microbiome’s resilience have not tested antibacterial washes or antibiotic creams and lotions. But there are ways of lessening the damage we’re doing to our skin microbiome.

     Our skin is acidic. Somewhere between 4 and 6 on the pH scale, and that acidity is necessary for a healthy microbiome. So when you use alkaline soaps, like those traditional soap bars made with lye, those have a pH of 10 to 11. You’ll disrupt it less if you use pH adjusted cleansers.

     High pH soaps not only disrupt the skin flora, they also disturb the skin barrier, which can lead to dryness, cracks, and an increased risk of infection. The skin, biome and all, is a massive and important organ—one that we’re increasingly realizing plays a big role in keeping us healthy.

    Our skin is actually the largest organ in our body. It is the barrier to the outside world and the outer part of the skin is a lot like a brick wall, and all or natural oils are like the mortar. Hot water and detergent decrease that mortar which makes your skin more susceptible to infectious agents, pollutants and allergens.

     One of the most important areas of research now is exploring the relationship between skin flora and the immune system. Dr. Vinod Chandran, clinician, scientist and rheumatologist at the University Health Network in Toronto is working on the relationship between the skin microbiome and psoriatic arthritis. He notes, however, that it’s early, partly because a lot of microbiome research so far has been focussed on the gut—not the skin.

     “We do know that the bacteria in the gut and the skin educate our immune response,” says Chandran. “And to have a very good immune response you need that exposure to irritants in the outside world. So because there are a lot more problems with things like eczema and allergies in Western countries, the hygiene hypothesis has come up, you know, that maybe because our spaces are too clean the kids are getting more allergies.”

     Chandran adds: “I have two kids, one born in India and one born here. The one born here has all sorts of allergies and the one born in India has no allergies at all but, that’s just from my own experience.”

     Other scientists have talked about the “farm effect, “which refers to higher immunity found among people raised on farms. The idea is that their early exposure to more dirt may have given them a more diverse microbiome. By contrast, kids in suburban and urban areas, who tend to spend less time outdoors, have less dirt in their lives, something that sounds like a good thing, but actually is not.

     Especially in the first two years of life and especially with children who have a genetic predisposition towards getting eczema, asthma or allergies, over-washing children by drawing a bath or showering them from head to toe is really not good for them. It’s not necessary. Both the American Pediatric and the American Dermatology Association say, that, unless kids have skin disease, they don’t need to be showered every day or bathed every day.

Neither do adults, but a lot of us enjoy the daily ritual of a nice hot shower a nice soothing bath. But don’t get me wrong. If you don’t bath or shower each day, you still have to wash certain areas such as armpits, feet and groin and choose products very carefully for those areas. There are many products but as a general rule if you use unscented products they are the safest because it is usually the agents that give a product a nice smell that can cause the most irritation.

     Erven when we get to a post-vaccine state and the risks are much lower, the one thing we should keep doing is paying attention to hand hygiene. So ditch your high pH soap and stock up on the good stuff.

     Your skin will thank you and so will the bugs that live there.