In This Episode
What would happen if you just … stopped showering? After all, we spend way more time washing than our ancestors ever did. Abdul reflects on the way the soap industry has created demand for its products by playing on our insecurities. Then he interviews Dr. James Hamblin, a preventive medicine doctor and author of the book “Clean: The New Science of Skin and the Beauty of Doing Less” about what he learned by not showering.
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Dr. Abdul El-Sayed, narrating: Protests erupt in China over that country’s zero-covid policy. Flu hospitalizations are up over 30% in the last week alone, and under its new CEO, Elon Musk, Twitter will no longer enforce its COVID-19 misinformation policies. This is America Dissected. I’m your host, Dr. Abdul El-Sayed.[music break] Today we’re talking about the elaborate ritual of cleansing, where it comes from and why we do it. But first, I want to take you back, like way back to the eighties. Remember this?
[clip of Zest commercial] Zestfully clean. You’re not fully clean unless you’re Zestfully clean. Do I look clean to you? Surprise, I’m not fully clean unless I’m Zestfully clean. Soap leaves a sticky film on you that won’t rinse away. But Zest rinses you fully clean. Zestfully. Zestfully. Zestfully clean. You’re not really clean unless you’re Zestfully clean.
Dr. Abdul El-Sayed, narrating: Yeah, I’ll admit it. I was like five when that commercial used to come on. Usually when I’d be watching Ninja Turtles and for, like, three years, I took it to heart. I basically forced my mom to buy me Zest. I needed to be Zestfully clean. And then one day, I realized that I was the only one in my family who used Zest. My parents they were cheating on me, they’d moved on to Irish Spring. And that stuff well, that stuff smelled like a field of clovers in Ireland. At least that’s what they said. Granted, I’ve never been to Ireland, but hey, they got me. Oh, and then there was this commercial when I was in middle school.
[clip of Clairol commercial] Stop by aisle five for Clairol’s Herbal Essences. It takes you where no shampoo has gone before with all natural botanicals and organic herbs and pure mountain water. Oh Yes. It will leave your hair looking beautiful. Yes. Yes. If you think that’s great, try the body wash. Clairol’s herbal essences, a totally organic experience.
Dr. Abdul El-Sayed, narrating: To be sure. I wasn’t the demographic they were probably after, but damned if I wasn’t going to get me some herbal essences. Today, as a 38 year old grown ass man. I’m still super finicky about my body washes, deodorants, and skincare routine. And now that I reflect on it, well, I’ve had an odd infatuation with soap for a while now. They tell me it’s quote “self-care”, but I’m skeptical. See, when I was a kid, I was super aware of the stereotypes people had about people like me. I was an overweight, brown kid with a foreign name. All the foods I ate were a lot more, we’ll say, pungent than the peanut butter and jelly my friends at school usually got. And so it only took a couple of people calling me dirty or smelly to instill a lifelong fear of being exactly that. And Zest and then Irish Spring, notice it’s not Arabian Summer, and Herbal Essences all of them were right there to monetize my insecurity by getting me to buy overpriced soap or shampoo and then antiperspirant and retinol serum and the list goes on. Now, self-care would have meant recognizing that there is nothing about me that is inherently less clean than anyone else. Not paying a ton of money because someone told me I was. But that’s the thing. See, I’m not the only victim of an industry built to sell us chemicals where our own self-worth should be. In fact, soap has been monetizing American’s insecurities now for nearly a century. Think about it. What do we call those dramas that play in the middle of the day? They’re soap operas. There were literally TV shows built to sell us soap. One soap wasn’t enough. There was soap for your mom. Soap for your kid. Soap for your face. Soap for your hands, soap for your body. Soap for your hair. And then when the soap inevitably dried out your skin, they sold you lotion and toner and serum. Look, don’t get me wrong. I love that fresh out of the shower feeling and nothing beats a nice shower after a good workout or on a cold winter day. I’m just saying it should be a personal enjoyment, not a corporate grift. And that’s exactly what our guest today wrote about in his book, Clean: the New Science of Skin and the Beauty of Doing Less. It’s a book I came across when it was published during the pandemic, when all of us, ironically, were washing our hands for 20 seconds while singing the birthday song. Or at least should have been. Dr. James Hamblin is a preventive medicine physician and journalist, and for a few years he decided to see what happened, if he, well, just stopped showering. Folks. Don’t try this at home. James is a trained professional, and he wanted to see how many of the shampoos and lotions he simply didn’t need. And in the process, he learned a lot about how our skin actually works and how our effort to enhance it can actually interrupt that process. Here’s my conversation with Dr. James Hamblin.
Dr. Abdul El-Sayed: All right. You should be good to go. Um. Ready to roll?
Dr. James Hamblin: Yes.
Dr. Abdul El-Sayed: All right. Uh. Can you introduce yourself for the tape?
Dr. James Hamblin: I’m James Hamblin. I am a journalist, a preventive medicine physician and a lecturer in public health at Yale.
Dr. Abdul El-Sayed: And you haven’t showered for a minute now?
Dr. James Hamblin: [laugh] No, I’m back. I’m back to it. I went on a journey in the course of researching some articles and later a book that took me to a place of extreme minimalism. But now I, I am just a, a minimalist, quick, almost product free showers. Yeah.
Dr. Abdul El-Sayed: All right, so uh we got to step, step all the way back. [laugh] What compelled you to not take a shower for what was several years on end there and then write a book about it?
Dr. James Hamblin: Um. I have an interest in our daily habits. I mean, I see that as the foundation of so much of our health. You know, we think about the medical system as someplace that’s going to fix us with pills and surgeries. And occasionally we can do some things. Um. We do uh parts of that better than others. But really, the foundation for what happens when we get sick, how we recover comes down to so many small daily habits. And I have written about all of them in the course of my journalism. And so hygiene is a big part of that. And uh showering is, I think, one of these unexamined habits that um people I don’t have a lot have very strong beliefs about the health properties of the practice, I should say, and yet kind of don’t talk about it. It’s a little taboo. Everyone has their own little rituals and it’s still pretty private. And so I wanted to explore that.
Dr. Abdul El-Sayed: So, you know, I, uh I shower on the regular and um, you know, it’s as much about my own comfort as it is about the comfort of people around me. Uh I’ve been told from a relatively young age that when I don’t shower, I’m less pleasant to be around. And you went at this for for several years. All right. So walk me through the principle. Right. You know, I agree with you that I think we take showering and particularly chemical driven showering way too seriously in comparison to some of the other things that we need to do to keep ourselves clean. That I’ll argue we probably don’t do as much as we should. What did you find in your your time not showering? What was your experience? Did you you know, did you go through like a withdrawal period? Did you start getting kind of kind of stanky after a while and then your body kind of kicked in and took care of it? Like, how what was the experience like? And I probably should be asking um your, your, your girlfriend, uh who was your girlfriend at the time of the book. Um. Probably better than you, but but but walk me through that. Like, what was that experience like?
Dr. James Hamblin: Yeah, well, I certainly didn’t stop cold turkey and I don’t recommend that for anyone. I think everyone has had that experience basically when they’ve gone a few days without showering and yeah, that’s what happens. You know, that’s a radical step that I don’t see as at all recommendable to anyone. What I did was kind of I was already gradually starting to do less and starting to become just fascinated by the marketing of soap products. Like they’re all over CVS, they’re right next to the medication. There’s like two aisles of different body washes and shampoos. And this was around 2015. The skincare craze was really rocketing, I mean, to new heights of cost and of amount of time that people are spending on it. And then on top of that, we were learning about the skin microbiome um kind of in the wake of the craze about probiotics and the gut microbiome and people rethinking how they might cultivate “good”, quote unquote, good bacteria in their guts. And so I started to think, why doesn’t that same principle maybe apply to your skin? We also have trillions of microbes all over our skin that are living there normally that are not causing a problem. What are we really doing by applying all these products so regularly? Is it good? And so I just wanted to experiment with kind of like [laugh] with doing less cutting back on certain things. Um. Different frequencies of showers, different temperatures, different kinds of products. And that for a while involved no showering at all, but for the most part was mostly just minimalist. Quick, quick regimens.
Dr. Abdul El-Sayed: Okay. So how did you, you said you didn’t cut back cold turkey. And that’s that’s not the way to do it. Um. And I promise for I’m sure anybody who knows me who’s listening, I’m not intending to cut back on showering, just want to put that out there. But how did you go back trimming? What did you lose first? I mean, was it sort of use of certain soaps or shampoos and conditioners, other kinds of things? Or or was it sort of, you know, you just took a shorter shower? How did you go about this? And then in the end, what was the experience like? What was the body feel of of not showering for days on end?
Dr. James Hamblin: Um. Well, this was not a uh controlled experiment in which I set out any sort of practical course. I just gradually started doing less. And of all these things and uh of shampoo especially. I mean, none of these that I quit overnight of deodorant, of body wash, you know, frequency of showers, duration of showers, all of it. I just. I was just trying to do less gradually. And because, like you and everyone else, I have gone without showering and felt, you know, gross and smelled bad um but wanted to understand what was the point at which, you know, what is really necessary here, what uh parts of this are really helping me, helping my skin to look better, helping me to feel better, um helping me to not smell terrible. And, you know, how do I focus on on just just that and stop doing the things that might be drying out my skin, messing with my microbiome in ways that I are counterproductive um kind of self replicating? I think um you know that’s a big thing is like shampoo and conditioner. We’re told you need to wash the oils off and then replace them with a conditioner right away. So [laugh] it was a lot of different uh permutations. I don’t have a prescription for how to do it and uh I think it certainly works differently for everyone.
Dr. Abdul El-Sayed: Mm. So it’s just fascinating. And I promise we’re going get to the to the um the scientific meat of the conversation in a second. But you taught you shower now. So what is your regimen? What did you find was what you needed personally to feel that sort of space between um suitably well kept um but not overly chemicalized?
Dr. James Hamblin: Well. I have completely stopped using shampoo. Um. I comb my hair to exfoliate my scalp. Um. I use a washcloth to scrub my face with just water. I occasionally use a quote unquote “natural deodorant” that’s mostly, well, the products are proprietary, but it’s made by Soapwalla. I’ll use that every couple of days, put a little under my arms um and then I use water in the shower and some scrubbing with the washcloth. And um that tends to but but I did realize that I liked doing that. Like, I like it especially during the pandemic. It became really important to me as a the ritual side of things. Um. This is something that starts your day, makes you feel refreshed in the winter, warms you up, like is a demarcation between this kind of lounging about in the morning and then, okay, we’re getting serious, we’re taking a shower, we’re getting dressed. This is part of a routine that separates and demarcates parts of life it’s that might sound silly, but when, you know, you really break this down, that to me is the main value of it.
Dr. Abdul El-Sayed: Mm.
Dr. James Hamblin: Yeah. So it’s short, it’s 5 minutes and in and out. But I, I look forward to it.
Dr. Abdul El-Sayed: You know, the the the notion of a shower as punctuation, I think is something that all of us who’ve lived through the pandemic very much appreciate, because I think the longest I went without showering was probably some point early in the pandemic when the days just mushed together and uh and you sort of looked up and you’re like, wait, I thought it was Monday. It’s actually Thursday. And I haven’t showered and I’m still wearing the same pair of sweatpants. And I need I need to take a shower.
Dr. James Hamblin: Yeah.
Dr. Abdul El-Sayed: Um. And it does offer you that sort of refreshment. And it’s also I think it’s there’s something nice about um, you know, we swim because we enjoy being surrounded by water. Um. And I think there’s something nice about being able to do that. But the central point, there are two points that I really want to I want to tease out here as we move to the scientific uh portion of the conversation, um A.) Is this notion that, you know, our bodies are really great at staying absolutely the same, right? We talk about it as homeostasis. Anybody’s whose ever taking a biology class. You start to appreciate that homeostasis is the simple goal. And, you know, anybody who’s ever done yoga knows that holding a position in place is actually really hard work. And our bodies do this thing really, really well. And most of our bodies don’t need our constant tending. We don’t uh think about trying to wash our livers or uh replenish our kidneys, but skin, which is the body’s uh largest by volume organ, we think about washing all the time. Um I was sort of watching my cats uh recently and they don’t they don’t shower. In fact, if you tried to shower them, they’d get really upset about it. And yet they stay pretty clean. Like granted they also like lick themselves, which I think for all of us would find, we’d find pretty odious. But but they have a system, right, that that keeps them clean and relatively refreshed. That does not involve constant washing with water, let alone washing with artificial soaps and cleansers and and lotions and toners and all these other things that that we use. And yet, for most of you know human history, there has been this effort to like wash, um and it is a part of like what we are and how we operate. And and so I guess I wonder like why the homeostatic double standard? Why why do you feel like we have this sort of drive to cleanse and deodorize this part of our body, um even though we kind of understand that the rest of it is uh homeostaticly, um self maintaining?
Dr. James Hamblin: Well, that’s a wonderful question and it is really the first half of the book. So through uh in very brief pre-industrial revolution, you know, it was our levels of hygiene were limited by we didn’t have indoor running water. Soap, you could make your own but it like it was uh it would burn your skin basically.
Dr. Abdul El-Sayed: Fight Club style?
Dr. James Hamblin: It was too much. [laugh] Yeah. And um and it was kind of like, you don’t want visible grime on you, if possible. Like, everyone had a smell. It was more known that you had a smell. There was still if you look back in literature, there’s there are people who are referenced as particularly bad smelling. But I think our threshold for like what was offensive was not just, oh, I can detect something, but you clear the room when you walk in. So um there was some level of decorum and people did kind of what they could, but it was mostly you jump in a river or when you can or like build a fire and boil some water and clean off every week or month or we know um it anyway it was very limited. Then you have this confluence around the Industrial Revolution and the period following that where we got indoor plumbing uh densely packed cities and a lot of disease transmission. Began to understand germ theory and begin to have the capacity to produce mass produce and mass market hygiene products. And um these things that were previously affordable only to, you know, royalty, basically like having uh luxury soaps and people draw you baths regularly. Suddenly um a lot of people could get them, most people could. And they became um very intertwined with class politics, with wealth, and with this new idea of science. And we swung very much in the other direction of like, oh, well, we know that diseases are caused by these little microscopic things. We get them all off, kill them all, the more the better. Uh. It’s virtuous and it’s good. And you should look like you have you know, there is you have never seen dirt in your life and you have just popped out of a shower everywhere you go. And that is the only way to be a proper person in the world. And and that still lingers a hundred years plus later.
Dr. Abdul El-Sayed, narrating: We’ll be back with more with Dr. James Hamblin after this break.
Dr. Abdul El-Sayed, narrating: And we’re back with more of my conversation with Dr. James Hamblin.
Dr. Abdul El-Sayed: At the same time, as you know, we have built this social norm around looking and smelling fresh and clean. There are a lot of things that have a lot more evidence behind them that people don’t consistently do or at least don’t enjoy doing. Um. One of them is brushing teeth. Right. If you’ve ever talked to a little kid that they’re they don’t like taking baths or showers all that much either. But um but brushing teeth is particularly unfun um for some reason. And yet, you know, we’ve got pretty good evidence that brushing teeth um is a is a good thing to do for a lot of reasons. And then another one is wearing sunscreen, which does imply protecting the most exposed parts of the skin. I guess I want to get your sense on on those two habits because they kind of break this homeostatic norm question that that we establish, which, you know, the body kind of takes care of itself. But sunscreen and um brushing teeth are two of those things that we have very strong evidence, are generally good for you in a number of different ways vis a vis, you know, washing your face every day, which there’s probably very little evidence actually does anything except for make you feel cleaner. Um. How do you think about those two things in the sense of what we ought to be doing in daily habits that really do um complement or supplement what our body can do for itself?
Dr. James Hamblin: Right. Um. Well, I’m I’m not a dentist, but and I never stopped brushing my teeth or or flossing. And I think that the theory behind that is that we have so uh disrupted whatever oral microbiomes, you know, we might have evolved with that are generally good with our very weird diets and things in our modern lifestyle. That brushing is the only solution. And then also we live way longer than our teeth were probably meant to last us. So we got to plan ahead here. Um. That’s the basic theory we’re drinking, you know, as we speak I’m drinking a diet coke that’s eroding the enamel on my teeth. And [?] later. Uh. Yeah. Brushing is good, sunscreen um I couldn’t tell you uh how things went historically with skin cancers. I know where we do have more intense UV radiation exposure as we erode our our atmosphere. And um it’s possible there’s something to do with how we are uh we’ve always removed the oil and grime from our skin, that might have helped it in some way to protect us from the sun. But I’m also yeah pro sunscreen as long as you don’t, doesn’t give you a feeling of invincibility. Like I got sunscreen on. I can stay out all day because it also has its limits.
Dr. Abdul El-Sayed: Yeah. And it’s also I mean, the other part of it is, you know, our our capacity to uh translocate ourselves has changed um where we live. And I think uh we take for granted that anyone living can live anywhere. And that’s, you know, an amazing thing, uh but also um that for most of human history, there was a long evolutionary process that allowed us to um to evolve vis a vis the kind of sun exposure that we actually had. Right. There’s a reason, I assume, that your family’s probably from somewhere in Europe. My family’s from North Africa. We look different. And in part that’s because of a long history of evolving to the sun exposure that that we had. And so I think in some respects, there’s also a a, you know, an implicit mismatch between the sun exposure that we have today um and uh what our skin has or different kinds of skin have evolved to um withstand. Um.
Dr. James Hamblin: Yeah. Absolutely.
Dr. Abdul El-Sayed: And at the same time, right, the point that you make about UV exposure and then norms, right? Like, like, you know, in the past, you know, I think about traditional uh garb in um the Middle East and there was always a headdress that flowed over the neck to protect you from the sun, um which, you know, nowaday the norm, like fresh and clean. Both you and I have shiny hair and uh we are not likely to put on a hat uh later today. And we’re definitely not likely to wear, you know, a full on uh garb that covers our neck. And so, you know, there’s just different norms to the kind of exposure that um that that we’ve we’ve developed.
Dr. James Hamblin: Yeah. Yeah.
Dr. Abdul El-Sayed: Um. The other part of this is washing hands, right. Um. I presume during the pandemic when you were uh conducting this um, you know, N equals one experiential uh case study uh that you were consistently washing your hands. How do you think about handwashing uh vis a vis the past? Right. When um like you talked about there was no ubiquitous access to water, uh hand sanitizer was not a thing. Um. How do you think about that?
Dr. James Hamblin: Yeah, I never stopped. I always advocated it. Um. I think that once again, we get a lot of you know, we have all these respiratory viruses going around right now, some of which are coming from uh surfaces. Um or you know, fecal oral transmission has always been a problem. We had terrible um outbreaks of cholera and all kinds of things that are no longer with us. And being able to wash has been central um to that. So it’s not that washing is good or bad. I think that is where the kind of marketing and belief systems have taken it to an extreme that washing your hands is good, then, you know, washing your elbow must be good. And [laugh] uh that and you know, just like if wearing a mask on your mouth is good, then wearing a mask on your elbow must be good. Um, so, yeah. No wash your hands. I think it helps with a lot of different uh disease transmission issues and it is also certainly a product of like dense, densely packed indoor settings where we spend so much of our lives.
Dr. Abdul El-Sayed: Yeah. No it’s a really good point, right. Is that we a lot of the sort of differences in the ways that um modern technology has enabled us to live, I mean, that we’re exposed to so many more people uh and the things that other people interact with then–
Dr. James Hamblin: Yeah.
Dr. Abdul El-Sayed: –You know, at any point in human history in the past. And so, you know, the degree to which your, um your coming in contact with other peoples uh flora, uh we’ll say it that way. Um. And and and then also the degree to which you are interacting with other things that can take that flora off your hands, right? So if you’re a hunter gatherer in the past, right, you may interact with other people. They’re probably the same people you’ve been interacting with your entire life, meaning you share probably all the same flora. And um you’re spending a lot of your days out in the world um and you’re using your hands to do a bunch of other things, which involves, yeah, you’re taking things from the outside, but you’re also leaving things out. So, you know, if you’re, if you have your hands in the dirt all day, you are you’re just getting a different mix of things than than you might um if you’re walking around New York City and touching the subway.
Dr. James Hamblin: Right. Right. That this is also why, you know, back pre-industrial revolution, we would have the ability for travelers to seed populations with new microbes and just decimate them because there was no preexisting immunity uh and not that we have great preexisting immunity to everything right now, but we have at least some familiarity with similar viruses globally. This so you can have a very bad pandemic, but not on the order of, you know, rates of mortality like you would with a virus to which our body had like, you know, we’ve seen coronaviruses before. We had some our immune systems we’re not dealing with, like something from outer space.
Dr. Abdul El-Sayed: Mm hmm. Yeah, it’s a really good point. I think we’d never seen this particular Corona virus, but we had seen coronaviruses, and there was some residual immune response that, you know, sort of baked in. And it’s impossible to know how much simply because the world is so globalized that you can’t really paint a counterfactual of people who had not been uh exposed. Um. And so it’s you know, there’s a world where the same exact virus hits a new population and fundamentally decimates it because they had not been as exposed to as many coronaviruses in the past. And the thing that folks you know don’t don’t don’t bake in is that the cold, the common cold, so many of the common colds that we are exposed to on a on an annual basis are themselves coronaviruses. I want to ask you right, because part of this story is not just about the skin as a homeostatic mechanism. It’s also about the role of capitalism in selling us things that we don’t necessarily need by creating social norms that are hard to resist. Right. And we try to take for granted that the kinds of TV shows that play during the day are called soap operas. Uh. And you talk about that in your book. Um. Can you tell us about the rise of Big Soap? Like, how did this happen and how did soap become such a ubiquitous um quote “need”? Uh. And then all of the other sort of products that that that cascade out of of washing your body so often.
Dr. James Hamblin: Yeah. Well, soap operas, these were um serialized television shows that were created to sell soap. Um. The soap companies wanted to reach certain demographic being people who were working in the home tended to be women um and taking care of families and being the one who were going to buy the groceries and, you know, uh make sure everyone had what they needed. And so that hence you got soap operas. The soap industry is there are uh there can be textbooks written around the rise of soap industry, which is really just an exercise in marketing. You had a very cheap, easy to manufacture product that suddenly flooded the markets. [laugh] It was the wild west of very, you know, no consumer protections. You could kind of say anything that you wanted. This is early 20th century that this soap will do for you. And people did it in order to differentiate their their products, because soaps can, you know, have slightly different phs, kind of have a little uh you know a different scent, a different color, but they’re fundamentally the same product. And so in order to differentiate them, you had to say, this is a soap for men, this is for women, this is for kids, this is for this will make you this is a health soap. This is a beauty soap. And there might have been threads of truth for that, but one of them that tended to work really well is like this keep this makes you a good parent. If you wash your kids with it, this keeps you alive. This makes you healthy. This is virtuous and moral and good. And our soap, you know, using this product, will confer these qualities to you throughout all of the marketing at the time. And so there’s no no mystery as to why we continue to believe it today. And we still use these judgmental terms like your gross, disgusting, like vague things when when you hear even just hear that someone doesn’t shower as much as you think, doesn’t use as much soap as you think they should.
Dr. Abdul El-Sayed: Yeah, I really appreciate that. And then the other point about soap is that it’s actually um it’s a pretty harsh chemical, right. The thing about soap that what it’s supposed to do, it is um a chemical that is unique in the fact that, you know, you think about oil and water don’t mix. And so much of what your body produces is oils and just rinsing them off doesn’t take away the oils, which as we’ve talked about earlier, may actually be a really good thing. And the thing about soap is it’s unique because on the one side of a soap molecule is the kind of molecule that can melt away oils or can coalesce around oils. And then the other um side is one that uh that mixes well with water. So it’s a unique um substance. But then in order to make soap, you actually have to treat a oil molecule with something extremely harsh, usually a very intense base to split apart that molecule and allow it to have the processes of soap, which means that you’re going to have some of that excess uh harshness. And the other part of it is that you know our bodies produce oils for a reason. Um. And then when we strip them of oils, our skin is less protected. And so there’s all kinds of other chemicals that um we’ve developed on top of that, can you speak to some some of those some of those chemicals and and and some of the, you know, very intense uh industry that has flowed from the consequence of using too much soap?
Dr. James Hamblin: Right. Um. Well, technically speaking, a soap is like a like a champagne is a champagne is this sparkling white wine from a particular region in France. And a soap is uh something that is made from a fat can be of animal or plant origin combined with a base. And like you mentioned, they used to use lye or whatever was available in rendering these really harsh soaps. And it’s just a pure product. There’s nothing else. Nothing else in it. And it turned out that, you know, that dries skin, people’s skin out like, you know, this about soap. That is the reason that moisturizers and conditioners exist is to counteract soap. And as soon as it was possible to add other products to it, like Dove, which is technically a beauty bar, not a soap, um that was essentially like the shampoo and conditioner all in one. You could add other things to kind of mitigate the effect of the soap, which doesn’t, you know, entirely, entirely make sense. And then in the you know 20th century, we got the ability to uh make detergents chemically, which are not soaps at all. But your liquid, your shampoos and body washes are hard detergents that will contain various compounds that essentially mitigate the effect of detergents that are in the formula. So this is mild, it’s non drying. All these things are kind of just like we’re watering it down and we’re watering it down or we’re adding something to counteract what it does. So it’s really much more about you like the smell of it and the feel of it and the ritual of it. And we’re making products that are closer and closer to nothing.
Dr. Abdul El-Sayed: Mm hmm. So it’s basically just really, really fancy cologne.
Dr. James Hamblin: [laugh] Yeah. And I mean, there are skincare companies that sell, you know, uh rosewater and things like that. And there are ways to recreate the act and to make yourself, you know, put something that you enjoy the smell of on your skin without washing away all the oils. So I think balance is pretty much in vogue now, but it wasn’t for a long time.
Dr. Abdul El-Sayed: What about deodorant? You’ve got pretty effective antiperspirant deodorants now that many people use, and this amounts effectively to clogging up your pores with aluminum. Um. Can you talk a little bit about the the advent of deodorant, about the sort of manufacture of this idea of BO, of body odor and how it’s become, you know, ubiquitous?
Dr. James Hamblin: Yeah, well and I mean, we’ve all smelled it. There’s no denying it. Um. The parts of your body where they’re oily glands, your groin and your armpits are going to generate almost all of your smell. And when it becomes, you know, noxious with we call body odor, if you take care of those areas, you’re pretty much like uh going to take care of that. The worst case. Um. So the idea is that to go to your points about evolution, we certainly didn’t evolve to smell, you know, to require an elaborate cleaning ritual every 24 hours or else smell so offensive that people are going to mock us and not want to be around us. That would not be productive, um evolutionarily speaking. So the sort of, you know, the worst of it, like the actual garbage smell or locker room smell of body odor, it likely comes from the fact that’s just extremely disrupted biome when we kind of decimate it, wipe everything out. Um. What grows back is pretty messed up because when you use a deodorant and when you use antimicrobial soaps or just wash all the oils away, you’re kind of you’re just messing up everything. And so where there might have been an equilibrium there in those areas, which would have an odor, like you smell like a like a human, but not not in a gross way. Once you mess it up, within about 24 hours, what grows back is kind of just weird and likely to make you smell bad. So then you need to, again, wipe it away, like, kill it all.
Dr. Abdul El-Sayed: Yeah. So it’s it’s–
Dr. James Hamblin: Yeah.
Dr. Abdul El-Sayed: It’s the idea of of, you know, what we talk about um and you talk a little bit about about this in the book. But, you know, we are constantly um eating probiotics, things that will uh create both a multitude and a diversity of the right kind of bacteria in our gut, which is, you know, populated entirely with bacteria uh in our in our in our large intestine. Um. And so much of, you know what, quote unquote, “causes gas” and a lot of, you know, foul smelling outcomes um is this sort of misgrowth. It’s overgrowth of a certain kind of bacteria or [?], some of some of them can be extremely deadly um in the context of some of these bacteria. And your argument is basically that on the skin, we have a similar microbiome. And if it’s diverse enough, um what’s happening is we’re blocking the kind of bacteria that produce really noxious smelling odors by processing our natural body oils uh out. And if we if we wipe out the entire you know microbiome, we are creating an environment where just that kind of bacteria can grow. And it causes us um the kind of smell that we associate with with BO. So actually, you know, what you’re arguing is that BO is actually not about being unclean. It’s actually about being too clean, um that you’ve wiped out your body’s natural microbiome and you’ve allowed one particular kind of bacteria to regrow.
Dr. James Hamblin: Yeah, I think it’s a combination of these things, right? When we have you’ve been very clean. We don’t have good baseline foundations of skin microbiota. And then um we go like one day without continuing to apply our cleansers and things that modify the skin surface in the biome. And yeah, you’ve got this weird population. The smells that we met are a product of what’s coming off of our skin. So, you know, we know that sleeping, exercising, what you’re eating, how stressed you are. All these things can change the oiliness and appearance of your skin. And then that is metabolized by these microbes and that leads to the smells that we smell. So there’s both, you know, lifestyle and immediate environmental issues as well as what you have applied or not applied.
Dr. Abdul El-Sayed: One of the interesting aspects of um the book is, is the difference in the kind of substances that we allow in our soaps and detergents in the United States versus in Europe. And it’s pretty striking. Right. There are 11 banned substances in the United States, over 500 in Europe. Why do you think there is such a difference?
Dr. James Hamblin: [laugh] Uh, I, uh, I’m not familiar enough with, um, with their policies. I wish I, you might know better than I, um since this is a political issue more than anything.
Dr. Abdul El-Sayed: Well, I mean, I can venture to guess that, you know, there’s there’s a lot more focus on consumer protection uh in Europe than there is the United States. I mean, you know, even some of the breakfast cereals that people eat every morning in the U.S., they’re banned for their sugar content in in Europe. And if they’re not banned, you know, you eat the same bowl of cereal and it tastes substantially less sweet in Europe than in the U.S.. And so I think in some respects, it’s the power of corporate lobbying and the sort of instinct against any sort of regulation um that tends to create this kind of situation. Ironically, we had a conversation with actually a fellow writer at The Atlantic um about sunscreens. And it’s interesting because um our regulatory environment in the US leaves some of the substances that actually make for far better sunscreens uh banned here than there. So we end up having the soaps that we don’t really need and not the sunscreens that that are probably substantially more beneficial. So, you know, it’s odd how these regulatory environments tend to be somewhat idiosyncratic um in the kinds of outcomes that they create. But in the US generally we’re um averse to any sort of regulation, even the kind that clearly can help people.
Dr. James Hamblin: Yeah, yeah. No that’s well stated. So I think the issue with most cosmetics is not the problem of any individual product causing harm to you. Like we’re decent at that. When something when something is actively making people’s hair fall out or burn their skin, we’ll get on it. But what we’re terrible at is the collective effect, and that seems to be the issue with a lot of things. So things that are building up in our in our water, building up over all of the products that we use over the course of a day, whether it’s, you know, dishwashing detergents and uh the laundry soap and all these things combined and keeping an eye on overall exposures as a population that we are, are not good at. And I guess they’re better in Europe–
Dr. Abdul El-Sayed: Yeah.
Dr. James Hamblin: –In saying, you know, like, okay, this is no individual product is going to hurt you, but we can’t be using these products, these compounds as widely, you know, as they are in the U.S. Those people over there, they’re crazy.
Dr. Abdul El-Sayed: Yeah, I. I appreciate that uh that point. I think it’s a really um astute observation. I think about what a listener can take away from our conversation. And if in the course of writing your book, in the course of sort of realigning your own daily habits, what are your recommendations to the average um listener about some of the ways that they can maybe get out of the cycle of knocking down their bodies’ skin microbiome, um just to just to try and uh uh facilitate, um you know, keeping it moisturized, etc., only to do it again tomorrow and tomorrow and tomorrow again.
Dr. James Hamblin: Yeah. Yeah.
Dr. Abdul El-Sayed: How do you think about it? What are some of the recommendations that you um you offer to folks?
Dr. James Hamblin: Well, you know, I talked to a lot of experts in researching this book. And so none of these are fully mine. But I think there is a very strong incentive for corporations to sell you uh something additional to add to your regimen if you are noticing something that you don’t like. I mean, whether acne, eczema, psoriasis, or just don’t like the appearance of your skin, whatever. It’s add a product, add a product, add a product. And then people go to dermatologists or beauticians and they will want more products. It’s really hard to tell people to do less. And that’s sort of that can be good. Um. One of the doctors I interview in the book recommends a product to cleanse to kind of if you’re if you’re there’s something that you’re unhappy with and you have accumulated ten different products in the course of trying to address it and you’re adding more and more just, you know, quit it all and start re-adding things and on a, you know, on the basis of what actually helps you, part of what is so interesting about the skin microbiome is it’s so diverse and it creates a lot of diversity in us. And that probably accounts for why there are some products that people will swear by and other people are like, I totally didn’t. I didn’t like it or it didn’t work for me. So this is a very personal thing and you have to do uh what works for you. And um if you enjoy it and it makes you feel and look the way you like, then it’s good. And if you’re doing it just because some ad or label told you that it was necessary, it’s probably not.
Dr. Abdul El-Sayed: Um. I do think there’s a way in which we sort of accumulate uh more and more and more habits. You get a more and more and more ornate approach to your shower or your skin routine, whatever that is. And I think the advice to sort of once you’ve gotten too much on, back off a little bit and ask which of these are actually worth doing? The other thing I really appreciate is just the point about there is something enjoyable, as you talked about at the top of the interview. Um. There’s something enjoyable about pampering yourself, about, you know, the refreshing feel of having taken a shower. And it’s not that these things um shouldn’t be done. It’s that one should be maybe more purposive uh about what they do and how they do it and um admit that it’s just an enjoyable thing to do. And so we like to smell nice and we like to look nice. And if it makes us feel good and it makes us feel like we look good and and smell nice, then that’s great. That’s, that’s, that’s worth doing it. Just that doing that at the edge of, of a corporate ad um where someone’s trying to take make your money to sell you some solution to something you feel like you lack. That’s that’s where it gets a little bit more caustic.
Dr. James Hamblin: Exactly. If if in the course of the history of this industry, they could have stopped and just said, you know, these are great, fun products that have social value, cultural importance that will make you feel good. That would be fine. But they are sold mostly in our pharmacies on every corner. They have all kinds of health language around them. People think they’re absolutely necessary and people are being sold more and more products to address issues that they may have not even had in the first place.
Dr. Abdul El-Sayed: I want to uh before we go, um you broke the Internet almost a decade ago now with a quick article about how to eat an apple. So what is the appropriate way to eat an apple?
Dr. James Hamblin: Well, the way that I like to do it, I pull the the stem off of it and then eat it from uh the bottom. Usually, I guess depending on on the shape um because the core, I’ll spit the seeds out. Um. Usually, the core, once you incorporate it with the rest of the apple is really not noticeable. It’s kind of a, a food waste uh issue that some people are quite moved by, I guess. I mean, I didn’t realize it was such a divisive topic, but, you know, it’s things like this. The showering, apple cores, people have strong feelings about it apparently, and uh they do it every single day or no. Well, not necessarily apples, but, uh you know, pretty often. And yet we haven’t we don’t talk about it.
Dr. Abdul El-Sayed: So the take home here is eat more of your apple, maybe less um soap products. Um.
Dr. James Hamblin: It’s a great conversation topic. You’re out at a picnic or something and you eat an apple and eat the whole thing. People just uh they don’t want to talk about anything else.
Dr. Abdul El-Sayed: I can imagine. [laugh] Uh. I can imagine it’s the um it is one of those things that people are both moved by and and also I imagine a full range of of responses. [laughing]
Dr. Abdul El-Sayed: Yeah.
Dr. James Hamblin: This is going to be the next politicized issue.
Dr. James Hamblin: Okay. Yeah. Yeah, I’m ready for it.
Dr. Abdul El-Sayed: The 2024 election is going to be fought over how do eat a [laughter] eat an apple appropriately. The American way um. [laughing] Our guest today was Dr. James Hamlin. Uh. He is the author of the book Clean: the New Science of Skin and the Beauty of Doing Less. Uh. James, thank you so much for taking the time.
Dr. James Hamblin: Thank you for having me.
Dr. Abdul El-Sayed, narrating: As usual. Here’s what I’m watching right now. Last week, ten people were killed in an apartment fire in Urumqi, China, a city in Xinjiang province, home to China’s Uyghur minority, which is currently being oppressed by the Chinese government in what the U.N. has called a violation of human rights. The circumstances of the fire remain unclear. The fire has called into question many of China’s draconian zero-covid policy, which many believe worsened the tragedy. Across China, there have been reports of first responders being delayed by road barricades and people being trapped in apartments where doors have been welded shut. Both extreme precautions taken by the government to ensure people were isolated in their apartments. Since the fire, China has seen massive protests against the nation’s zero-covid policy. Protests have been largely peaceful, with many protesters waving blank white paper, daring authorities to silence their, quote, “empty speech”. And yet, the breadth of the protests and the regime’s sweeping efforts to silence them signal something far deeper, maybe afoot in Chinese society. China’s Zero-Covid policy has been a blunder of massive proportions, and that’s because it’s not really about COVID. It’s about control. For a regime that has used COVID as a pretext to tighten its grip over people’s lives. It has largely failed to stop the highly contagious Omicron variant and massively curtailing civil liberties for hundreds of millions at a time doesn’t really inspire much public trust. Which may explain why vaccination rates across China are so low. Only two thirds of Chinese citizens, over 80 have gotten two doses of vaccine. That’s slower than in the United States. Vaccination rates among younger people are even lower. Back in the states, flu hospitalizations accelerated again last week, up 30%. COVID hospitalizations are up 21% over the past two weeks. And none of this fully factors in the transmission that happened across Thanksgiving tables last week. And all of it should remind us that, no, the pandemic is not yet over. And yes, we’re facing a whole swath of other serious infectious diseases. Make sure that you, your loved ones and friends are up to date on your flu and COVID vaccines. And just in case it bears reminding. A mask is a really effective way to protect yourself from flu, COVID and a whole host of other respiratory illnesses. But now you can openly say the opposite of what I just said on Twitter. The platform’s new CEO, Elon Musk, announced that the company is no longer enforcing its COVID 19 misinformation policies because, of course not. All of this should force us to consider one of the central points Dr. Seema Yasmin, our guest a few weeks back, made about the social contagion of misinformation that going viral isn’t just for viruses. It’s also for the misinformation that enables them. Oh, and one more note on your way out. I’m going back to public service. Last week I started with the Department of Health, Human and Veteran Services in Wayne County, Michigan. If the County Commission approves of my appointment, I’ll serve as the director of the department beginning in March. As many of our longtime listeners know, I began my career in public service, leading Detroit’s health department. I can’t wait to be a public health official again. Wayne is Michigan’s biggest and most diverse county, and our work will touch nearly 2 million lives. We’ll be focusing on health equity, maternal and child health, environmental justice, health access and senior well-being. All of the things that we talk about on this podcast and yeah don’t worry, this pod isn’t going anywhere. I’ll still be doing new episodes of America Dissected every week. That’s it for today. On your way out. Don’t forget to rate and review. It really does go a long way. Also, if you love the show and want to rep us, I hope you’ll drop by the Crooked Store for some America Dissected merch. We’ve got our logo, mugs and T-shirts, our science always win sweatshirts and dad caps are available too. [music break] America Dissected is a product of Crooked Media. Our producer is Austin Fisher. Our associate producers are Tara Terpstra and Emma Illic-Frank. Vasilis Fotopoulos mixes and masters the show. Production support from Ari Schwartz and Ines Maza. Our theme song is by Taka Yasuzawa and Alex Sugiura. Our executive producers are Leo Duran, Sarah Geismer, Sandy Girard, Michael Martinez and me, Dr. Abdul El-Sayed. Your host. Thanks for listening. [music break] This show is for general information and entertainment purposes only. It’s not intended to provide specific health care or medical advice and should not be construed as providing health care or medical advice. Please consult your physician with any questions related to your own health. The views expressed in this podcast reflect those of the host and his guests and do not necessarily represent the views and opinions of Wayne County, Michigan, or its Department of Health, Human and Veterans Services.