Summary of the book "Clean"-By James Hamblin

Key Insights in this book:

1. We wash ourselves excessively because of contemporary notions of "cleanliness."
2. Throughout human history, the justifications for washing ourselves have varied.
3. Advertising was utilised by the soap industry to change how people view hygiene.
4. Though less severely regulated than medicines, skin care is slowly but surely encroaching on the realm of medicine.
5. It's not always terrible to expose our skin to microorganisms.
6. More than excessively strict hygiene habits, our usage of antibiotics likely compromises our health.
7. The skin microbiota may contain vital data on our health.
8. To stay healthy, we need a balance between cleanliness and exposure to germs.

Why should I care? Learn how the extreme hygiene we practise today may be doing more damage than good.

Imagine a society in which showering was no longer practised. I know, it's disgusting. But hold on. What if that future world was actually healthier for us?

Believe it or not, author James Hamblin has discovered that we might all be too clean after speaking with dermatologists, microbiologists, and historians. Naturally, we should continue to wash our hands to prevent the transmission of disease, particularly during a pandemic. However, our obsession with cleanliness that borders on the clinical may be weakening our immune systems.

Why, in any case, did we begin washing ourselves so thoroughly? The emergence of soap corresponded, like so many other things, with the beginning of capitalism. Ingenious marketing about 200 years ago persuaded us that we needed to "combat germs." Since then, marketers have been increasingly skilled at persuading consumers to purchase skin care products. They make us feel clean, healthy, and beautiful.

The natural microbiome of our skin, which consists of all the bacteria that dwell on the outside of our bodies, is finally being recognised by doctors as being important.

A varied microbiome is already understood to be important for our stomach by science. But the skin also benefits from it. And if you isolate yourself with soap, there is no possibility for you to develop this diversity.

You'll discover in these insights why the Amish have such low rates of allergies and asthma, how soap businesses were the first to combine entertainment and advertising with things like soap operas, and why dogs may be able to detect sickness based on changes in our skin microbiomes.

1. We wash ourselves excessively because of contemporary notions of "cleanliness."

James Hamblin, the author of Clean, gave up taking showers five years before he began writing it. He continued to wash his hands and occasionally drank water, but aside from that, he stopped using any personal care items. He included this in his "existential audit." After quitting his safe, lucrative work as a doctor to pursue a career in journalism, Hamblin decided to attempt quitting some of his bad habits in an effort to save money and time.

His body required a couple of months to adjust to the shift. When it did, he observed that his skin became less oily and that his eczema flare-ups had decreased. He no longer smelled like a field of daisies, but rather, as his girlfriend put it, "like a person."

Additionally, he discovered that the majority of skin researchers he contacted with likewise adopted a simple showering routine.

The main takeaway from this is that we overwash ourselves because of contemporary notions of "cleanliness."

We spend more time indoors and clean ourselves more frequently as a result of advances in technology and medicine. We have a far lower risk of dying from an infectious disease. However, chronic disease rates have exploded.

There is a chance that some of these chronic illnesses are related to how frequently we wash ourselves. Eczema, or atopic dermatitis, is one illustration. It irritates and reddens the skin.

Dermatologist Sandy Skotnicki, a professor at the University of Toronto, recommends people with eczema flares to avoid taking hot showers and to discard their soaps and gels. After all, the majority of the ingredients in these products are detergents, which can be damaging to the skin. She advises people to merely wash their feet, groyne, and armpits.

This "soap simplicity" aids the skin in doing what it does best, which is to maintain balance. It has evolved over millions of years to be able to do this. Researchers are now examining the interactions between the skin's microbiome and its environs.

The function of the apocrine sweat glands has been further illuminated by recent study. They create the oily secretions that give off a bad smell in the armpits and groyne area. However, they also perform a remarkably beneficial task: they support the trillions of bacteria that dwell inside and on top of us.

Although it may sound disgusting, these bacteria could serve as our skin's top, invisible layer. They encourage its vibrant interaction with the outer world.

2. Throughout human history, the justifications for washing ourselves have varied.

We didn't always have a fixation on perfect cleanliness. Before the germ theory, people took baths for a variety of reasons, such as recreation and general health.

Consider the historic Roman baths, for instance. They served as a gathering spot and a place to unwind. Last was washing. Since there was no circulation mechanism in the baths, human sweat and scum were probably certainly present in the water. It's unlikely that hygiene was a major concern.

Furthermore, people in ancient Jerusalem bathed themselves to prevent spiritual defilement. Hebrews had to wash their hands and feet before entering the Temple. Additionally, they insisted that everyone wash their hands both before and after eating. It was once believed by rabbis that spiritual purity comes from physical purity. In Islam, ceremonial bathing is also required five times every day, before each prayer. This indicated that Arabs developed sophisticated water systems before Europeans.

The main takeaway from this is that throughout human history, there have been various motivations for cleaning oneself.

Christians, on the other hand, thought taking too many baths was a sinful indulgence. This was done for religious reasons; after all, Jesus thought that inner purity was more significant than ritual purity. So, to put it plainly, the European attitude toward hygiene was careless. It contributed to the Black Death, which ravaged the continent and killed one in three Europeans, in the fourteenth century.

The connection between habitation and illness wasn't identified until 1854. A cholera outbreak was only linked to one place by London doctor John Snow: a well that was near to a cesspool of human waste.

However, Snow was not taken seriously by the authorities. After all, if he were accurate, they would have to completely rebuild London. It would be another 30 years before Snow's research was confirmed. When German physician Robert Koch observed cholera-causing bacteria under a microscope, this occurred. This verified the connection between cholera and tainted water when combined with Snow's research and additional later observations.

The germ theory finally caught on. The idea is that minute living things spread infectious diseases. Governments started making investments in preventative infrastructure, such sewage and water treatment facilities, to stop harmful pathogens. Social conventions also evolved, to the point where being ungroomed was seen as a threat.

The working class started being referred to as "the vast unwashed" by the wealthy, and prestige came to be associated with cleanliness. Soap now has a vast market because to this.

3. Advertising was utilised by the soap industry to change how people view hygiene.

A soap boom was happening in America and Britain at the turn of the twentieth century. Lever Brothers stood out as one such business. Their soap production wasn't particularly inventive, but their marketing was. They asserted that Sunlight Soap, their product, was a lifesaver. Lever Brothers became the largest soap distributor in the world because to this marketing strategy.

William Lever, the eldest brother, was the mastermind of the scheme. "Lever didn't market so much as paint the globe with his brand," one historian observed. Advertising was prevalent. William even started a newspaper and wrote a book about medicine. The periodical was published under the name Sunlight Almanac, and the book was published under the name Sunlight Year Book.

Lever was among the first to realise that he could now sell to every family as a result of the creation of a new middle class. Because of cost reductions from mass production, soap was becoming more widely accessible.

The main takeaway from this is that the soap industry uses advertising to change how people view hygiene.

The use of media by early soap vendors to disseminate their message was brilliant. They invented sponsored content, which we now see everywhere. Procter & Gamble developed a parenting manual and liberally sprinkled it with Ivory Soap usage tips.

From there, soap operas eventually took over radio and then TV. They changed broadcasting rather than just running advertisements. The daytime serial genre was invented by soap opera producers. These shows, which catered to housewives, became known as soap operas.

Among the early users of marketing language were titans of the soap industry. Despite the fact that there is no such thing as "hard milling" or "soft milling," Colgate & Company promoted its Cashmere luxury soap as being "hard milled" and so "safer."

Additionally, Palmolive cited anonymous doctors' advice. Here's one from a 1943 commercial: "With Palmolive Soap, you can have a more attractive complexion in 14 days. Medicos provate!

Every home now had soap, but businesses demanded more. Their product offerings needed to be increased. As a result, marketers developed a fresh message.

Soap was no longer sufficient as a single product. To reverse its effects, you had to buy more items. Does using soap cause dry skin? Purchase moisturiser. This paved the way for the rise of skincare oligarchies.

4. Though less severely regulated than medicines, skin care is slowly but surely encroaching on the realm of medicine.

In the present day, "indie" brands are revolutionising the skin care market.

The current vogue at the Indie Beauty Expo in New York is to use terms like "clean," "cruelty-free," and "pure." Indie companies frequently draw attention to a certain "new" element; something that hasn't previously been addressed.

However, the distinction between independent and mainstream businesses is more to do with their marketing and aesthetics than with the size of the business.

Small independent brands frequently make bolder claims. As long as you don't promise a cure for a sickness, it is totally permissible to state whatever you want about a cosmetic product's advantages in the US. This indicates that entrance requirements are modest. Social media or word-of-mouth can propel a product to the top.

The main takeaway from this is that, while not as severely controlled as medications, skin care is edging closer to the world of medicine.

Independent and well-known businesses are straddling the border between cosmetics and pharmaceuticals. The use of fancy scientific terminology makes it difficult for consumers to distinguish between medical fact and cosmetic fiction.

Consider collagen, a protein that maintains skin taut and hence seeming "fresh." It would be useless to apply collagen directly to your face because the molecule is too large to enter the skin. Nevertheless, collagen products were widely available at the Indie Beauty Expo. It tightens the skin, smoothes it out, and makes it look plumper, according to the sellers.

Retinoids, which are made from vitamin A, are currently allowed as both cosmetics and medications. Actually, there is some scientific proof that they encourage collagen formation. But consumers must conduct their own research.

Contrast the regulation of medications with this free-for-all. Pharmaceutical corporations test new medications for effectiveness and safety for years before releasing them to the market. However, we have a tendency to be hesitant about pharmaceuticals while being confident in skin care products. Why is that so?

Because they feel that the medical community has wronged them, many people believe in skin care companies. They decide that it hasn't satisfied their demands, so they begin exploring for alternatives. Skin care devotees acknowledge the possibility of scammers. The community will be able to distinguish between quality products and subpar ones, they believe, if people share their personal experiences online.

A sensation of control is offered by skin care.

5. It's not always terrible to expose our skin to microorganisms.

We have been distancing ourselves from nature ever since the Industrial Revolution. However, a study published in August 2016 suggested that early contact to the outer microbial world may be beneficial for our immune systems.

The Amish and Hutterites were the subjects of two study groups. These societies have mostly remained intact since the seventeenth century and share a genetic similarity. But there is one crucial distinction. Children never go with their fathers to the communal farm in the Hutterite community. While doing their chores, the Amish carry their infants strapped on their backs. Thus, their offspring interact with the soil, creatures, and bacteria as they grow up.

Mark Holbreich, an allergist and immunologist, and his team of researchers wanted to determine whether this had any impact. And it undoubtedly did. Much fewer kids in the Amish neighbourhood had asthma and allergies. In actuality, four to six times less.

The main takeaway from this is that exposing our skin to microorganisms isn't always a bad thing.

Therefore, microbes may benefit us. Why? Let's first analyse how the immune system functions in order to comprehend this. Immune cells are exchanged back and forth between the lymphatic system, which transports lymph throughout our bodies, and the circulatory system, which includes our blood vessels. Immune cells, or lymphocytes, are found in abundance in lymph, a liquid.

Their major responsibility is to keep an eye out for foreign objects that enter or land on our body. These foreign substances are called antigens, and your body launches a defence once lymphocytes raise the alert. Inflammation is what we refer to as the mechanism that protects us from illness. But occasionally the immune system malfunctions. It even turns against our own cells or assaults completely harmless particles. This is how autoimmune diseases are contracted.

So how could we prevent making such perilous errors? One approach is to teach the immune system how to react appropriately. By exposing it to microorganisms, we can do this. This method works best when we are very young.

The early seconds of our existence may contain this exposure. In a vaginal birth, the infant picks up some of her mother's microorganisms as she leaves the womb and enters the outer world. She is then nursed, receiving adult immune cells with each feeding.

Through routine contact, children continue to shape their microbiota. They pick up these microorganisms via their relatives, the ground, pets, and even the toys of other kids.

6. More than excessively strict hygiene habits, our usage of antibiotics likely compromises our health.

Do you recall the Lever Brothers from a previous insight? With Sunlight Soap, their effect on contemporary hygiene didn't cease. In fact, they popularised a marketing concept that has persisted for more than a century.

They introduced a brand-new soap called Lifebuoy in 1894. They argued that it could treat colds and fevers just as well as pharmaceuticals. Why? Because its primary component, carbolic acid, was an antiseptic that killed hazardous germs. This sales pitch was effective in a culture that had recently learned about germ theory.

The creators of Lifebuoy Health Soap later came up with the now-well-known phrase "body odour," or B.O. This was also a marketing gimmick. Lever Brothers provided the following explanation: body odour is brought on by bacteria, so soap is required to eradicate those bacteria. Although this was not supported by evidence, fear-based marketing was effective, and sales increased fourfold. It wasn't long before soap manufacturers started including antibiotics in their products.

The main takeaway is that excessive antibiotic use is probably worse for human health than too stringent sanitation standards.

A brand-new deodorant soap entered the market in 1948. It was known by the brand name Dial and contains the antibiotic hexachlorophene. Hexachlorophene finally gained acceptance as a cosmetic component after similar goods appeared. However, research conducted 30 years later showed that this substance may penetrate the skin and impact the nervous system. This might have signalled the end of antibiotics in soap, but cosmetics manufacturers came up with a workaround by switching out hexachlorophene for the microbe-killing substance triclosan.

Issue resolved? I guess not quite. According to recent research, exposure to triclosan over time may promote the growth of tumours, change how hormones function, and even result in allergies.

This sounds concerning, particularly given how frequently we are exposed to triclosan. Three out of four Americans had triclosan in their urine, according to a 2009 study.

Are the risks worth it, then? Are antibacterial cosmetics really more effective at preventing disease than regular soap and water? When the US government decided to investigate in 2013, the Food and Drug Administration requested proof from soap manufacturers. They provided essentially none. As a result, regulators outlawed 17 other antimicrobial chemicals, including triclosan and hexachlorophene, from soap.

Ironically, the most recent skin care fads advise deliberately introducing bacteria into our bodies. These days, a lot of independent skin care companies provide products that contain probiotics and prebiotics—substances that encourage the development of microbial communities. Perhaps soon, major corporations will join the bandwagon.

7. The skin microbiota may contain vital data on our health.

Claire Guest was investigating the notion that dogs could detect cancer in 2009. Daisy, a golden retriever who was one of the study's dogs, ended up being Claire's companion. The scientist recalls that as they were returning from the park by foot, the dog began acting strangely. She remembered, "She seemed a bit wary of me.

Claire suddenly recalled: a few days prior, she had felt a small lump in her breast. She hadn't really given breast cancer much thought at the time.

Since that time, Claire has been working full-time with dogs who can recognise symptoms of cancer and other illnesses. Claire's cancer is currently in remission.

The main takeaway from this is that the skin microbiota may contain crucial data about our health.

Dogs have a keen sense of smell, as we all know. But how severe is it exactly? It turns out that they are able to detect even the slightest variations in our volatiles, the complex chemical cocktail that we all emit. Dogs are therefore excellent at spotting disease.

Dogs have been taught to respond to high blood sugar levels so far, and they are also showing promise in identifying Parkinson's disease, which is connected to changes in our skin.

Claire Guest is intrigued by the source of this ominous odour. What are the canines searching for? Could our microbiota be to blame?

There is growing evidence for this notion, and if study confirms Guest's findings, humans may be able to employ these modifications to our skin bacteria. That might enable medical professionals to diagnose and cure diseases earlier.

British researchers intended to employ dogs to detect malaria in a different investigation.

After testing hundreds of kids in the Gambia for the disease, each youngster received a brand-new pair of socks. After a few hours, researchers gathered the socks and transferred them to London, where medical detection dogs started their work. Dogs properly detected socks worn by infected youngsters in seven out of ten instances.

It is evident that the substances our skin generates are not created at random. Perhaps it's time to focus our efforts on understanding our skin rather than trying to scrub it clean.

8. To stay healthy, we need a balance between cleanliness and exposure to germs.

Florence Nightingale oversaw a group of nurses at a military hospital in Crimea during the 1800s, when the British were resisting Russian expansion. The hospital care was chaotic when Nightingale arrived in the warzone. Infectious illness deaths among soldiers were ten times higher than combat fatalities.

Wards were filthy and crawling with fleas. Nightingale suggested opening up new doors and windows to increase circulation since she thought the men needed air to recover. Her strategy was successful, according to one assessment, as the death rate decreased by over 40%.

The work of Nightingale altered hospitals all over the world. Her successes inspired doctors to open up their clinics more to fresh air.

The germ theory then became popular. Even though Nightingale's method was proven to be effective, contemporary hospitals started placing patients in cramped spaces with poor ventilation. Once more, the windows were closed.

The primary takeaway from this is that maintaining good health requires a balance between cleanliness and exposure to germs.

Extremes have been present throughout human history in terms of cleanliness. It might be time to think about the lessons we can draw from each strategy.

Two things are noteworthy. Let's first consider how we can preserve microbial diversity. Living in a community is one method to accomplish that. According to a 2017 University of Waterloo study, cohabiting individuals had similar microbiomes. They also have a wider variety of microorganisms. The same is true for those who exercise outside, own dogs, and consume less alcohol.

Additionally, we must address the disparity in hygiene standards around the world. Often to their own disadvantage, richer nations have embraced sterility. However, in some parts of the world, individuals lack even access to safe drinking water. More than 30% of us lack a handwashing station at home.

Worldwide, infectious diseases continue to claim the lives of billions of people. Following the 2010 earthquake, cholera claimed 8,000 lives in Haiti. These deaths could have been avoided with clean water and good hygiene.

Since health is such a deeply personal matter, it is only reasonable that we raise concerns about the structures that shape our wellness and hygiene practises. But healthcare is also a matter of public concern, so rather than hoarding funds, we should collaborate to support global health projects.

Final thoughts

The main takeaway from these insights is that it's crucial to adopt basic hygiene habits, like washing our hands with soap and fresh water, in order to stop the spread of contagious diseases. However, we shouldn't overdo the cleaning. Less can be more. Our health will be benefited significantly more by cultivating a diversified microbiome through exposure to the outside world than by taking a lot of showers.

Practical suggestions:

Talk about your personal hygiene values and habits.

To challenge arbitrary standards of personal hygiene, one strategy is to inquire about people's hygiene practises. In the author's experience, individuals are very willing to contribute, making it a terrific way to break the ice. It aids in removing barriers to communication. Additionally, after you hear what other individuals actually do, you'll be better equipped to decide for yourself.