One Doctor's Decision To Stop Showering

Summary

Chasing Life: One Doctor's Decision To Stop Showering

Host: Dr. Sanjay Gupta
Guest: Dr. James Hamblin, Lecturer at Yale School of Public Health
Release Date: January 24, 2025

In this compelling episode of Chasing Life, Dr. Sanjay Gupta delves into the unconventional hygiene practices of Dr. James Hamblin, exploring the cultural norms surrounding showering and their impact on health. Dr. Hamblin shares his personal experiment of reducing shower frequency and his insights into the broader implications for our understanding of cleanliness and well-being.

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Dr. Hamblin’s Minimalist Approach to Showering

Dr. James Hamblin recounts his decision to minimize his showering routine, a practice that sparked significant reactions given society's entrenched beliefs about hygiene. Eight years prior, while serving as a staff writer at The Atlantic, Hamblin questioned the necessity of frequent showers and the pervasive use of soaps and shampoos.

Dr. James Hamblin (02:12): "So just rinsing. You're saying you don't really use soap or shampoo unless there's a particular reason from some obviously dirty, you know, fluid, bodily fluid, whatever type thing."

Hamblin's minimalist approach involves using only water during his morning washes, foregoing traditional cleansing agents unless absolutely necessary. This practice not only challenges societal norms but also raises questions about the actual health benefits of habitual showering.

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Cultural vs. Health-Driven Hygiene Practices

A significant portion of the conversation centers on distinguishing between hygiene practices driven by cultural and social expectations versus those grounded in actual health benefits. Hamblin argues that much of our hygiene routine is influenced by societal standards rather than medical necessity.

Dr. James Hamblin (05:27): "Almost all of it is cultural, social, psychological, personal preference... outside of washing your hands and actually making sure you don't have like bodily fluids on you or blood or vomit or anything else that might transmit disease, the rest of it is making you look and feel and smell good."

He emphasizes that while certain hygiene practices are essential for preventing disease transmission, many others are adopted based on the desire to conform to societal norms about attractiveness and cleanliness.

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The Microbiome and the Biodiversity Hypothesis

Dr. Hamblin introduces the concept of the biodiversity hypothesis, a modern evolution of the traditional hygiene hypothesis. This theory suggests that reduced exposure to diverse microbes due to excessive cleanliness may impair our immune systems and overall health.

Dr. James Hamblin (17:07): "We're just...living isolated lives in sterile offices... not getting a ton of exposure to the outdoors and not traveling enough and not physically close to many people at all."

He explains that our skin microbiome, much like our gut flora, benefits from diverse microbial exposure. Overuse of soaps and sanitizers can disrupt this balance, potentially exacerbating conditions like eczema and acne by altering the natural microbial ecosystem of our skin.

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Practical Impacts and Personal Experiences

The discussion shifts to the practical aspects of reducing shower frequency and its effects. Dr. Hamblin shares his personal experiences, including feedback from others and the social perceptions he encountered.

Dr. James Hamblin (13:35): "You gradually adapt to things. I think oftentimes diets fail because people try to radically overhaul everything... similar changes happen where you just gradually adapt to them."

He underscores the importance of a gradual approach to altering hygiene routines, allowing the body and social circles to adjust naturally. Hamblin also touches on specific scenarios, such as post-exercise cleaning, where minimal cleansing (e.g., using water) suffices to remove sweat without the need for soaps.

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Takeaways and Conclusions

As the episode wraps up, Dr. Hamblin offers key takeaways for listeners considering a re-evaluation of their hygiene practices:

Dr. James Hamblin (21:05): "If something is working for you, it makes you happy, you enjoy it... there's very little that is necessary for disease transmission prevention."

He advocates for a personalized approach to hygiene, encouraging individuals to assess what genuinely benefits their health and well-being versus what is adopted purely due to societal pressures or marketing influences. The overarching message is one of empowerment—allowing individuals to make informed choices about their hygiene routines based on personal needs and scientific understanding rather than conforming to external expectations.

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Final Thoughts

Dr. Sanjay Gupta concludes the episode by reflecting on the insights shared by Dr. Hamblin. He urges listeners to critically evaluate their daily habits and consider whether they are influenced more by cultural expectations or by evidence-based health practices.

Dr. Sanjay Gupta (23:06): "Do you really need to do what you're about to do. That's all for today's show."

This episode challenges conventional wisdom about cleanliness, inviting listeners to reconsider and potentially embrace a more balanced and evidence-based approach to personal hygiene.

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Notable Quotes:

• Dr. James Hamblin (05:27): "Almost all of it is cultural, social, psychological, personal preference... making you look and feel and smell good."

• Dr. James Hamblin (17:07): "We're just...living isolated lives in sterile offices... not getting a ton of exposure to the outdoors..."

• Dr. James Hamblin (21:05): "If something is working for you, it makes you happy, you enjoy it... there's very little that is necessary for disease transmission prevention."

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This episode of Chasing Life offers a thought-provoking exploration of hygiene practices, encouraging listeners to balance societal norms with personal health needs. By questioning the status quo, Dr. Hamblin provides valuable insights into how doing less in certain aspects of hygiene might contribute to better health and well-being.

Transcript

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[Dr. Sanjay Gupta]

Welcome to Chasing Life. You know, I promised that we were going to take a slightly different approach to the new year. Instead of committing to do more, more, more, which is typically what happens this time of year, I wanted to convince you instead of the value of sometimes doing less and even embracing that. Now, to be fair, when I started thinking about this, I didn't necessarily have less hygiene on the list, but today's guest did less showering, to be specific.

[Dr. James Hamblin]

For me, it's very, very minimal. I don't use any kind of shampoo. I like to wash with water in the morning.

[Dr. Sanjay Gupta]

Dr. James Hamblin was a staff writer at the Atlantic when he embarked on this experiment. It was about eight years ago, and in many ways he was asking the same questions we are asking now. And he was specifically asking, why do we shower so much and what does it really mean to be clean?

[Dr. James Hamblin]

You walk into any pharmacy and next to the cold and flu medications, there are aisles of shampoos and soaps. It just got me thinking, what is this all for? How much of it is necessary for health and how much of this is just a personal preference? And am I wasting time and money? Would I be better off if I did less? These were just questions that I wanted to explore.

[Dr. Sanjay Gupta]

The good doctor probably got a much bigger reaction than he expected because people love their showers, especially in the United States, and they love their products while they are showering.

[Interviewer]

So just sort of rinsing. You're saying you don't really use soap or shampoo unless there's a particular reason from some obviously dirty, you know, fluid, bodily fluid, whatever type thing. Other than that, you're not going to use those products?

[Dr. James Hamblin]

Yeah, yeah. No.

[Dr. Sanjay Gupta]

And besides the products, there is the time. Most of us will spend about 12,167 hours of our lives just washing our bodies. That's about two years of washing if you spend about 20 minutes per day doing it. So if you could cut down on even part of that daily routine. Why not try?

[Dr. James Hamblin]

Maybe adding more is not, is not the right thing. Maybe gradually doing less would actually work.

[Dr. Sanjay Gupta]

Today we continue our series of New Year's anti resolutions with the new approach to hygiene and why sometimes lathering up may be doing your body more harm than good. I'm Dr. Sanjay Gupta, CNN's chief medical correspondent and this is Chasing Life. Dr. Hamblin is now a lecturer at Yale School of Public Health and he's written a book, the New science of skin. When he first started his non showering experiment, he was actually intrigued by what was then a fairly new health trend.

[Dr. James Hamblin]

People were suddenly taking probiotics and wanting to have optimal gut flora. This was not something that would be talked about or even, you know, conceived of in say the 90s by most people. But it had made its way into a way of thinking about gut health. And I saw the same thing potentially happening in, in skin health because you have these trillions of microbes all over you. It's the, the skin microbiome is smaller than the gut microbiome. But it's a similar principle that this is something that is with you all the time, these populations, and they're there whether you like it or not. You know, unless you completely drench yourself in iodine, you're not going to be rid of them. And even if you did that, they would, you would quickly repopulate. So it got me thinking, what, what am I even trying to really accomplish when I'm cleaning? You know, obviously when you scrub in for surgery, you are trying to get as sterile as possible for that moment before a surgical procedure to avoid contamination. But that's not possible in real life. And you're not even getting sterile in the, in the shower, even when you wash your hands in a regular way in a non surgical scrubbing in capacity. So it just got me thinking, what is this all for? How much of it is necessary for health and how much of this is just a personal preference and am I wasting time and money? Would I be better off if I did less? These were just questions that I wanted to explore.

[Interviewer]

I realize you wrote a whole book about this, but is there a way to summarize how much of what we do from a personal hygiene standpoint is just cultural and personal preference versus actual, you know, objective benefit for health?

[Dr. James Hamblin]

Almost all of it is cultural, social, psychological, personal preference. And that is not at all to belittle the importance of it. But you walk into any pharmacy and next to the cold and flu medications, there are aisles of shampoos and soaps, and a lot of them have medical sounding claims about what they're doing for you. And there is a large health halo around these products and we think of them as hygiene products and we stigmatize people who don't use them and call them disgusting and gross and all kinds of things. But if you look at the actual way in which many of those products are actually doing anything to prevent disease transmission, outside of washing your hands and actually making sure you don't have like bodily fluids on you or blood or vomit or anything else that might transmit disease, the rest of it is making you look and feel and smell good. And these are socially determined standards that we tend to internalize. And they've varied widely in, you know, throughout history and globally over time. And right now we're in a, a very maximalist phase where if you ever go out appearing that you haven't completely cleaned every part of your body within the last 24 hours, you, you know, you risk being thought of in a negative way.

[Interviewer]

Sort of strikes me when I was reading your book book, that we do things to disrupt our microbiome and then we try and replenish it with probiotics and things like that, which may or may not work sometimes. There's not a lot of data behind some of those products. Is the thinking sort of the same with the skin microbiome, that you might be disrupting it with these products and then trying to replenish it?

[Dr. James Hamblin]

Yeah, yeah, exactly. So there is a harmony between the oils and chemicals that your skin secretes naturally and the skin microbiome that lives on that skin. And you temporarily disrupt the microbiome when you take a hot shower and you use a detergent, but you're also disrupting essentially the soil on which those microbes live. By drying out your skin and removing all the oils, it's not necessarily bad, but it changes the dynamic. And if you are prone to an inflammatory cascade like happens with eczema or acne, you can be exacerbating it. It's a sort of clear cutting of a forest. It's not always the best approach. And we are just scratching the surface, I think, in understanding exactly what that looks like. It is a difficult thing to study. Just like the gut microbiome.

[Interviewer]

Do you ever use antibacterial soap? I mean, when you talk about the impact on the microbiome, are there certain soaps that are just going to be worse? Do, do all soaps sort of affect skin microbiome in the same way?

[Dr. James Hamblin]

Yeah, well, a soap by definition, you know, is a very specific product that just removes the fats from your skin, the lipid, the oils that are on your skin. So, and then in doing that, it's sort of like taking away the soil from your front lawn. You're going to kill the grass. You know, you're going to remove the grass. It's not actually killing the grass itself, but you're removing the substrate, the thing that it grows on. So, you know, that will come back, your skin will continue to produce oils and microbes will repopulate. And the question is then, well, what effect did that have when you perturbed the populations? Which ones grew back quickest in place of what was there? And what sort of cycles are you getting yourself into? But all soaps do is, is target the lipids to wash them off. And soaps and detergents being used interchangeably. A lot of liquid soaps are technically detergents, but they're not killing things. And I don't know the utility of any antibacterial soap, again, outside of a context like surgery, where you might be trying to briefly attain some state of being as close to sterile as possible.

[Interviewer]

Yeah. And you make this point in your book as well, that sterility and hygiene are often sort of used interchangeably, but they're not the same thing.

[Dr. James Hamblin]

Yeah, that's just the thing is, I think without examining, like, what you're trying to do when you wash, there's a notion you're just taking everything away and that's good, that we'll just get rid of everything and things will be better. Better. But a, you're not doing that because, yeah, you'd have to completely soak yourself in something like iodine for. For a period. And hygiene can help you by removing things. Like if there's actual. You've sneezed, it coughed into your hand, and there's actually mucus on your hand and you don't want to shake someone else's hand. You can wash your hand and get that off of there. So that macroscopic stuff that's going to get washed down the drain in a way that with just water alone, maybe it wouldn't have come off as well. And so it helps in that way, but it's not at a microscopic level, actually clearing the field. And I don't think that there are many contexts in which you'd want that to happen.

[Interviewer]

What is life like for you now with that experience and all that you've learned? I mean, it's a personal question, I guess, but what is Your hygiene sort of like.

[Dr. James Hamblin]

Well, I think part of the reason that people have kind of wild ideas about what is really necessary to health in terms of showering and cleaning ourselves is because it's one of the areas we're still very private about. And there's still a lot of stigma around, you know, people who are perceived to not do enough. And people have very strong ideas about what needs to be done, when and for what frequency, and how long. And if you don't wash this part and this part and this part in this way, then you're doing it wrong. But in truth, it's a very private matter, and people have their own feelings about it. And if. Maybe if we just talked more about it, we'd realize that there are many, many different people taking many, many different approaches, many of whom have decided to write to me about their practices just because they're kind of like, I thought I was weird. But no, there are lots of different ways to do things correctly. And I think one of the messages I hope from the book is that people feel empowered to do less if it's working for them. If you're happy about the way that you look and feel and you're not causing offense to others with a smell or your appearance, then you can get away with very little. I mean, I know a lot of people who don't use deodorant don't seem to need it. And so, you know, you learn that yourself if you. If you do what kinds work for you, how often you need to use it, how often you need to bathe, and how often you need to use soap and shampoo in that process. And it's pretty much up to you. For me, it's very minimal. I don't use any kind of shampoo. I like to wash with water in the morning. Uh, I found that it just helps me start my day. And I feel like that that's a big reason that a lot of people do these things, either to start or end their day. It's a sort of demarcating ritual of just waking up or shutting down or both. Some people do both, and without it, you just don't feel like quite like yourself. You don't feel as put together. But you. You can be fine with, you know, what works for you. Again, assuming you're not causing offense to others and disrupting society.

[Interviewer]

Was that ever a problem? I mean, did people say that you were causing offense or. I mean.

[Dr. James Hamblin]

No, I never would have let it go that far. And in these things, I seem to work best when People are quitting things like deodorant by doing so gradually. Just like anything you would. Any change you would make in life, your body adapts to things slowly. You don't decide you're going to be a runner and go out and run a marathon on day one.

[Interviewer]

Right.

[Dr. James Hamblin]

You gradually adapt to things. I think oftentimes diets fail because people try to radically overhaul everything they're eating on January 1st instead of gradually saying, okay, well, maybe one meal a week is going to be healthier and two meals and then this. And I think a lot of these changes happen similarly where you just gradually adapt to them.

[Interviewer]

I like to shower, especially after I work out. I mean, it's sweat. You talked about the fact that obviously if you have blood on you or vomit on you, something obvious definitely shower.

[Dr. Sanjay Gupta]

What about sweat?

[Dr. James Hamblin]

Yeah, I ran the New York marathon and I got done and my face was coated in because of the weather. It was such that the sweat dried out and I had white sodium caked on my skin. And so obviously, yeah, I want to rinse that off. It feels it. It's dry and it look, people were looking at me like, what, what's that stuff on your face on the subway home. So. Yeah, but you can get that off really quickly with just water. That washes water very easily. Yeah.

[Interviewer]

So even after a workout, point of.

[Dr. James Hamblin]

Soap is if there's something that will come off. It's. It's an extremely valuable tool if you have grease on your hands, if you have really oily skin and it's. But usually it's more the mechanical force that's doing most of the washing. So when you rub your hands together, you're getting underwater, you're getting a lot of that off. The soap takes it the extra mile, especially if there's something sticky on your. You know you've got honey or motor oil on your. On your hands. You need something to help break that sticky attachment to your skin. But something like sweat will come off with water.

[Dr. Sanjay Gupta]

Alright, so what about you? You gonna do less? Even shower less? After listening to Dr. Hamblin, we're gonna take a short break here, but when we come back, transforming your daily hygiene routine.

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[Dr. Sanjay Gupta]

Welcome back to Chasing Life.

[Interviewer]

People have talked about this thing known as the hygiene hypothesis, and they've attributed even the increase in allergies, for example, to that. And you've made this point a couple of times, Dr. Hamblin, that some of this is just cultural expectations and practices. But that's also important. Like, we evolve, we evolve as human beings on the planet to start doing certain things. And it's okay, I think, as long as there's not evidence of harm to that. And I think that's where I get hung up a little bit. Like, is it a question of those products causing harm or are we not doing enough to properly repopulate our microbiome by being in the dirt?

[Dr. James Hamblin]

Yeah. You know, what was known as the hygiene hypothesis. The idea that we might be doing harm to ourselves by too much hygiene, I think has fallen out of favor and been replaced with something called the biodiversity hypothesis, which is to say that we might be not having as much biodiversity on our skin, in our guts by way of our exposure and our lifestyle in many, many different ways. That technically hygiene, if you're doing it well, is a very targeted approach to saying I'm why, why am I doing this practice? Why am I wearing a face mask right now? Why am I washing my hands right now? I'm washing my hands after I use the bathroom because there is this evidence that we need to do this to, you know, remove any possible transmission of microbes that might happen during that time. But that doesn't mean it's not hygiene to wash your Hands every five minutes. There's no evidence that that would make you any healthier, prevent, you know, disease transmission. But the biodiversity hypothesis would say, well, we're just. Many of us are living isolated lives in sterile offices surrounded by the same few people and very few animals, and not getting a ton of exposure to the outdoors and not traveling enough and not physically close to many people at all. Getting very little physical contact with people outside of an occasional handshake. And for all these reasons that we might, you know, not have these sorts of microbial inputs that shape a robust immune system. I think it's just being about being deliberate about what you do. You don't want to encase yourself in a bubble anymore than you want to go out and deliberately expose yourself to dangerous situations. You want this. This balance of exposure and protection. And striking that balance is easier said than done, for sure.

[Interviewer]

Find that balance. And probably a lot of it is common sense. I mean, not encapsulating yourself in a bubble and not overly, you know, just cleaning yourself all the time. I know you just mentioned you run the New York Marathon. You're out there in, you know, in the environment. Do you have pets?

[Dr. James Hamblin]

I do. I have two big dogs, and I have a baby. And I know as a parent, you know, it's very easy to err on the side of just protect, protect, keep everything away. You know, keep that away. You know, constantly clean the kid. You know, it's. It's just easier and simpler to think, let's err on the side of hygiene. But exposure is important, too. You know, you are building essentially all these exposures in the same way that you want to expose a kid to arts and music and stories and education. But a lot of people don't think that same way about just worldly exposures, you know, so, yeah, if the kid can pet a dog, if somebody else can, you know, hold your kid and give him a hug, I'm all for it. I think that's a valuable thing in the same way that, you know, trying to keep the kid away from somebody who's sneezing in their face is valuable.

[Interviewer]

You know, in the book, you are pretty clear. You don't want the takeaway to be that people should shower less. What is the takeaway?

[Dr. James Hamblin]

I think it sort of comes back to that biodiversity hypothesis that there is a lot of marketing out there in the world of cleanliness and beauty and hygiene products about what this product will do for your health and how it will make you better and more virtuous and how it's Necessary and how you're hurting yourself. And maybe you're a bad parent if you don't use these things. But in fact, there are a lot of ways to do things correctly, and there's very little that is necessary for disease transmission prevention. And so if something is working for you, it makes you happy, you enjoy it, you enjoy the process, you enjoy the product, you like the look of the product, the smell of it, you enjoy applying it and using it, then great. And it's part of your cultural practice. You know, all these things are great. And I would never tell anyone to give up something that they're enjoying. But there is a large segment of the population also that's doing things just because they thought it was necessary, because they were sold something by marketing, because they think it's making them healthier in some vague way, even though it's annoying and expensive, and maybe it dries their skin out. And I don't know. And if people could have the freedom, just feel free to just let that go, try going without it, try doing less, then that would be great.

[Interviewer]

A lot of people make resolutions this time of year. Do you make resolutions? Is that a thing for you?

[Dr. James Hamblin]

I don't. Because if I decide I'm going to do something, it's really hard for me to say, oh, wait until January 1st, start that. So I'll just start it right away. But yeah, if people are looking for resolutions, you know, just oftentimes the natural inclination in our society is add another product, do more, do more, do more. And, you know, I think the interesting suggestion is at least to think, well, maybe adding more is not. Is not the right thing. Maybe, maybe gradually doing less would actually work.

[Interviewer]

I'm going to take your advice, Doctor. I really am. I actually started taking your advice already, to be honest, and I really appreciate it.

[Dr. James Hamblin]

Oh, yeah, you too. This has been a real pleasure. Thank you.

[Dr. Sanjay Gupta]

Such an interesting guy. That was Dr. James Hamlin. He's a doctor and a public policy lecturer at Yale University. Gave me a lot to think about. How much of what we do is because of expectations. Expectations that are often created, by the way, for one primary reason, which is to sell you another product. Today we talked about hygiene, and that's very tangible. But there are so many examples of this throughout our lives where we do too much, where we use too much, buy too much, and many times we don't really need to do it. And as Dr. Hamblin points out, sometimes those things can even hurt us. So just take the extra beat and give it a thought. Do you really need to do what you're about to do. That's all for today's show. If you missed any of our other episodes focused on doing less in the new year, consider giving them a listen. Whether you're interested in releasing yourself from the pressure to be perfect or even the benefits of boredom. Thanks so much for listening. Chasing Life is a production of CNN Audio. Our podcast is produced by Aaron Mathewson, Jennifer Lai, Grace Walker, Lori Gallaretta, Jesse Remedios, Sofia Sanchez and Kira Dehring. Andrea Cain is our medical writer, Our senior producer is Dan Bloom, Amanda Seeley is our showrunner, Dan Dezulla is our technical director and the executive producer of CNN Audio is Steve Lichti, with support from Jamis Andrest, John Dionora, Hailey Thomas, Alex Maniserie, Robert Mathers, Lainey Steinhart, Nicole Pesaru and Lisa Namorow. Special thanks to Ben Tinker and Nadia Kanang of CNN Health and Katie Hinman.

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