
Rethinking the Science of Skin - haltingproblem
https://www.newyorker.com/magazine/2020/08/03/rethinking-the-science-of-skin
======
DoreenMichele
Overall, I'm glad to see this piece proposing a more complex understanding of
our largest organ. But some of what is said in this piece aggravates me, like
this quote:

 _Disorders such as celiac disease, Crohn’s disease, rosacea, and eczema—all
of which involve the skin, the immune system, and the gut—reveal just how
intertwined these systems are._

As I noted a couple of days back, the so-called "immune system" is not a
distinct, identifiable, separate set of organs and the skin's job of keeping
out invaders makes it part of the immune system.

[https://news.ycombinator.com/item?id=24015957](https://news.ycombinator.com/item?id=24015957)

I will add that skin and gut tissue are both the exact same class of tissue:
They are both _epithelial tissue_. So it should hardly be shocking that when
one of your epithelial tissues has an issue, so does another.

~~~
girzel
I've had rosacea since my late teens. About six years ago I stopped using
shampoo as an experiment: I figured it would either make my skin worse, or
better. To my surprise it had no effect at all. I had super greasy hair for
about five days, then suddenly it was fine. I never went back to using shampoo
regularly, but mostly just to save money – I use it maybe once every few
months if I've actually gotten dirty, or I'm in a super humid climate.

By contrast, what I eat and drink has has a huge effect on my skin, and the
only time I've actually looked 100% "normal" was when I was drinking an
enormous regular dose of Chinese herbal medicine. But later I used a topical
antibiotic, and that more or less fixed it: not as thoroughly as the Chinese
medicine, but close enough (and it's way less hassle).

What is the moral of this story? I guess that no one I've ever spoken to has
the remotest clue how the skin works.

~~~
Legogris
Just curious if you're still using anything in your hair (water/conditioner)
when you shower

~~~
girzel
I don't use anything but hot water and "vigorous agitation", no. Though as
noted I do end up using shampoo (diluted Dr Bronners) on occasion. For the
rest i use a coarse washcloth, and I think I come out cleaner than those
slathering themselves with "product". I'm currently talking myself out of
using soap on the pits, though I think it will take much more time (and
probably some other lifestyle changes) to stop using it on the nethers.

------
pdm55
These scientists must really have gotten some insights into the skin to be
able to do what they did. They used a polyurethane scaffold for skin grafts. I
cannot believe how fantastic the skin of the burns' victims now looks.
Repaired with no scarring! (Scroll down. Warning: graphic images)

[https://www.sciencedirect.com/science/article/pii/S246891221...](https://www.sciencedirect.com/science/article/pii/S2468912217300378#bb0065)

~~~
totetsu
That's pretty amazing. This paper has some pretty graphic images. Not too far
off in level of .. gore.. to some that might be shared on the disturbing
misanthropic nsfl side of reddit or the like. Somehow, that these images are
produced, and shared in the context of looking after people, they don't really
cause the same kind of psychological disgust reaction for me. (also makes me
feel not so bad about my current sunburn.)

------
Fezzik
I highly encourage everyone^ to at least try ditching the soaps, scrubs, and
shampoos - unless you have a medical condition, your skin and hair will
probably feel amazing. I haven’t used body soap or shampoo in well over 15
years. That said, I take 3 short showers everyday - after running in the
morning, after swimming in the afternoon, and before bed. At 38 I get a lot of
compliments about my skin and hair, and I think the trick is not wrecking them
with chemicals that primarily remove all the natural oils that they need to be
healthy. I do use Old Spice Deodorant (no antiperspirant) as I have not found
a good replacement for classic DO. Minimalism FTW.

^ it works well for me, a male with an average head of hair. Results may vary.

~~~
brandonmenc
Every single person I have ever known who tries this just ends up stinking and
greasy, and everyone else can detect that but they just don't say anything out
of politeness.

~~~
ericmcer
I think you need a clean diet, exercise and outdoor time to go along with it.

I met up with one of my friends and his girlfriend who had been Wwoofing for a
few months and camping/backpacking. Probably 2 weeks since they last bathed. I
was amazed how they both just smelled kind of earthy, not at all like B.O. or
funky just sort of like the earth. Maybe so much time in the dirt had built up
a really healthy balance of bacteria on their skin.

~~~
brandonmenc
Define "clean diet" in a non-pseudoscientific way.

~~~
phyzome
Low carb probably helps. Also likely: Low in synthetic chemicals, low in
heavily processed foods.

~~~
brandonmenc
> Low carb probably helps

So in other words, whatever the dietary fad of the day happens to be.

~~~
phyzome
And here I thought you were asking in good faith.

------
phyzome
My advice: Scrub hard, don't soap.

I stopped using body soap in the shower about a year ago and I can't recall a
time my skin has ever been healthier or cleaner.

Instead of soap, I use a wet washcloth and scrape my skin with it, similar to
using a loofah or pumice stone or (as I infer from the article) wet sand. The
dead skin, sweat, and accumulated dirt gets pulled right off even more
effectively than with soap -- I never get that gross "skin pilling" thing
anymore. I get zits way, way less often.

The washcloth obviously gets dirtier, even being thoroughly rinsed and wrung
out several times, so I swap it out more often than I used to. The soap in the
washing machine cleans it just fine.

I sometimes still end up with a mild musky armpit scent either way -- I find
that scent pleasant on people, and think it's just how people are supposed to
smell. Whenever it gets strong enough that I think others might be offended,
I'll dash on a bit of baking soda, which kills the scent instantly (and I
think resets the microbiome a bit).

(For reference: Male, European descent.)

------
audunw
I'm surprised nobody has mentioned Nitryfing Bacteria and/or Mother Dirt. I
see people mentioning that some people who stop showering end up smelling
rather nice over time, especially if they've been in contact with nature or
living on farms. But some people can also stink if they stop showering

There's a class of bacteria that are quite important to preventing bad smells,
Nitrifying Bacteria:
[https://en.wikipedia.org/wiki/Nitrifying_bacteria](https://en.wikipedia.org/wiki/Nitrifying_bacteria)

They're quite sensitive, and is easily killed off by soap. You'd usually
acquire them from contact with soil, but most of us aren't in daily contact
with soil.

I've tried to breed the bacteria myself. I found a recipe for a medium for
growing nitrifying bacteria, and just used some soil from the garden to start
it. Sprayed the resulting water on one armpit and not the other. Asked my wife
to smell both armpits after 3 days or so, and she found that the one I had
sprayed smelled much better (I didn't tell her which was which)

There's a company that sells a spray with this kind of bacteria:
[https://motherdirt.com/](https://motherdirt.com/)

I've tried it and also found it has a similar effect. Can't say for sure that
it increased the health of my skin much, I don't have many problems with my
skin these days anyway (I use body wash, but only gentle and perfume free ones
and not much/often)

I'd probably buy a spray with bacteria and use it daily if it was cheaper and
I could buy it locally. I think in the future, probiotics for the skin will be
as common as probiotics in food. It just makes sense.

I think it should be possible to make a simple procedure from making a
probiotic treatment from soil that anyone could follow, similar to how people
make sour-bread now a days. The procedure I used was way too complicated, but
if you have access to clean soil, should be possible to just use a sieve to
clean it up, mix in a thing or two that helps the nice bacteria multiply,
leave it for a while and then apply it somehow.

~~~
phyzome
I tried just rubbing dirt in one armpit for a couple months a while back, to
no effect. I'll have to try the more principled approach (what process did you
use?), or maybe just give the AOB spray a shot and see what happens.

------
keenmaster
Please shower, and please shampoo...I don’t think this article or the low
soap/shower movements are helpful for most people. Here’s why:

1\. Showering every day with shampoo makes you cleaner and more approachable (
_at least_ shower every other day). Even if it’s theoretically healthier to
shower/shampoo less, you will appear less cleanly and people won’t trust your
hygiene as much. They just won’t say anything... This is problematic. The same
goes for deodorant. It is a must. If you are worried about chemicals, avoid
anti-perspirants. They usually last longer than traditional deodorants but may
contain aluminum shavings. Even then, many physicians and researchers agree
that aluminum shavings aren’t bad for your health.

2\. Moisturizing is often helpful. This is because there are a number of
things that dry your skin, including: showering, AC, dry climates, and
retinol. People who wear makeup or have oily skin might use cleansers, which
dry the skin even further. Moisturizer is the remedy. It doesn’t have to be
the fancy stuff. There’s almost no correlation between price and quality. At
the very least, moisturizing increases comfort and aesthetic appeal. It can
also improve skin health when your skin is excessively dry.

3\. Sunscreen is critical. It prevents UV damage, reduces cancer risk, and
slows aging. I understand that the article didn’t target sunscreen, but it
vaguely casts doubt over “all those chemicals” used in skincare and downplays
the benefits of pretty much any additive. I recommend daily use of a facial
sunscreen that is SPF 30+, UVA/UVB, and zinc-based. Reapply after every 2
hours of continuous sun exposure. Even if you never use moisturizer but you
regularly use a cheap SPF30 sunscreen, you will look better in old age than
someone who uses expensive skincare products but never uses sunscreen. Both
moisturizer and sunscreen may require experimenting with different brands to
find one that suits your skin type (some are oilier than others). Note: Don’t
use combination moisturizer/sunscreens, they have enough moisturizer but not
enough sunscreen. The proper amount of sunscreen varies by face size, Google
it.

4\. Retinol has empirically proven anti-aging benefits. There are many pricey
BS products that contain an ineffectual amount of retinol. Just ask your
doctor for prescription retinol. Apply every night (not in the morning because
it makes you sensitive to the sun) along with moisturizer. Your skin will
visibly improve over the next 3-6 months, though it might look worse for the
first month as your skin adjusts and you find the right routine. Retinol will
also make your skin look better into old age. Lastly, it can be extremely
effective against acne if that is an issue with you.

Sure, collagen creams are a scam. Sure, most skincare products over $10-$20
have no marginal benefits and exist to make you feel luxurious. I just don’t
want people reading the article and then some of the minimalist Thoreau-esque
comments here before coming to the conclusion that they should shower less and
use almost no skincare products. Some skincare products are great, most suck.
Keep it simple and stick to the recommendations embedded in points 1-4 above.
If you use resources like Reddit to research specific skincare products, just
be wary of their obsession with exfoliating acids (AHA, BHA, lactic acid...).
They add complexity and cost for little marginal benefit unless you have acne.

~~~
girzel
Is the movement really "low shower"? Every article I've ever read on the
subject says " don't use soap/shampoo, but shower daily ". That's what I do,
and yes I'm port sure I don't smell bad. I sure as hell wouldn't go multiple
days without a shower, though.

~~~
keenmaster
“Low-shampoo/soap” and “shower less” often appear together. Specifically on
the matter of shampoo, I think it’s necessary to manage oiliness. Maybe if you
have lots of hair, shower every day, and groom well, you can get away with
less frequent shampoo use. For most people, especially men, it’s better to be
safe and just shampoo every day.

~~~
1_over_n
I have not used shampoo for 12 years and i am frequently complemented on my
hair. It's far less greasy than everyone elses i know. Not using shampoo !=
not showering, i get 2-3 showers a day due to heavy gym use which is why i
originally stopped using shampoo (frequent showers with shampoo made my hair
very dry). I do use conditioner sporadically (around once per month). I would
say others perception of me is quite a well groomed and clean person for what
it is worth. I cant speak for everyone but i seriously do not need shampoo and
would say people who are interested could experiement with it if they are
still taking regular showers for little downside.

~~~
nicoburns
When showering without shampoo, do you still wash your hair with water?

~~~
1_over_n
yes 100% ! This is why i mentioned that not shampooing != not showering. My
hair is thouroughly "washed" with plain water 2 to 3 times a day depeding on
how many times i hit the gym.

------
mr_spothawk
For folks who are going to try this... you need to give your body at least 4
days to stop stinking.

------
jbotz
I have quite a bit of experience here that people may find helpful, and I'm
going to share it in some detail; but since this comment is pretty long, let
me give you the TL;DR first:

Water good, use plenty, daily. Soap not so much, use small targeted doses.
Natural oils good, use after soap. Shampoo bad, but maybe necessary; minimize
use. Other "skin care" products mostly harmful. Avoid.

Now for the details and my experience. First of all, I live in the humid
tropics, on a farm with animals, so the environment is on the extreme side in
terms of demands on physical hygiene. Secondly, this is Brazil, and Brazilians
are if anything even more averse to any trace of "BO" than North Americans,
and they are more likely to tell you if they think you stink, so there's that.
And thirdly my wife has as sensitive a nose as anyone I've ever known, and she
has an allergic reaction to a lot of strong odours.

I believe, and it is consistent with my experience, experimentation and
research in this regard, that when healthy skin is clean, slightly oily, and
protected by a healthy "microbiome", it almost never has a strong "BO" smell.
What people call BO is actually mostly the smell of certain opportunistic
bacteria overgrowing when there aren't others to keep them in check... the
more you eliminate it with soap and "personal hygiene products", the more of
it you have soon after the slightest bit of physical activity.

However, note that I said _" clean"_ skin. If your skin is dirty, depending on
the nature of that dirt it can serve as food for all sorts of other bacteria
and/or have its own smell.

So how do you keep your skin clean while keeping its microbiome intact and
healthY? With water. Just water, but plenty of it; we never shower less than
once a day, and often several times. Preferably not chlorinated water... this
may be a key factor that's often overlooked in this conversation, and may
limit the extend to which other people can follow my personal regime with the
same results... Chlorinated water may disrupt your skin's microbiome even
without soap, I really don't know. We use water from our own well (it's all we
have anyway). But if you do have pure water, you don't need much else for skin
hygiene.

When I do use soap, normally only on my hands and privates, I always spread a
bit of natural oil afterward. I use coconut oil; just a few drops on the hands
which I then spread on my still wet skin wherever I used soap. This
compensates for the oils the soap removed; think of of the process as an oil-
change, remove dirty oil, replace with clean oil. The quantity is small enough
that it is mostly absorbed by the skin right away, and the skin never feels
oily, but rather silky smooth and cleaner than without the oil, and it stays
that way throughout the day. This is particularly helpful on the privates...
once you make this a regular practice, you'll never want to go without.

Soap is certainly a powerful and useful tool for cleanliness... we know that
it is potent at disrupting bacterial biofilms and even destroys viruses, so
soap is a good thing in its own right. After handling animals or sticking my
hands in the soil I wash my hands with soap. But overusing soap on the whole
body is very harmful. Using a lot of soap strips your skin of both the oils on
the cell membranes that are part of every cell's normal functioning and
barrier to the outside, as well as the functioning bacterial communities that
exist in an equilibrium that normally prevents the overgrowth of any specific
(smelly or harmful) bacteria. So if you use soap at all, use it only on those
parts that are most exposed to "foreign" bacteria which don't belong on your
skin, and always follow up by replacing the oils the soap strips off.

The soap I use is the simplest soap I can find, just soap. When I lived in the
US I used Dr. Bronner's. Here in Brazil I use diluted liquid coconut soap. In
general, I much prefer liquid soap, as I find it easier to use in targeted way
and I find it rinses off easier. Avoid any artificial scents and additives...
they don't help anything and some of them may even be dangerous; none of this
crap is regulated, and we really don't know much about what most of these
chemicals do to organisms.

As for shampoo, it's a bit more difficult. Generally most people can get away
with shampooing a lot less, and after an adjustment period the hair will get a
lot less oily. But hair does accumulate crap that just water won't remove so
easily and you will need some way to get it really clean now and then. Heavily
diluted soap works in place of shampoo, but I for one use shampoo once every
couple of weeks or so, and when I do I have to use conditioner as well or I
won't be able to pass a brush through my hair afterwards. Some people just use
diluted soap and follow with oil on the hair as well. YMMV.

I don't use any other "personal care products"... as far as I'm concerned that
whole industry is 99% marketing; billions of dollars worth of crap that does
more harm than good. When I travel to colder or drier climates, I bring my
coconut oil and use a bit more of it on the whole body and that's all the
moisturizer I need.

Now as for the people in this thread who seemed sceptical... I assure you, I'm
at least as clean and probably smell better than you, and the people around me
are _not_ just "being polite".

------
phyzome
Paywalled. Anyone have a bypass?

Edit: Got one! [https://outline.com/HX3MA7](https://outline.com/HX3MA7)

