We are used to searching online for ANSWERS TO MOST OF THE QUESTIONS THAT HAVE ASKED US . In the new series of materials, we ask just such questions: burning, unexpected or common – to professionals in various fields.
Water treatments that were once a luxury are now available to many, as are a huge selection of cleansers. A shower in the morning, another after a workout and a relaxing bath in the evening (and then a moisturizer for the whole body) have become commonplace. But can there be too much washing? Isn’t it the frequent hygiene that leads to a constant need for hydration? Do water and soap dry the skin and are antibacterial handwashes needed? We asked these questions to an expert.
doctor of the highest category, candidate of medical sciences, dermatologist at the Rassvet clinic
There is a clear link between improving overall cleanliness and improving health. Personal hygiene (first of all, hand washing) is important for the prevention of many diseases, which are called hygiene-related diseases. These are intestinal infections, dental caries, parasitic infestations, fungal infections of the skin, scabies, lice, trachoma (an infectious eye disease). At the same time, it is difficult to accurately assess the contribution of personal hygiene to the reduction of infectious diseases – other factors have changed, including nutrition and water treatment, and the level of knowledge about prevention has increased. The causal link between dirty hands and infection transmission is one of the most well-documented facts in medicine. Recently, however, evidence has emerged that forces us to look at skin hygiene in a new way.
For many years, it was believed that the superficial layer of the skin (stratum corneum) creates a mechanical barrier like a film that prevents drying and protects against adverse external factors and the penetration of infection. But now the understanding of the processes occurring in the skin has radically changed. It is now known that the cells of the stratum corneum and the substances between them create a semi-permeable structure in which biochemical processes are actively taking place. This whole system was combined into the concept of “epidermal barrier”. The stratum corneum consists of about fifteen layers of cells held together by various substances – among them ceramides, sphingosine and components of a natural moisturizing factor are considered especially important.
Every day, a fresh layer of cells is formed deep in the skin, and the superficial layer is separated, that is, there is a constant renewal and cleansing of the skin. The surface of human skin is inhabited by a huge number of microorganisms that form a stable community – the microbiome – and prevent pathogenic microbes from multiplying. Skin microflora varies from person to person, but it is surprisingly stable for each person. Even without washing for many days, the composition and number of skin microorganisms remains unchanged .
Washing, especially with soap, violates the epidermal barrier – water loss increases, the acidity of the skin surface decreases, lipids are washed out
By cleansing the skin, we strive to get rid of dead cells and pathogenic microorganisms. But washing does not go unnoticed for the components of the epidermal barrier and the normal microbiome. The studies point out that the washing, especially with soap breaks the epidermal barrier – enhanced water loss, reduces the acidity of the skin surface lipids are washed out. This damage leads to dryness, redness and cracking of the skin. This is especially true for those who often have to wash their hands due to the nature of their work: in surveys among nurses and other medical personnel, at least 25% of participants reported injuries to the skin of their hands . In experiments, redness, a decrease in acidity and other damage occurred even after a single wash and persisted for several days – even after seventeen days of observation, the skin often did not completely recover .
Another important aspect is the state of microorganisms that inhabit the surface of the skin. Cosmetics, emollients, soaps and other hygiene products potentially contribute to changes in microflora – however, the effect of these products has not yet been clearly determined, because such studies have not been carried out. Damage to the epidermal barrier as a result of frequent washing can also contribute to a change in the microbiome and an increase in the number of bacteria on the skin .
When it comes to antibacterial soaps, there is no evidence from the FDA that antibacterial soaps are better than regular soaps with water in terms of preventing infections. Moreover, the frequent use of antibacterial hygiene products can be dangerous if it leads to the emergence of resistant strains of microorganisms. There is evidence of the possible effect of some antibacterial substances on the endocrine system.
So, handwashing advice is still one of the most important steps you can take to avoid infectious diseases and prevent germs from spreading. You can wash your hands with regular soap and water. There are no standard recommendations for cleansing the skin of the body for everyone, but it is worth remembering that it is better to protect the epidermal barrier. The water should be warm, not hot; you should not stay in it for too long. Instead of liquid soap or shower gel, it is better to use oils or syndets ( synthetic detergents with a pH optimal for the skin. – Ed.) . It is better not to rub the skin with a towel, but to blot gently, and if it is dry, use moisturizers and emollients.