Wash Your Hands with Soap, But Not Too Much
By Robert Rowen, MD.
My mother was absolutely preoccupied about germs and cleanliness, after all “cleanliness is next to Godliness,” right?
Articles are now coming out that childhood exposure to germs that normally exist in the environment strengthens their immune systems and may be a necessary part of a healthy life. What about handwashing, especially with antimicrobial agents? Even as a health professional, I've been concerned about overzealous washing and scrubbing. My concerns are not only for the damaging effects on the skin, but also for the secondary spreading of germs by the damaged skin.
A review of this subject by Dr. Elaine Larson, from the Columbia University School of Nursing, confirms my suspicions. As with antibiotics, when bacteria develop resistance, they not only become resistant to the single exposed agent, but somehow a whole slew of other agents the bugs never saw. The flora (bacteria) of the skin remains remarkably constant over time even without washing. Like the flora we develop in our gut after birth, the resident germs prevent colonization of more pathogenic germs.
However, washing too frequently, even with simple soaps or harsh agents, may break the skin's protective layer, remove protective lipids, or alter flora to more pathogenic organisms. Studies on health professionals reveal an alarming rate of deteriorated skin, which carries a higher risk of germ transmission even when washed. Thus, routine public use of antimicrobial detergents isn't only contraindicated, but potentially harmful, except in cases where there is a high risk of disease transmission (such as known contamination like fecal, crowded residence facilities, neonates, immune compromised individuals, food preparers, etc.).
Newer alcohol-based hand rinses may be superior since they do provide rapid killing of germs without the skin damaging effects of soaps, detergents, or chemical anti-microbials. PMID:20061060
Action to take: Try not to be too fearful or zealous about germs. Normal bathing is fine, as good hygiene is healthful, but avoid using skin-damaging substances like anti-bacterial soaps. Routine use of topical antimicrobials should be avoided as well as unnecessary repeated exposure to detergents and soaps. Of course, use prudence where there's obviously a known risk of transmission to yourself or others.
Author Robert Rowen is a pioneer in health care, having received his medical degree from University of California at San Francisco School of Medicine.
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