The harm in a common hygiene habit
Key Takeaways
Approximately two-thirds of Americans take a shower every day, but health experts say this can throw off the delicate ecosystem of the skin.
Bathing products often contain additives like oils, perfumes, and deodorants which can cause allergic reactions, and excessive bathing can pave the way for skin infections.
Healthcare practitioners may want to advise patients with skin disorders that bathing several times a week is acceptable, but every day is likely too much.
An estimated two-thirds of Americans take a shower every day, and don't think twice about it. But according to health experts, this may not be necessary, and for patients with skin conditions, it may even be detrimental.[]
The oils, deodorants, perfumes, and other additives in soaps and shampoos can lead to allergies or other skin conditions, and too much bathing can open the door for skin infections. If you're a physician advising patients with skin disorders, here's what health experts and researchers say about how often people need to shower and why bathing daily may actually be an unhealthy habit.
The skin as an armor
As the body’s largest organ, the skin is host to millions of bacteria, viruses, and fungi, which form a skin microbiome. According to an article published in Nature Reviews Microbiology, this microbiota—much like the gut microbiome—protects the body from pathogens, bolsters our immune system, and disposes of natural waste. If this ecosystem is disturbed, it can increase the risk of diseases affecting the skin.[]
According to Harvard Health’s Robert Shmerling, MD, showering too much can lead to a disruption of the balance of bacteria and other useful microorganisms, which can result in dry, irritated, or itchy skin.
If the skin dries enough to crack open or thin out, bacteria and allergens can pass through the protective barrier that the skin provides, which can increase the risk of infections.
Additionally, using antibacterial soap in the shower regularly may be killing off the normal “good” bacteria that live on the skin. This can result in an imbalance of microorganisms and may ultimately lead to an increase in organisms that are more resistant to antibiotics. The skin needs to keep this balance because exposure to certain normal microorganisms and other environmental elements helps to create protective antibodies and build immune defenses. Bathing too frequently can upset this process.
According to an article published on the health website Verywell Health,[] this can be especially damaging for those with skin conditions like eczema or psoriasis. For these individuals, cleaning with lots of soap and hot water can lead to an imbalance of the acid mantle, which is the layer of fatty acids and sebum that protects against outside contaminants and keeps the skin moisturized. Disrupting these elements can leave the skin dry, flaky, and more vulnerable to infection.
One key reason so many of us bathe every day is body odor. But according to author James Hamblin, MD, cleaning too often can exacerbate our BO.
In an article for The Atlantic, Hamblin notes that body odor is a result of bacteria that live off the oils and sweat on our skin, and bathing too much and using excessive soap throws off the balance of this ecosystem. As bacteria repopulate, those that produce more odor are favored. As a result, body odor may be more pungent in frequent bathers. On the flip-side, if individuals are more prudent with the frequency of bathing, this ecosystem will achieve balance and body odor will become less noticeable.[]
How often should people bathe?
It’s about finding a balance.
Going without bathing for prolonged periods will lead to a buildup of dead skin cells and oils on the skin, which can clog pores and trigger skin outbreaks. Likewise, spending too long wearing sweaty clothing can increase the risk of bacterial or fungal infections, like jock itch. Those who hit the gym regularly will want to be sure to shower after a workout, as certain pathogens can thrive on gym equipment and in locker rooms.
Individuals who are unable to bathe for a long time can develop a condition called “dermatitis neglecta,” characterized by brown patches of dead cells, sweat, and dirt on the body. Post-surgery patients or people with physical disabilities are most likely to develop these conditions.
According to Dr. Shmerling of Harvard Health, there’s no one-size-fits-all strategy for bathing frequency. Unless people been doing something that leaves them dirty, sweaty, or unclean, health experts suggest that several times a week—but not daily—is enough to keep the body in balance for most people.
The Verywell Health article suggests using warm rather than hot water, which can dry out the skin. When showering, 5 to 10 minutes is enough to maintain cleanliness, and soap should typically be used in the key areas: groin, armpits, buttocks, and feet. For those with dray skin, moisturizer can be applied afterward.
That said, continue advising patients to wash hands frequently—even if most people already have that drilled into their heads and daily routines, thanks to COVID-19.
What this means for you
The majority of Americans, and likely many of your patients, are bathing every day. This is not only unnecessary, but can be detrimental, especially for patients with skin conditions and disorders like psoriasis or eczema. Healthcare practitioners can advise these patients to limit bathing to a few times a week, apply moisturizers afterward, and follow the guidance of their dermatologists.