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Tuesday 23 January 2018

Rogue Hypothesis: Excessive Cleanliness as a Cause of Acne?

I know many epidemiologists have proposed that one of the major causes of rising rates of asthma and allergies is probably excessively sterile and disinfected environments (we have seen a big rise in helicopter parenting (decline in outdoor play), wet wipes and Dettol since the 1960s and 1970s, and this seems coincident with the big increase in the frequency of these conditions). (Extra support for this thesis lies in the fact that c-section babies are more likely to have asthma and allergies (presumably  because they don't get a big dose of vaginal bacteria to start off their life).) I think that some (many?) health experts believe that the fact that kids are hitting puberty much earlier than a few decades is also related to this environmental factor. Also, I just came across this link (https://jamanetwork.com/journals/jamadermatology/fullarticle/479093), which made me think that acne vulgaris may (somewhat paradoxically but not implausibly) be related to excessive cleanliness too! Just as using shampoo causes the scalp to produce far more oils than it otherwise would (people, like me, who have stopped using shampoo, experience a dramatic reduction in oiliness), it may be that showering every day and scrubbing oils away from the skin causes the skin to 'overcompensate'.
My own life history lends a small modicum of support to this thesis. Relative to my childhood peers, I know I had an extremely lax hygiene routine, almost never washing my face and often bathing only once a week (I'd try to do twice, but I think I only did three times a week sporadically) (and I didn't like using the shower). Even as a teenager, I didn't really use the shower, and didn't really come close to bathing every day. Our house was also quite dirty and we went camping annually to a place without showers. Perhaps this explains why I didn't get any teenage acne (just pimples on the chin and the forehead every now and then but on their own (nothing resembling acne)). (I've had very sporadic, short-term outbreaks of rosacea-related, cheek-restricted pimples since I was 18, but I have massively mitigated/virtually eliminated my rosacea simply by starting to use moisturiser and it doesn't seem implausible that I will never have such an outbreak again.)
Anyhow, my sister was similar in the laxness of her hygiene routine and also never seemed to get teenage acne like her peers. We also both hit puberty very late. Yes, there are probably genetic factors involved here. The real test would be to see if the rates and severity of teenage acne in Western countries several decades ago was significantly lower relative to now. If that is the case, then the hygiene hypothesis seems much strengthened (and the palaeo-advocate-favoured "dairy" and "gluten" hypotheses are dead in the water).

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