Nursing Book Club

Clean: the New Science of Skin by James Hamblin

Putting soap under the microscope

This is a book you must read if you’ve ever wondered about the difference between the affordable shower gel you buy at the grocery store and the wish-list expensive skincare products you find in the high-end shops.

Author James Hamblin has the answers, which he found after five years of not showering. Intrigued? So was I. Hamblin is an M.D. with a master of public health degree who has branched out into journalism. (He’s a lecturer at Yale School of Public Health as well as a staff writer for The Atlantic.) He wanted to know what exactly we’re putting on our skin and what it purports to accomplish.

Beginning with a history of hygiene, he continues on to the development of the soap industry. Of course, it’s difficult to separate this from a review of advertising and the ways catchy slogans and radio and TV programs have been used to convince shoppers that one cleaning product is superior to rivals that may use the exact same ingredients. (There’s a reason we call serialized dramas “soap operas”!) Scents and dyes might also sway customers one way or another, but do they help or hinder the cleaning process? Hamblin investigates.

Soaps and Cosmetics

All of this background leads to an examination of today’s proliferation of beauty and lifestyle products and what they can and cannot do. This raises many complex questions. For example, too much soap dries out the skin and needs added moisturizer, but does the moisturizer actually get below the surface of the skin?

Hamblin also explains that the contents of beauty products can have important legal implications. Adding ingredients such as detergent, scent or oils might take a skin care product out of the soap category (which is overseen by the Consumer Product Safety Commission) and turn it into a cosmetic — which federal law defines as a product intended to be “rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body … for cleansing, beautifying, promoting attractiveness or altering the appearance” — subject to FDA regulations. Hamblin has plenty to say about that agency and how well they do their job.

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The Skin Ecosystem

In the final chapters, the author considers the purpose of our skin and its relationship to bacteria and probiotics. There’s good evidence that dirt, grime and germs play a part in protecting us from developing allergies, both in rural and urban settings. In short, our skin is not just an empty canvas and it doesn’t necessarily need our improvement. It is a large and important organ, and how we treat it is critical.

Hamblin argues that skin is its own ecosystem, and that its cleanliness and condition are probably more dependent on “sleeping and eating well, minimizing anxiety and spending time in nature” than on anything else we can purchase for skin health. The media is full of people with strong opinions and conflicting advice about skincare, but as a physician specializing in preventive medicine, Hamblin isn’t just another “influencer.” I was very interested in what he had to say.

Clean: The New Science of Skin by James Hamblin (Riverhead Books, 2020)


Christine Contillo, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.


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