Revisiting how we think about cleanliness and bacteria could be the key to improving overall skin health. Clean is good, but you can have too much of a good thing, writes Dr Juanita Killian (founder of DrK Dermal Health Care).
We are all familiar with the old saying that cleanliness is next to godliness, yet a new movement is suggesting the sanitisation of our modern lives could be doing more harm than good. Talks of “rewilding” or “reconnecting” with nature are cropping up, and just like the interest in “good bacteria” for the gut before it, the focus is now on the skin microbiome. As allergic reactions and inflammatory conditions such as eczema and psoriasis continue to rise, attention is shifting towards the idea of a healthy bacterial balance on the skin – and how it can not only protect the skin – but also help repair it.
The microbiome, in essence, is a community of organisms that live on the skin, including bacteria, viruses, and fungi. It is a finely tuned ecosystem that controls our skin health and, much like gut bacteria, it can have far-reaching consequences.
Alarmingly, our modern hygiene practices contribute the most towards an unhealthy skin microbiome. Modern hygiene practices literally start by having hot water piped into our homes and using antibacterial surfactants every day. This already places your skin microbiome under constant pressure, as the skin is quite acidic. So, suffice to say, the Skin Microbiome already has some adjustments to do.
What’s more, every time we take a hot shower, we are removing sebum (the oily substance on our skin that is largely responsible for its moisturisation ), as this waxy matter melts at a temperature of 26-28-degree Celsius (while the average shower runs at 40 degree Celsius). This makes our skin more vulnerable to inflammation.
In fact, the balance on the skin is so finely intricate, that when the regulation fails, we start seeing flushes of inflammation into the skin. For example, eczema is linked to the overgrowth of a certain bacteria that indirectly spikes the skin inflammatory response.

The balance on the skin is so finely intricate that when the regulation fails, we start seeing flushes of inflammation into the skin. For example, eczema is linked to the overgrowth of a certain bacteria that indirectly spikes the skin’s inflammatory response.
How our lifestyle is jeopardising our skin
Now research and brands are suggesting our lifestyles are also damaging the skin microbiome and taking our skin health down with it. Hygiene is not bad, but we have moved to a point of sterilisation and over cleansing.
Remember, humans used to walk barefoot, swim naked in rivers; bacteria were very ubiquitous. And now, as our lives have been taken indoors and we are less in touch with nature, we are feeling the effects. There have been studies that have sequenced the microbiome of uncontacted tribes around the world, which show they still have these anti-inflammatory bacteria, and the rest of the world has lost it. And these tribes do not have the same incidences of acne, eczema or other inflammatory conditions.
Indeed, a 2015 study of the skin microbiome of the previously uncontacted Yanomami tribe found they possessed an unprecedented volume of bacterial biodiversity and even possessed some functional natural antibiotics as well. This bacteria is now referred to as ammonia oxidising bacteria. Believed to feed on sweat and then convert into nitrite and nitric oxide, it functions as a sort of built-in cleanser and deodorant.
Some people even refer to the microbiome as the newly discovered ancient organ or the second genome. It can impact everything from the look and feel of skin, how oily it is and the texture. Optimum skin health starts and ends with microbiome diversity and balance.

We have a potential paradigm shift in the way we think about cleanliness and bacteria… consumers are thinking twice about lathering up in the same way they did before.
No more Skincare, now its Microbiome care
Much research around the skin microbiome has been focused on inflammatory conditions, such as eczema, while trials have also been undertaken for conditions including keratosis pilaris (the red bumps that can present on arms and legs sometimes referred to as “chicken skin”).
Eczema is not just an unpleasant and painful condition, but it also represents a breakdown in the skin barrier. This can then leave the skin more open to infection or other kinds of irritation.
It is widely accepted we have gradually lost some strains of bacteria from our microbiome (such as ammonia oxidising bacteria), as our lives modernised and became less agricultural.
Why we need to think twice about hygiene
We’re just at the beginning of our understanding of the full potential of the skin microbiome. The technology needed to investigate this thoroughly is still only about 15 years old.
What we do have, however, is a potential paradigm shift in the way we think about cleanliness and bacteria. Just like your doctor may now advise a probiotic or kefir with your course of penicillin, consumers are starting to think twice about lathering up in the same way they did before – especially if they’re suffering with an atopic inflammatory condition.
With the knowledge that hard water can exacerbate skin conditions, and fears around pollution and skin damage, we are left with the perfect storm of modern, Western issues: how clean is clean enough? And could our daily hygiene practices be harming us, not helping us?

What we have, is a potential paradigm shift in the way we think about cleanliness and bacteria. Just like your doctor may now advise a probiotic or kefir with your course of penicillin, consumers are starting to think twice about lathering up in the same way they did before – especially if they’re suffering with an atopic inflammatory condition.
Written by Dr Juanita Kilian

Dr Juanita Kilian
B.Pharm, M.Sc Pharm, Ph.D,
Founder of DrK Dermal Health Care www.drkdermalhealth.com
- Master’s in Dermaceutical product development
- Doctorate in Transdermal Delivery Technology
- Engaged in the study of transdermal delivery systems
- Discovered formulations which had a profound influence on the development of the DrK Dermal Health Care product range www.drkdermalhealth.com
A2 Disclaimer: This article is published for information purposes only, nor should it be regarded as a replacement for sound medical advice.
This article was written by Dr Juanita Kilian and edited by the A2 team EXCLUSIVELY for the A2 Aesthetic & Anti-Ageing Magazine Summer 2020 Edition (Issue 35 – Dec 2020 to Mar 2021).
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