Episode 236: James Hamblin

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Cleanliness, Purity, Health and Culture

When is clean too clean? And what science connects how we treat our skin with common skin conditions? While the virtues of cleanliness may seem to flow from modern scientific findings about germs, there are deep cultural and economic factors that have shaped the evolution of hygiene.

James Hamblin is a physician who specializes in public health and preventative medicine. He is also a journalist, author, and lecturer at Yale University. His latest book is titled Clean: The New Science of Skin, which was named an editor’s choice by The New York Times Book Review, and Vanity Fair named it among the best books of 2020. 

James and Greg discuss James’s book and the counterintuitive way we sometimes think of clean and healthy skin. They touch on the history of marketing by the soap and beauty industry and the relationship between status and cleanliness. James discusses new insights into the skin biome, how doctors blur the lines between the medical and the cosmetic, and unlocks some of the mysteries around various small body parts.

Episode Quotes:

How marketing manipulated us to things we don't really need

11:26: You have to create a need in someone. You have to make them believe that they are lacking something, that they previously were fine. The term "body odor" didn't exist before people trying to sell deodorant. People didn't worry about fine lines before certain beauty soaps started saying they could prevent them—a soap for preventing wrinkles. They just were using every possible marketing strategy, and that's what’s really unfortunate about it. It didn’t have to go that way.

On the concept of cleanliness

03:54: The concept of cleanliness goes back far, far beyond germ theory, and it's always been a stand-in for purity, whether it's religious purity, ethnic purity, or sexual purity, and these are arbitrary concepts, but it's been used as this sort of idea of what is right and wrong, essentially.

The information constraints faced by doctors

26:56: All kinds of different psychological stressors require constant work, help, and support. It's not that doctors don't know. It's just that we don't have a healthcare system that makes those things part of the toolkit.

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Episode 235: Abigail Marsh