Skin Care Doesn't Stop At The Neck: How To Take A Microbiome-Healthy Shower

In skin care circles, we tend to talk about the skin barrier and microbiome as it relates to the face. It makes sense, as the face tends to get the skin care attention overall. And recently the conversation began expanding to our hands, as we all are spending more and more time sanitizing and washing them. 

Of course, skin covers the whole of our bodies—and yet, we rarely give the rest of our skin the attention it so deserves. Except in the shower. The shower is when you are able to connect with your skin from the neck down in a fundamental way. But are you taking your "healthiest" shower? And on that note, what does a better-for-skin shower even look like? 

Taking a healthier shower means thinking about your body's skin with the same care you think about your face with. If you think about all the precautions you might take with your nightly face wash, apply that to your whole body. No, this doesn't mean you need to add an extra seven steps to your shower routine, and in many cases, it shouldn't; it does mean there are several variables in the shower that we might be overlooking. And now, it's time to pay attention.

Your microbiome is a beautiful thing. It's what we call the trillions of bugs and fungi that live on our skin, good and bad. Each area of our body, too, has an "eco-niche," physician Kara Fitzgerald, N.D., writes, and tends to require different measures of care. "The critters also vary depending on the amount of light and whether the area is moist, dry, hairy, or oily," she explains. This means that the biome on your scalp, face, hands, pits, and elsewhere all serve different functions, have unique needs, and should be treated differently. She goes on to note that "the microbiome differs with age and gender. For instance, a hormonal, sweaty teenage boy sports a very different microbiome than a sedentary, postmenopausal woman." 

And its flora does a lot for us: helps us deal with skin infections by crowding out pathogens with good bacteria, acts as a vital part of our skin barrier, protects us from environmental damage by limiting exposure to allergens and oxidative stress, and even communicates with our internal immune system1, new research shows. And even then, we're really only scratching the surface. There is so much we don't fully understand about the biome yet, and we are learning more nearly every day. 

"The microbiome is essentially an organ system and could be thought of as that important," says physician James Hamblin, M.D., author of Clean: The New Science of Skin. "We know that you don't want to be sterile, or without these microbes. The function is far greater in scope than what we can actually understand right now. So, it is at once very difficult to say how exactly to keep the microbiome well and optimized while also knowing it is very important to keep it healthy."

Take a moment to think about your daily shower. First up, is it daily—or more or less? What's the temperature of the water? How long is it? Are you washing your full body with a lathering, sudsy soap? What sort of ingredients are in that soap? Do you exfoliate at any point—and if so, how often? After the shower, do you apply a lotion or cream? 

Indeed, a lot of variables to consider. And the thing is, each of these steps can be optimized to better support your microbiome and skin barrier. But the key here is that it's your microbiome: You know your needs and body better than anyone else.

"One thing I like to make clear is that this is a personal decision," reminds Hamblin. "There's advice that you can offer to help in the decision-making process, but I would never tell anyone how exactly to approach this. However, if you want to make changes, it is possible to think outside the box. And it's not unhealthy and unhygienic to do these things less or different from what we're normally told."

For some, the idea of not adhering to a daily shower regimen is a nonstarter (or two, for that matter). Others are more lackadaisical with their routine and make showering choices based on what they happened to do that day. And we're not going to tell you there's a right answer. But there are several factors you should consider when choosing your frequency: Your lifestyle, body odors, natural oil production, and just overall feeling of cleanliness. 

"For many people, daily showering isn't a big problem," says Hamblin. "But for some who have skin conditions, fluctuating between oiliness and dryness, or going between inflammatory skin flares and no flares, you may consider that over-showering may be part of the problem."

So even if you do want to shower daily, you can also just stick to a rinse every so often, notes board-certified dermatologist Zenovia Gabriel, M.D., FAAD. Gabriel says you can skip the allover cleanser and simply tend to the sweatier places—underarm and groin area—with a wash. Then use soap only two to three times a week, which can prevent drying out skin and causing inflammation, she tells us about choosing body cleansers.

Temperature plays a large role in the list of variables. You've likely heard this before but it bears repeating: Do not take too hot of a shower. Hot water has the incredible ability to strip skin of its natural oils and lipids, thereby stealing from the skin its natural defense system: Your skin needs a lipid barrier; otherwise, you get cracks and dry, vulnerable skin. When this happens, you compromise your skin barrier, full stop. Stick to lukewarm water always. 

This has more to do with personal preference and time constraints (some simply loathe wasting time in the shower; some can't get enough). However, be sure to spend enough time in the shower to adequately cover the body with moisture, so you can seal it in later with a moisturizer (more on that momentarily). 

"Take lengthy showers in tepid water, staying under the water until your fingertips get wrinkled," says dermatologist Loretta Ciraldo, M.D., FAAD. "This is a sign that you have tremendously rehydrated your skin." 

But on the other end, you don't need to spend too much time: "You can take shorter showers," says Hamblin. "That's a very simple way to change your habits."

Perhaps one of the most important variables in the equation: your soap. Soaps can contain a host of stripping ingredients, including sulfates, as well as irritating ones, like parabens and fragrance. We recommend avoiding those ingredients—while also looking for options with added skin-care-focused ingredients. 

"Ideal soaps are made without harsh sulfates like sodium lauryl sulfate, that can damage the skin barrier," board-certified dermatologist Whitney Bowe, M.D., tells us. "I also love seeing hand soaps that are enriched with soothing, hydrating ingredients like milk, aloe, honey, and oatmeal. Also, any ingredients that restore the barrier and help bring the pH back to the normal range—slightly acidic—are imperative. Our skin has an invisible layer called the 'acid mantle,' and we need to respect the pH of our skin to keep it healthy." 

As for irritants, some people are more susceptible to fragrances and the like. "[Artificial fragrance] is one of the most common ingredients to cause sensitivity, puffiness, itch, and rash," Ciraldo has noted about hypoallergenic products. Also, parabens and other common preservatives have been linked to allergic reactions. 

And, again, as noted above: Do not feel the need to fully lather up with every wash. Some showers only call for a light rinse of water. Or, as a more economical option: "Just don't use as much soap," says Hamblin.

From time to time, you may want to use a scrub or tool to slough away dead skin cells and flakes. If that's something you're interested in, stick to about once a week, and always be mindful of how abrasive the scrub is. Sure, the skin on your body tends to be thicker than that of your face—and thus can handle a denser, coarser scrub—but still err on the side of gentleness. Also be mindful of your in-shower tools: If you are using a loofah or sponge, those act as mild physical exfoliants too—perhaps limiting the need for a granular scrub or wash. 

Apply a moisturizer post-shower. This seals in the water, replenishes your skin's lipids, and prevents transepidermal water loss2. "It's essential to moisturize as often as possible to restore those lipids and encourage the regrowth of healthy bacteria, or your microbiome," Bowe tells us. "If you wait too long, you miss that narrow window of opportunity to really trap and seal those nourishing ingredients in the skin before all the water evaporates off the surface, further compromising your skin."

You may not think about your shower habits. But it's time to—your microflora is an incredibly important thing, and we are continually learning more about all the ways in which it helps us. You can be smart about your showering habits, in a way that feels good to you.