Showering every day isn’t good for your skin, but never washing isn’t an option either. Black, wart-like spots on your body, navel stones, and green toes are lurking. So how do you take good care of your skin?
Dermatologist Folkert Blok occasionally encounters truly dirty skin. It’s called dermatitis neglecta. You see it, for example, on the skin under plaster casts, in people who are dependent on care or living on the streets, but also in healthy people with a roof over their heads.
This skin has dark spots that resemble pigment spots or dark-colored, wart-like plaques of dirt, sweat, sebum, and dead skin cells. “You can polish it away with some paraffin or alcohol.”
Such skin full of flakes and dirt is dirty, but skin conditions such as eczema, psoriasis, ‘fish skin’, scabies mites, warts, or acne are not, says Blok. Poor hygiene can worsen these skin conditions.
Wash yourself from clean to dirty
Washing yourself well is not difficult, but you have to pay attention to it, knows Margriet Oudhof. She is a nurse and teaches informal caregivers in personal care and general daily living activities (ADL). Lesson one when you wash yourself or others: don’t use too much soap. It dries out your skin, causes itching, and as a result, you scratch your skin.
“Wash yourself from top to bottom, from clean to dirty. Your face and your arms first and then your buttocks and genitals. Never wash the vagina with soap. This disrupts the acidity and that is asking for a yeast infection.”
Pull the foreskin back and clean it well. Don’t forget between the buttocks, because there may be feces left behind, says Oudhof.
Washing too much kills good bacteria
Skin that is washed a lot and often with soap becomes dry and gets cracks and plaques of scales, says Blok, who founded Allergiecentra Nederland as a dermatologist. People who are sensitive to it can develop eczema or allergies as a result. If you wash yourself more than twice a day, we call that excessive.
“Soaps are milder nowadays, but showering with a detergent damages the skin. Children can handle it because the skin is still young, but around thirty it makes your skin very dry. By using too much soap, you destroy your own microbiome. You remove your own good bacteria and invite the wrong bacteria. The question then is what ‘dirty’ actually is.”
What is dirty is the navel stone: an accumulation of sebum, textile fibers, skin fat, dirt, and dead skin cells in the navel. That forms into a kind of black, smelly stone, an umbolite.
Because it is caked in the skin, a doctor must remove it. Blok: “We don’t see it often, but if you have a very small navel, or one that is not completely closed, dirt can remain behind and fungi can grow there.”
Drying is at least as important as washing, says Oudhof. “Skin folds can develop chafing spots due to friction of the skin and moisture. This can be caused by poor drying, sweat, or because the skin comes into contact with feces or urine.”
That applies to bedridden patients, but also to young people with obesity and women with large breasts. “That soft skin smells very unpleasant and is also painful, especially when it comes into contact with urine.” If you already have chafing spots: dry carefully dabbing.
Pus in the folds, chafing spots in the groin
You have to keep a close eye on folds, says Blok. Especially if you move little and have reduced immunity. “With chafing spots you can smell that something is wrong. Greasing cream and cotton between the folds can help.”
Acne inversa can also occur in the skin folds. You are absolutely not dirty or unkempt if you have this form of acne, emphasizes the dermatologist. Pus then forms subcutaneous passages and spreads over the skin. That inflammation is so severe that it breaks through the skin barrier, and then the pus comes out. “Don’t spread that pus with bacteria yourself by squeezing. That is dirty.”
Prevent athlete’s foot
Soap residues easily remain between the toes, clean there well and dry well, Oudhof tips. If you are at the feet anyway: keep the nails short and straight. “A thickened fungal nail is really not a pleasant sight.”
Between the fourth and fifth toe, the misfortune comes first, Blok knows. The so-called ‘toe web’ infection can then occur; a mix of infections that causes thick, white, plaques between the toes, often with a green discoloration. That can be prevented by drying well.
Shower little if you have eczema
Shower once a day or once every two days, says Blok. If you have eczema, one to two times a week. “We also advise people with a lot of eczema not to shower for six weeks. That is long, but that way the skin can rebuild itself, layer by layer.” Apply a urea cream if the skin is dry and dry well.
And, adds nurse Oudhof: don’t forget the mouth. Keep brushing well, because in elderly care she sees just a little too many people walking around with painful inflammations. “That is very nasty and causes bad breath.”