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Hand-sanitizer users of the world, beware!

That’s the message of Dr. Richard Gallo, chief of University of California, San Diego’s Division of Dermatology, who’s warning that cleanliness might be next to … illness.

Earlier this month, Gallo and colleagues garnered attention after the journal Nature Medicine published their study revealing the positive role that germs on the skin play.

In a brief Q&A today, I asked Gallo about his research and how we can protect ourselves without overdoing it:

What was the purpose of your research into germs on the skin?

Many types of germs might be good for us. In the skin specifically, there’s been no real concrete scientific explanation for why bacteria that we normally find may exist there and whether they may be doing any benefit.

Our study was designed to look at one type of very common skin germ, Staphylococcus epidermidis, and see if there’s something that germ might be doing that helps us rather than hurts us.

What did you find out?

Staphylococcus epidermidis calms down the immune system. Without it, the skin would have excessive inflammation after any kind of superficial injury.

Is this germ found on all of our hands?

It’s the most commonly cultured bacteria on the skin, and not just on the hands.

Do we get rid of these germs when we use antibacterial soaps or hand sanitizers?

The broad-spectrum antibacterials will clearly be killing that germ. We depleted mouse skin of these germs, and we showed that had a detrimental effect.

What do you think these soaps and sanitizers might be doing to people who use them?

We know that people who live in industrial nations — in cleaner environments and more exposed to topical antiseptics and antibiotics — have more frequent problems [with autoimmune and inflammatory skin disease].

There may be an explanation for why that occurs: we’re depleting some of the surface bacteria that were there to help us.

[By using antibacterial soap and hand sanitizers], you may even make your skin more likely to pick up a bad bacteria. Good bacteria helps prevent colonization by the bad bacteria, and you could put yourself at risk by being too clean.

How has all this affected your own personal hygiene?

One of the real tricks with this is that germs that cause disease have to be eliminated. We’d never advocate not doing something to eliminate the bad germs, especially in the hospital.

For myself, I’m much more selective in when I’m using hand cleaners and so forth.

What do you advise people in general?

A little bit of dirt is good for you. But we don’t know enough to make new recommendations about how often to wash your hands.

What’s next?

For the future, we need to develop strategies for cleaning our skin that rely on targeting only the clearly bad germs while allowing the more beneficial ones to survive.

— RANDY DOTINGA

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