I recently came upon an article in the New York Times about how people with skin disorders such as acne or eczema could be helped by a sort of topical probiotic treatment. In other words if we take bacteria from the skin of healthy people and spread them on the skin of diseased people, evidence suggests that the good bacteria will fight off the bad bacteria and the skin condition may go away.

This idea of probiotics, (using good bacteria to fight off bad bacteria) has been around for a while now, but it’s been steadily gaining popularity.

I find the whole thing fascinating for a number of reasons. I like the counter-intuitive aspect of it. I like how it looks at the problem of infection from more of a systems perspective, rather than seeing it as a single cause requiring a single remedy. And finally I like how it flies in the face of all the do-gooders who were telling us all how to live our lives in the 80’s and 90’s when I was growing up.

Bacteria husbandry?

It turns out (to a certain extent) it’s better to have children go out and be dirty for a bit. Visiting a farm and interacting with animals, for instance, reduces the risk of asthma. It turns out we shouldn’t take antibiotics every time we get a stomachache since it kills off our gut microbiota and could cause even nastier diseases to run rampant. And now it turns out that if you’re worried about getting a disgusting skin condition, perhaps what you should do is shake hands with as many (healthy) people as possible.

Of course it’s important not to get too carried away. A little dirt outside is okay, but living in filth is not. Just because antibiotics aren’t always the best choice doesn’t mean you should stop using them when you need them. And obviously you should wash your hands often and thoroughly to prevent the spread of diseases like MRSA and the flu.

What the researchers did in this study was put healthy bacteria into a lotion and put this on the forearms of people with eczema. There seemed to be a reduction in the disease, but there are still questions of whether the treatment will continue to work over time, or what might happen if there’s an open wound.

My personal prediction would be that a small open wound like a scratch or abrasion wouldn’t be much of a problem in this case. The bacteria used in the study (Staphylococcus hominis and Staphylococcus epidermidis) are so common that most people’s immune systems will quickly recognize the bacteria in the blood stream and destroy them before they can cause any harm. That “most people” would not include immunocompromised people like the elderly, people preparing for transplant surgery, or AIDS sufferers, however. And if someone has a skin condition, there’s a good chance that something might be off about their immune system.

Ultimately, like many science stories out there, this is cause for some cautious optimism. IF someone has a bacteria-related skin problem, and IF they don’t have some other complicating condition, then they MAY be helped by this therapy IN THE FUTURE (probably 5 years or so I would guess), ASSUMING there aren’t some unforeseen side effects.

As for most of us living outside of laboratories and going about our day to day existences, what I would say this means is that we shouldn’t worry so much about germs. Or more precisely, don’t worry so much about getting rid of them. It’s not good to douse our bodies with antibacterial soaps at every opportunity. It’s also still not a good idea to live in squalor either. Chances are, if you wash your hands regularly and don’t stink, you are clean enough.

Beyond that common sense assessment, if you want to improve your health, you might try finding someone who has healthier skin than you, and shake their hand. Or ask them to rub some lotion on you. Or maybe do none of these things. That way they won’t think you’re a creep and you may benefit from their simple proximity. Yes, it may be that if you want to be prettier, you need to hang around pretty people, which will be easier if you are already pretty. Perhaps yet another astounding example of the Matthew Effect.