Articles on hand washing

Skin Care and Protection (Mainly for Hands With Eczema/allergy)

Dr. Sandeep Gupta, Dermatologist
Skin Care and Protection1. Wash your hands in lukewarm water. Rinse and dry your hands thoroughly after washingThe skin damaging potential of a detergent is temperature dependent. Warm, soapy water causes more skin irritation than lukewarm or cold soapy water.2. Use protective gloves when starting wet-work tasks  Unprotected wet work is a significant risk factor for the development of skin irritation. Gloves are essential for protecting the skin against water, dirt, detergents,shampoos, and foodstuffs. 3. Protective gloves should be used when necessary but for as short a time as possibleIrritant reactions due to wearing gloves are frequently reported. Prolonged use of gloves leads to impairment of the skin barrier, especially if the skin has previously been exposed to detergents .4. Protective gloves should be intact and clean and dry inside Even a small amount of an irritant may  act as a strong irritant when the skin is occluded. Furthermore, allergens trapped inside a glove could induce sensitization or elicit allergic contact dermatitis in a person already sensitized.5. When protective gloves are used for more than10 min, cotton gloves should be worn underneathWearing a cotton glove inside the protective glove has been shown to protect the skin from deterioration caused by using gloves.6. Do not wear rings at work Eczema often starts under a finger ring. Irritants may become trapped under the ring, causing irritation and irritant contact dermatitis .7. Disinfectants should be used according to the recommendations for the workplaceUse of disinfectants may cause skin irritation followed by irritant contact dermatitis, and was recently reported as a contributory factor for development of hand dermatitis. However, individual factors for each workplace have to be considered.8. Select a lipid-rich moisturizer free from fragrance and with preservatives having the lowest allergen potential, Apply moisturizers on your hands during the working day or after work.Moisturizers have been shown to promote regeneration of barrier-damaged skin. Moisturizers that are rich in lipids promote regeneration faster than those that contain less lipid. Fragrance and preservatives are common causes of allergic reactions to cosmetic products .9. Moisturizers should be applied all over the hands,including the finger webs, fingertips and back of the hand Application of moisturizers to the hands is often incomplete,since many areas are skipped during application .10. Take care also when doing housework, use protective gloves for dishwashing and warm gloves when going outside in winter Development of irritant contact dermatitis is caused by exposure to cumulative irritants, often in low concentrations. Domestic exposure therefore adds to exposure at work. Domestic wet work has been recognised as an important risk factor for the development of hand eczema. During the winter, the skin is more susceptible to irritant exposure.

Using Hand Sanitizers? Think and Then Use!

Dr. Pradnya Shastri, Dermatologist
It’s early in the evening. I am drinking my coffee with wonderful music of a light drizzle. And the air is pierced by the scream of a woman. "Look at how dirty your hands are!" Says she.The child looks at her hands with amusement.“Ye lo hand sanitizer... aur saaf karo (clean using this hand sanitizer)!” She shrieks.The child, but of course does as she is told. And I try to recall the days when people used simple soap and water! How wonderful they were. There was more common sense in the world then there is today... People washed their hands only when needed. People thought 10 times before using any product on themselves. People led a simple, yet mindful and meaningful life. Today, despite our ‘progress’, technologically or economically, one would think that people, rather humans as an evolved species, would get more sensible and independant... but on the contrary, people have become more technology dependent and callous. So much so, that they refuse to think at all! They see a T.V. commercial and think not only can they get ‘fair’ in 7 days but ‘wrinkle’ free in 10 days and thinner in 15 days. And these mindless habits ( of not analysing the pros and cons of a product and still using it) are being passed on to children!How many of you, who use hand sanitizers, actually know it's pros and the cons? ( Other than the fact that it is antibacterial)  Does anyone stop to think the damages that a hand sanitizer can cause?Did you know that:1. Antibacterial hand sanitizers kill the good bacteria on the skin? These helpful bacteria are important in replenishing the bacterial flora in the intestines that prevent loose motions!2. Antimicrobial hand sanitizers kill only bacteria? They do not kill viruses or fungi?! Yes, antibacterial is defined as a a substance active against ‘bacteria’ and nothing else. So if there is a viral infection like the flu or cold or viral conjunctivitis going around, using a hand sanitizer is pointless. 3. Hand sanitizers (most of them) contain a ingredient called Triclosan or Triclocarban. Like I have said, this kills the ‘good’ bacteria but inadvertent use of it in children (without a doctors advise) can cause early puberty! Yes, the triclosan/ triclocarban can get absorbed into the body and cause raised levels of testosterone as a study (March 2008, Endrocrinology ) indicated. 4. Hand sanitizers are inflammable (because they have alcohol) and like any inflammable product like a match box or firecrackers... they need to be kept out of the reach of children.5. Hand Sanitizers contain high level of isopropyl or ethyl alcohol. Excessive use can cause absorption through the skin leading to possibilities like poisoning, shortness of breath, dizziness and stomach pain. Again an important reason why you should keep it away from children. 6. If your hands are soiled because of dirt or mud or blood... a hand sanitizer is useless. You will need to use soap and water to remove that layer of grime. And after using soap (which is an antiseptic in itself due to it’s surfactant action) a hand sanitizer is of no use.7. Hand sanitizer is one of the common reasons that people are getting Hand Dermatitis. Yes, the alcohol removes the Natural Moisturizing Factor (NMF) and thus makes the skin very dry. If adults skin can develop dermatitis, imagine what would happen to a child’s skin.So simply avoid the mindless use of hand sanitizers. When you have the age old priceless soap (NOT AN ANTISEPTIC SOAP but a regular soap bar ) and water around, use that! It is a safer and a better option than  a hand sanitizer could ever be. Limit the use of hand sanitizer only under dire circumstances where there is no water!And most importantly, do not encourage your children to use them especially without your supervision! Certain ‘fads’ are better left alone. They only lead to epidemics! Like the ‘hand sanitizer epidemic’ we doctors are facing today.Think before you act!

Are You Washing Your Hair the Right Way?

Anchal Shah
The reason your hair look and feel so good after a trip to the salon is the difference in art of shampooing and managing your strands with care. You might not really know how to wash your hair the right way. Using the correct technique can make a world of difference in your hair’s health, bounce and shine.Here are 10 hair washing tips for salon like hair:1. BRUSH YOUR HAIR BEFORE YOU SHOWERIt's better to detangle your hair before shampooing.2. YOU ARE WASHING HAIR TOO OFTENMost young men and women today wash their hair too often. Three times a week is sufficient for most hair types.3. RINSE HAIR WITH COLD WATERStart with a rinse. Hair should be thoroughly wet before you apply your shampoo. Cold water helps in shutting the cuticle tight, seal the outer layer and this reflects more light and gives off most shine.4. YOU SHOWER IN PIPING-HOT WATERSteamy shower are relaxing, but exposing your hair strands to high temperature leaves them dry and frizzy. It's preferable to wash hair in cold water because it helps in locking moisture.5. LATHER UP, BUT ONLY AT THE SCALPWe need to shampoo the hair at the scalp only. Best way is to lather up from roots to ends. Never use more shampoo than you need.6. YOU ARE SCRUBBING YOUR SCALPBe gentle. Don't use nails or massage the scalp too harshly, apply minimal pressure. Usually two rounds of gentle, non-abrasive shampooing is enough. Friction can permanently damage your hair cuticle, leading to breakage and frizzy hair.7. DON'T RINSE AND REPEATDespite the instructions on the back of your shampoo bottle may say, there is no need to wash your hair twice .8. YOU ARE NOT PATIENT WITH YOUR CONDITIONERDo you constantly wonder how long to leave your conditioner on? Unlike shampoo, conditioning is not about quick massage and rinse. Apply conditioner from mid shaft of hair towards end. You can leave conditioner applied for 5-7 minutes. Applying conditioner will lock moisture to your hair.9. NO CONDITIONER ON YOUR SCALPScalp itself produces a lot of natural oils. So, you don't need to condition your scalp at all. Just condition the middle of your hair all the way down to your tip.10. YOU ARE TOO HARSH ON YOUR POST-SHOWER STRANDSNever comb your hair after washing it, instead comb through it whilst the conditioner is still settling in. Never towel dry your hair.The way you treat your hair post-wash is vital to overall health and appearance of hair.

Why Do We Over React to Illnesses? Despite Bird Flu, Enjoy Festivities.

Dr. Neelam Nath Bhatia, General Physician
Take few precautions about any communicable disease passed on through humans or animals. Every Germ gets killed on cooking. Germs of Deadly AIDS cannot survive for more than 15 minutes when exposed to Sun or washed with routine antiseptic.If doctors were so cautious about their own health, our forefathers would not have invented Penicillin or Medicines for deadly Plague.Agree that Prevention is the Mantra but it is of no use to spread Panic about Seasonal Illnesses. Birds may be dying due to Many Reasons.Every Death of Any Bird is Not Due to Germs of Bird Flu.Doctors are getting cautious about online practice. Why ? It gives us pleasure when a patient tells us that they have been referred by Practo after searching online.No body will Slap a Court case, if Job has been done well , charges are modest and patient is not made to hop from one center to another.Take simple precautions but do enjoy your well cooked non vegetarian dishes,including eggs. Yellow of egg does carry germs of Typhoid but people started eating boiled/ cooked eggs instead of Raw eggs and That was it ! No body stopped eating eggs because half cooked eggs May Be carrying germs of Typhoid.Simple precautions are known to everyone.Do Wear a mask as Pollution is deadlier than Bird Flu !Do wash your hands as It is a Good Habit that prevents other diseases too.Maintain Cleanliness in surroundings. Do Not Let Every disease get Multiplied due to Filth.Swatch Bharat for Me too and for Everyone as a Duty !Eat only Completely cooked meat and meat products ( 100 degree C)If it is a Flu, treat it like routine Flu which has no Specific tests or treatment. H1N1 blood test may be Negative.It Takes at least 7 days to recover from flu, remain in isolation but within home only as in hospitals one is likely to spread infection to a lot more people. Maintain Hygiene, remain hydrated by drinking lots of water, Salt gargles/steam inhalation helps clear the respiratory passages besides acting as anti septic. Take medicines for fever and take light nourishment with lots of proteins but little fats only.

Loose Motions or Acute Gastroenteritis

Dr. Poonam.M. Sambhaji, Pediatrician
What is diarrhea?Passage of 3 or more abnormally loose or liquid motions regardless of cause, color or illness associated with it.What is dysentery?Presence of blood and pus in the stools along with abdominal cramps and fever.Age groupOver 80% of acute diarrhea (diarrhea lasting less than 7 days) occurs in the age group of 6 months to 3 years.SeasonHot humid climate and monsoonHow dangerous is diarrhea?Two major danger of diarrhea are 'dehydration' and 'under nutrition' both of which may kill the child.What is dehydration?Most people know that diarrhea can make the body very weak. This weakness is the most important sign of what doctors call "dehydration". Dehydration is loss of water and salts from the body. When a child has diarrhea, she loses a lot of salts and water with every loose motion. If the salts and water are not replaced fast  enough, child will become weaker and weaker. Most children who has diarrhea dies because they do not have enough water left in their bodies.RECOGNISING SUNKEN EYES video What causes diarrhea?Diarrhea can occur because of Gastro intestinal infection due to a variety of infecting organisms. Large majority are due to viral (Rotavirus) and bacterial (cholera, shigella, E.coli) infections. In smaller percentage of cases, food intolerance to various foods/ food components like lactose, cow's milk protein, gluten (protein in wheat) can also cause diarrhea.TREAT DIARRHEA AT ONCEBegin treatment at home.3 rules for management of diarrhea at home are•Increase fluids – home based and breast feeding•Continue feeding.•Recognize danger signs.Most children will recover from diarrhea just by drinking lots of whatever fluid is available at home. The treatment is so simple! All you have to do is to replace the water your child loses each time she/he passes a loose motion.Home available feeds (HAF) — which could include —• lime juice,• salted butter milk,• tender coconut water,• rice kanji,• weak tea with sugar and• barley water.If no fluids are available at home you can make a Sharbath drink, (salt sugar solution) with salt, sugar and water, which are usually found in every home. Sharbath drink can be made by taking 200ml of clean water (large cup of glass) and adding 1 two finger pinch of salt (0.8gm) and 1 heaped Tea spoon of sugar (8gm). Give your child any fluid available at home as soon as she has a loose motion. Early treatment not only restores strength to your child, it could even save her life! If diarrhea continues, child should receive special mixture of a life-saving drink in a packet. This is known as an Oral Rehydration Salt (ORS). For over 25 years, WHO and UNICEF have recommended ORS to prevent / treat dehydration  from diarrhea irrespective of the cause or age group suffered. WHO considers ORS as a drug. ORS has saved more lives thanall drugs put together.How to make the special drink from the ORS packet?ORS packets are available at health center or commercially as Electral, Electrobion, Walyte, Relyte, Punarjal etc.• Wash your hands with soap and water.• Take 1 liter of water (5 glasses) in a clean container.• Empty ORS packet into the container and stir till it dissolves.• Prepare fresh solution everyday (should be consumed within 24 hrs).How to give ORS•Give frequent sips from a cup• If child vomits, wait for 5-10minutes, then give the solution more slowly (2 to 4 tea spoon fulls) every 5-10minutes.When to see doctor? • Loose motion large in number and quantity• Presence of blood and mucus•Vomiting and pain in lower abdomen•Thirsty, tired and weak•Dryness of mouth•Soft spot on the baby's head gets sunken•Skin — looses its firmness and looks wrinkled•If skin is pinched, it stays folded for a few seconds•Sunken eyes, cold, clammy skin• Passes little or no urine • Faints or gets convulsion•Weak pulse•Stomach gets distendedPractical tips for management of acute diarrhea:•Treatment is not meant to stop diarrhea but to prevent and correct dehydration•Acute diarrhea is a self limiting disease in most cases•Very small percentages of cases require drugs. (Cholera, Dysentery, Amebiasis etc.)Following is a small video, regarding Loose motions myths and managementSTOP DEHYDRATION, NOT DIARRHEANot with drugs but with ORS.  Important rules for feeding during and after diarrhea are as follows: • Continue Breast feeding - It will prevent dehydration• Give - Home available fluids. Special drink (salt sugar solution)• Continue feeding during diarrhea As patient cannot digest food, give small, frequent feeds. Give soft foods like Khichri, Mashed bananas• Give extra food after diarrhea stops.Feed extra meal a day for at least one weekWhat causes Diarrhea?• Feeding bottles — Never use them as they carry germs• Dirty water — from rivers and lakes• Spoilt or dirty food — unwashed vegetables and fruits Left over food can get bad and give you diarrhea• Flies — sit on stools, then sit on food and make it dirty• Dirty hands and nails — dirt can get on to the food and cause diarrhea • No proper toilet— stools passed near houses are dangerous How to Prevent Diarrhea?• Mother's milk is cleanest and safest food. Give other fluids with cup and  spoon• Clean drinking water from a hand pump, tube well or other clean sources•Wash all vegetables and fruits. Try to eat freshly cooked food as far as possible. Do not eat any food that smells bad or tastes bad•Cover the food and drinking water, so that flies cannot sit on it •Wash your hands with soap and water after going to toilet and before meal•Use toilet, If there is no toilet, pass stool far away from home and drinking water supply in the fields. Cover the stool with earth.

Eczema in Children: Daily Care Tips.

Dr. (Lt Cdr) Siddharth Garekar, Dermatologist
Hi everyone, This blogpost is for people who have atopic dermatitis (eczema) and parents of a child/ baby with atopic dermatitis. Atopic Dermatitis is a distressing disease for the parents and like any other Paediatric Dermatologist in Gurgaon, we frequently spend a lot of time consulting them about daily do’s and don’ts.  Here, we highlighted a few things you should be doing for your little one, in order to minimize flares of the disease.The guiding principle:The most crucial aspect of Eczemz/ Atopic Dermatitis is the preservation of skin moisture. It is only through the maintenance of this moisture that we can break the itch scratch cycle.General care:Use cotton clothes, avoid synthetic materials and especially wool.In winters, the first layer has to be cotton and then a woollen, to avoid direct contact with wool.Keep child’s fingernails filed short.Use regular laundry detergent, but rinse and clean well. No bleach or fabric softener.Wash new clothes before wearing them to remove irritating dyes and fabric finishers.Avoid drying laundry outside during the pollination season.Air the room out in all seasons.Avoid dust, animal hair etc.No tobacco smokeWriting a diary to note any triggers that cause flare-ups.Bathing:Water temperature should be between 32° and 34° (lukewarm)Showers are better. A short duration, a five minute shower every day.Turn the water off when washing to decrease contact time.For those who like baths and for children: add a liquid emollient to the bath to neutralize water hardness. 5-10 minutes at most, to minimise the contact time with the municipal water.Wash with soap-free products (dermatologist recommended) as the pH is closest to that of the skin and does not aggravate skin dryness.Wash hair with dermatological shampoos that are soft or intended for frequent use.Dry by patting, as rubbing reactivates itching. Leave the body wet after bathing.Moisturization in atopic dermatitis:5-minute, lukewarm baths followed by the application of a moisturizer. (Dermatologist recommended)Keep the moisturizer in the bathroom and apply all over the body while wet, to seal in moisture and allow water to be absorbed through the skin.Moisturize 2-3 times a day.Wash your hands before applying a moisturiser.Apply a liberal amount of the moisturizer, warming it first between your hands, and apply in large circular movements. (Massage)Do not apply an emollient on raw/ red skinDo not rub the skinWhen to contact a Dermatologist:Condition not responding to moisturizersSymptoms continue to worsenThere are signs of infection fever, redness, or pain

5 Tips to Protect Your Eyes This Monsoon

Dr. Vishal Arora, Ophthalmologist
It’s raining heavily this monsoon. Rain brings relief to the population but is also responsible for various food and water borne diseases. Eye conditions common during the monsoons are:1. Bacterial conjunctivitis2. Viral conjunctivitis3. AllergyThese conditions commonly cause redness in the eye, clear watery or muddy or purulent discharge from the eye. Eye infections cause the lids to be covered with discharge, particularly when one wakes up in the morning. Eye itching and foreign body sensation (feeling that something is there in the eye) is also commonly reported by the patients.Eye redness, watery or mucoid discharge is commonly seen in conjunctivitis.You can protect your eyes by1. Maintaining ocular hygiene: Don't touch or rub the affected eye. Use disposable tissues to wipe off the overflowing discharge or tears.2. Avoid smoke, sun, dusty environment3. Avoiding contact with a person already affected:  As a courtesy, it’s better to shift to Namaste, rather than the routine handshake or hug.4. Limiting the spread of infection: Stay away from public places and children as they are more vulnerable to infections.5. Hand washing with soap and water: Simple hand wash with soap and water can reduce the infectious load by 99 percent. Alcohol-based hand sanitizer works fast, but is not effective against viruses.Visit your ophthalmologist if you develop symptoms so that appropriate therapy is started at the earliest.