Combating Wintertime Dry Hands in Kids

When the temperatures drop, the wind swells and the house’s heater gets cranked up each winter, dry and cracked hands are an unfortunate and common side effect in children and adults alike.

“The cold air is more drying and wind is also more drying. And then add forced-air heating, and that will dry skin out even more,” CHOC Children’s pediatrician Dr. Angela Dangvu says.

While parents can’t do much to control the weather, they can take a few steps to help protect tiny hands against dryness.

Choose soap carefully

Start by using a moisturizing hand soap. Frequent hand washing, which is critical during winter viral season, compounds the problem by the further dehydrating the skin, Dr. Dangvu says.

Look for soaps that more resemble a lotion than a traditional soap and have words like “moisturizing” or “conditioning” on the label. Avoid antibacterial or deodorant soaps.

Also, hand sanitizer gel is an effective way to clean hands that is less drying than a soap-and-water method. However, children with the beginnings of dry skin should avoid gel as its alcohol content can sting, Dr. Dangvu cautions.

Creams, not lotions

As a preventative measure, parents can apply moisturizer to their child’s hands after hand-washing or bath time. Look for products described as creams rather than as lotions: These are richer and have more staying power than thinner products like baby lotions, Dr. Dangvu says.

“They tend to stay on and be a better moisture barrier,” she says. “Parents should use them right after children wash their hands. If skin is still a little moist, the cream will trap that moisture. Apply it after bath time too.”

A three-step approach

If a child’s little hands still become dry, Dr. Dangvu recommends a three-step approach:

  1. Start by regularly applying cream to the hands.
  2. If dryness doesn’t improve after a few days, move on to a petroleum-based ointment. Parents can intensify the therapy by applying ointment to hands before bed, and asking children to wear cotton gloves or even socks over their hands to lock in moisture while they sleep.
  3. If the condition doesn’t change after a few more days, parents can try an over-the-counter hydrocortisone cream.

If these steps don’t yield improvement, it’s time to take children to the pediatrician to rule out a bacterial infection or other condition, Dr. Dangvu says.

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Ring in the New Year with these Flu Prevention Tips

Flu activity peaks between December and February and can last as late as May. To ensure the start of a healthy new year, remind your friends and family of these flu prevention tips to stop the spread of germs:

  • Wash your hands often and use respiratory etiquette during flu season. There are many other respiratory viruses out there besides the seasonal flu, and the flu vaccine cannot protect against all of them.
  • Use hand sanitizer.
  • Postpone play dates with sick kids.
  • Wear appropriate outdoor clothing.
  • If you are sick with the flu, stay home from work or school to prevent spreading influenza to others.

If you haven’t already, get a flu shot. CHOC Children’s and the American Academy of Pediatrics urge that all children ages 6 months or older be immunized against influenza. It is especially important for people who are at high risk of complications from flu to get a flu vaccine, including:

  • Pregnant women
  • People 50 years of age and older
  • People of any age with chronic medical conditions
  • People who are immunosuppressed
  • People who live in nursing homes and other long-term care facilities
  • Health care workers

For more health tips from the experts at CHOC, visit www.choc.org/health.     

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5 Things to Know About Enterovirus D68

As news continues to spread about enterovirus D68 (also known as EV-D68), it’s important to know what the virus is and how it can be prevented. To help protect you and your family, please read the following tips provided by Kids Health. Be sure to share them with your family and social networks!

1. There are many kinds of enteroviruses, including coxsackieviruses, echoviruses, polioviruses, the hepatitis A virus, and enterovirus D68. These viruses are common and infect millions of people every year. They can infect anyone, but they’re more likely to cause illnesses in infants, children, and teens who haven’t developed immunity against the virus, and people with weakened immune systems.

2. EV-D68 causes respiratory illness, and the virus can be found in respiratory secretions such as saliva and mucus. The virus likely spreads from person to person when an infected person coughs, sneezes, or touches contaminated surfaces.

3. There is no vaccine for preventing EV-D68, but you can help protect yourself and your family by following these tips:

• Wash hands often with soap and warm water for 20 seconds, especially after using the bathroom or changing diapers. Make sure you clean in between the fingers and under the nails, where germs can collect.

• Avoid touching your eyes, nose, or mouth with unwashed hands.

• Avoid kissing, hugging, and sharing utensils with people who are sick.

• Disinfect frequently touched surfaces, such as toys and doorknobs.

• Teach kids how to cough safely –into their elbow, not their hands.

4. No antiviral medications are currently available for EV-D68. But symptoms such as fever and muscle aches can be relieved while the infection runs its course, which often takes as little as a day or two. However, some people with severe respiratory illness may need to be hospitalized.

5. When to call the doctor: Emergency rooms across the country are seeing a spike in visits because caregivers are concerned that their child may have an EV-D68 infection. Most kids who are infected with EV-D68 will have cold-like symptoms, such as cough, congestion, and a runny nose. These symptoms should be watched closely, but do not require emergency medical care. If your child has a history of asthma and develops cold-like symptoms, it’s best to contact your doctor for advice. Seek emergency medical care if your child has severe respiratory symptoms such as wheezing or difficult or labored breathing.

For more information, please visit the Centers for Disease Control and Prevention (CDC) website.

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Kids and the Immune System

girl getting a shotTHE IMMUNE SYSTEM
“Our immune system is a series of cells, tissues and organs that, throughout our lifetime, protects us from different invading pathogens and keeps us healthy and able to resist many repeated infections,” says Dr. Ashouri, a pediatric infectious disease specialist at CHOC. “When babies are infants, they get immune cells from mom through the placenta and breast milk, if they are breastfeeding. Over time, the baby’s system becomes mature and can fight off infections. A healthy lifestyle that includes getting enough rest, low stress and a balanced diet plus exercise helps to strengthen the immune system in people of all ages.”

BOOSTING BABY’S IMMUNE SYSTEM
“Breastfeeding is probably one of the best ways to help support a baby’s immune system when it’s developing,” explains Dr. Ashouri. “Getting babies the recommended vaccines at the scheduled times also helps to protect them from the different infections they are at risk for at that age. We recommend that parents and children also get a flu shot each year and are up-to-date with their Tdap vaccine to protect kids from pertussis (whooping cough). The
more people in the community who are vaccinated, the better it is for everyone. In pockets of areas where vaccine rates have fallen, there have been outbreaks of measles, whooping cough and other preventable diseases.”

KIDS AND COLDS
“Proper hand-washing is important to prevent the spread of colds and the flu virus and other types of infections. When kids can’t wash their hands, they should use a hand sanitizer to kill germs. Getting kids vaccinated against the flu also prevents kids from getting the flu,” Dr. Ashouri says. She adds, “Over time as the immune system recognizes certain viruses, it will get better at preventing infection, especially if the person has a balanced diet and good lifestyle. Taking vitamins won’t hurt either but they don’t replace a well-balanced diet.”

FAST FACTS

  • Number of infants who died in California’s 2010 Pertussis (Whooping Cough) outbreak. It was the worst outbreak in 60 years. More than 9,000 cases were reported: 10
  • Percent of the U.S. population that gets the seasonal flu (Influenza) each year: 5 to 20
  • Number of children hospitalized in the U.S. each year with respiratory infections: 500,000

View the full feature on Kids and the Immune System

Dr. Negar Ashouri
Dr. Negar Ashouri
CHOC Pediatric Infectious
Disease Specialist

PHYSICIAN FOCUS: DR. NEGAR ASHOURI

Dr. Ashouri completed her residency at CHOC, followed by a year as chief resident. After completing a fellowship in pediatric infectious diseases at Children’s Hospital of Los Angeles, she returned to CHOC. She is also a clinical instructor of Pediatrics at the UC Irvine School of Medicine.

Dr. Ashouri is involved in many research projects dealing with bloodstream infections and drug trials. She is also part of the Collaborative Antiviral Study Group. To further her research, Dr. Ashouri maintains an ongoing database of blood cultures and can frequently be found looking back through patient data and charts as she investigates how vaccines impact infections and specific risk factors for high-risk groups.

EDUCATION:
St. George’s University School of Medicine, Grenada, West Indies

BOARD CERTIFICATIONS:
Pediatric Infectious Disease

More about Dr. Ashouri

This article was featured in the Orange County Register on March 9, 2014 and was written by Amy Bentley.

How Effective are Hand Sanitizers?

SONY DSCThough old-fashioned hand-washing is the best way to keep hands clean and combat germs, gel hand sanitizers are a good alternative when soap and water aren’t readily available, a CHOC Children’s physician says.

“They certainly don’t take the place of proper hand-washing,” says Dr. Negar Ashouri, a CHOC infectious disease specialist. “That is still the best way to help prevent the spread of infection. But when you don’t have access to soap and water, hand sanitizers are a good alternative.”

Hand sanitizers can also supplement hand-washing, Dr. Ashouri says. The Centers for Disease Control (CDC) recommends scrubbing hands with soap and water for at least 20 seconds. However, the average person doesn’t always wash their hands long enough or effectively enough to kill germs entirely. In addition, people don’t always use enough soap, or they don’t clean the entire hand.

If you coat the whole hand with the gel, alcohol-based hand sanitizers work well to help kill germs, she says. The CDC notes that alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs.

Hand sanitizers should be alcohol-based and have a concentration of at least 60 percent alcohol to be effective. Dr. Ashouri says any brand is fine as long as it meets that level of alcohol concentration.

Also, she adds that it’s a myth that people build a resistance to gel sanitizers and that long-term use renders them ineffective.

Learn more about CHOC’s infectious disease division.

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