Saving Skin With Hand Sanitizers

Q. I have become obsessive about washing my hands. All the news reports about the shortage of flu vaccine stress the importance of washing hands. Now they are red and rough and getting worse by the day.
My work requires that I shake a lot of hands and I can’t always get to a bathroom to wash up. How effective are waterless hand sanitizers? Won’t they irritate my hands even more than liquid soap.
A. This may come as a surprise, but alcohol-based hand sanitizers are actually less irritating than liquid soap. They are as effective as soap and water and do not require wetting hands or drying them off. They work best if you put a dime-sized dollop in your palm and rub vigorously until the alcohol has dried and disinfected your skin.
Q. Please help me locate Estring. I’ve been using it for a couple of years to alleviate vaginal dryness.
My doctor gave me a new prescription but said it might be hard to find. My local drugstore told me in October that they would have it by November. Now they say the manufacturer stopped making it.
What is going on? Has it been found unsafe? I’ve gone online to order it from Canada but was told it might be weeks before the order is filled.
A. The manufacturer of this low-dose vaginal estrogen delivery system has had Estring on backorder since July. A representative for Pharmacia & Upjohn reassured us it is not a production or safety problem, but rather a paperwork snafu with the FDA. He was hopeful that you would be able to fill your prescription sometime in December.
In the meantime you might want to try Sylk. This natural lubricant is made in New Zealand from an extract of kiwi fruit vine. It is available in the U.S. from 866-831-2920.
Q. I have had trouble sleeping for years. Sometimes it takes me hours to fall asleep. Other times I fall asleep only to wake up after a few hours to go to the bathroom. Then I can’t get back to sleep.
Lack of sleep makes me irritable and I have a hard time concentrating in the afternoon. I wonder if my medications affect my sleep. I take Toprol XL (metoprolol), Zestril (lisinopril), and HCTZ.
A friend has had good success alternating between Benadryl, melatonin and alprazolam so as not to get addicted. Is that a good idea?
A. Your blood pressure medicine may be contributing to your sleeping problems, but do not stop any drug without discussing this with your physician. The sedating antihistamine diphenhydramine is found in Benadryl, Tylenol PM and Sominex. It can work if used occasionally, but older people may be especially sensitive to side effects such as confusion, dry mouth and dizziness.
Alprazolam (Xanax) and other benzodiazepine sedatives may increase the risk of a fall, especially if you have to get up in the middle of the night. Melatonin may be a good choice, since it can help with both insomnia and high blood pressure. Recent research shows it can improve the sleep of asthma sufferers.
We are sending you our Guide to Getting a Good Night’s Sleep with more information on melatonin, herbal remedies and prescription sleeping pills like Ambien. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. I-70, P. O. Box 52027, Durham, NC 27717-2027.