The Problem with Sunscreen is that People aren’t Using it Enough

The Problem with Sunscreen is that People aren’t Using it Enough

New research reveals neglected sun protection practices. Leading dermatologist, Dr. Joshua Fox, comments on the long term damage of sunburn and the importance of daily use of sunscreen.

New Hyde Park, NY (PRWEB) July 16, 2009 — Most people know using sunscreen is one of the best ways to prevent skin cancer. Yet research shows as many as 40 percent of people never use it–even when they go to the beach.

“This is a big part of why skin cancer is the most common form of cancer in the United States,” said New York dermatologist Joshua Fox, M.D., founder and medical director of Advanced Dermatology, P.C. and the Center for Laser and Cosmetic Surgery. “But the importance of regular sunscreen use, especially for beachgoers in the summertime, can’t be stressed enough. What’s perceived as an uncomfortable but harmless sun burn today could very well become the cause of skin cancer in the future.”

Indeed, more than 100 million American each year experience some degree of sunburn from either not using sunscreen, or improperly applying it, said the U.S. Centers for Disease Control. Yet even the mildest cases can have a significant impact, Dr. Fox stressed.

“Skin cancer is an insidious disease because it appears years after the damage has been done,” Dr. Fox added, “and I think that’s part of the reason people have such a hard time understanding why they need to use sunscreen now. They think, ‘Nothing is going to happen to me 20 years from now.’ But the truth is that something can.”

That “something,” said the American Academy of Dermatology (AAD), is an estimated over 1 million cases of non-melanoma skin cancer and 132,000 new cases of melanoma skin cancer diagnosed in the U.S. each year. Melanoma, the most serious form, is responsible for roughly 8,500 skin cancer deaths each year. In fact, incidents of melanoma have risen drastically over the past decade, the AAD reported, with increased, unprotected sun exposure largely to blame.

To stress the importance of continued sunscreen education both within and outside the medical community, New Age Skin Research Foundation, a nonprofit organization of which Dr. Fox is President, conducted, and recently presented to the American Academy of Dermatology, the results of a study that focused on the before and after sun-protection habits of melanoma patients.

Although most patients in the study admitted to being aware of the dangers of sun exposure and importance of sun protection, few practiced applying and reapplying sunscreen, avoiding direct sun exposure and wearing protective clothing until after they were diagnosed with skin cancer.

According to the study, patients’ primary recommendation for preventing new skin cancer is an increase in education, with a focus on young people, explained New Age Skin Foundation Director Rao Saladi, M.D., adding that melanoma is often linked to too much sun exposure.

Complete results of the study, including participants’ comments, will be published in Melanoma Research. This supports previous research on skin cancer that found fewer than one-third of U.S. youths practice effective skin protection.

Focused on youths 11 to 18 years old, the survey revealed alarming trends that include:

  • More than 68 percent not wearing sunglasses on sunny days.
  • More than 79 percent not wearing protective clothing, such as long pants.
  • More than 78 percent not avoiding direct sun exposure or staying in the shade.
  • More than 69 percent not properly applying, or reapplying, sunscreen.
  • More than 43 percent not using a sunscreen with a sun protection factor (SPF) of 15 or more when at the beach or pool.
  • Despite skin cancer’s devastating effects, young people–and even adults–seeking the perfect tan continue to spend time in the sun unprotected at an alarming rate. The reality is that there is no such thing as a healthy tan. Other risk factors for skin cancer include age and a family history of the disease. But long-term, unprotected exposure to the sun’s ultraviolet (UV) rays is the primary risk factor.
  • “Even on a cloudy day, or in a shaded area, you should apply a sunscreen with an SPF of 15 of greater 30 minutes before you leave the house,” he added. “The sun’s ultraviolet rays have great reflective powers and can burn your skin on a cloudy day as well as on a sunny one. The risk is year-round.”
  • Remembering to reapply sunscreen after swimming or vigorous activity that makes you perspire, is important too, Dr. Fox said. Other daily sun safety rules should include:
  • Avoiding direct sun between 10 a.m. and 4 p.m., when UV rays are the strongest.
  • Covering the skin with loose, comfortable clothing made of tightly woven fabric.
  • Applying generous amounts of sunscreen and lip balm with an SPF of 15 or higher.
  • Wearing a wide-brimmed hat.
  • Wearing sunglasses with lenses that have 99 to 100 percent UV absorption.
  • Avoiding other sources of UV light, like tanning beds and sun lamps that also damage the skin.

“When proper sun protective practices are followed consistently, skin cancer can largely be prevented,” Dr. Fox said. “We need to change habits and mindsets to help people see the necessity–and urgency–of protecting themselves against skin cancer.”

Large Pores: Suprisingly common facial problem


Large Pores: Suprisingly common facial problem

Leading Dermatologist Dr. Joshua Fox explains unsightly large pores on the face and offers tips for treatment.

New Hyde Park, New York (PRWEB) July 2009 – Most people associate enlarged, and often unsightly, facial pores with the teen-age years, when puberty causes increased oil gland production and, in turn, larger pores. For many, however, the problem of enlarged pores and excess oil continues into adulthood. The condition, in fact, is one of the most common facial problems that adult women complain about, experts say.

“As with any medical problem, the degree of pore enlargement varies from person to person, but in some it can be quite pronounced and embarrassing,” says New York-based dermatologist Joshua L. Fox, M.D., F.A.A.D., medical director of Advanced Dermatology, P.C. and the Center for Laser and Cosmetic Surgery. “The good news is there are ways to improve the condition.”

What causes enlarged pores?

On the body, everywhere there is skin, there are pores. These tiny openings are responsible for secreting perspiration and oil–perspiration to keep the body cool, and oil to lubricate and protect the skin. Although it’s impossible to count the number of pores on any one person, some estimate as many as 1 million pores per square inch of skin.

Most of those pores are too small to be seen, which is desirable, Dr. Fox says. Small pores keep the skin looking tight and young.

It’s common for both men and women to have bigger pores around the nose, forehead and central facial area, where extra body oil is secreted. But those born with bigger pores, or experiencing the problem because of either a medical condition or the environment, may see them all over, though the face is where they tend to be most noticeable, Dr. Fox says.

In addition to heredity, causes of enlarged pores generally include:

  • Skin damage caused by chronic, unprotected exposure to the sun’s ultraviolet rays
  • Aging
  • Oily skin and seborrhea,, one of the most common skin problems, characterized by a red, itchy rash and white scales”Enlarged skin pores sound like a somewhat silly problem, but it can be a real issue,” explains Dr. Fox, who as a leading authority on skin cancer, cosmetic surgery and laser procedures is also a spokesperson for the American Academy of Dermatology and the American Society of Dermatologic Surgery. “Enlarged pores can be quite prominent and unsightly, causing people to have self-confidence and self-esteem issues and to just not feel good about themselves,” adds Dr. Fox.How enlarged pores are treatedKeeping the skin clean, and free of excess oil, is among the best ways to care for enlarged pores. This will also help prevent blackheads, which on the face can draw attention to larger pores.

    The internet offers many alleged holistic and “proven” home remedies. But like most health experts, Dr. Fox recommends people with the condition stay away from online advice or self-treatment and instead to seek the help of a board-certified dermatologist.

    “There are good over-the-counter and in-office treatment options. But whatever a patient chooses, it should be with the guidance of a physician,” Dr. Fox stresses.

    Topical treatments include using a facial cream with benzoyl peroxide, which removes excess oil and dead skin, or salicylic acid, which helps prevent pores from clogging. Also helpful are topical acne creams made with sulfur or resorcinol, or skin astringents used to clean away oil. Products which stimulate collagen and elastin, like vitamin C, are also useful because they may help the pores from stretching. Lastly, topical retinoids and retinol can help reduce oil production and increase collagen and elastin.

Other treatments performed in a doctor’s office include:

  • Microdermabrasion. A technique that uses tiny rough grains or crystals to buff away the surface layer of skin and, with it, excess oil and dead skin.
  • Laser resurfacing. Short, concentrated, pulsating laser beams are used to carefully and precisely remove dead or irregular skin, layer by layer, while stimulating and tightening underlying collagen.
  • Chemical peel. A chemical solution is applied to the skin, and reveals “new” smooth skin underneath. Over-the-counter peels are also available.For most people, it’s a combination of good, at-home facial cleansing and doctor care that leads to the best results. Dr. Fox advises patients to be thorough, but careful in their facial cleansing and not to over scrub or rub, which can cause pores to be enlarged. “And since it’s summertime and sunny, it’s important for me to stress the effects of unprotected sun exposure. Sunscreen use is essential for everyone, but those who are unhappy with large pores should be extra diligent since sun damage is one of the causes.”

Autumn Proofing Your Skin: Leading Dermatologist Dr. Joshua Fox on Skin Problems, Solutions as Season Changes


Autumn Proofing Your Skin: Leading Dermatologist Dr. Joshua Fox on Skin Problems, Solutions as Season Changes

Joshua Fox, MD, a leading dermatologist, founder of Advanced Dermatology and a spokesperson for the American Academy of Dermatology: As summer turns to autumn and the green leaves turn red, yellow and orange, your skin also changes with the season. During the fall, the skin needs extra nourishment and protection. Three things that everyone should do to protect their skin in the autumn include drinking lots of water to remain hydrated, applying moisturizer before going outside to give it time to be absorbed and, importantly, continuing to use a sunscreen with an SPF of at least 15.

New Hyde Park, NY (PRWEB) September 5, 2009 — As summer turns to autumn and the green leaves turn red, yellow and orange, your skin also changes with the season, says Joshua Fox, MD, a leading dermatologist, founder of Advanced Dermatology and a spokesperson for the American Academy of Dermatology.

While the autumn weather may encourage outdoor activities, your skin will retain less moisture because of the cooler, drier air. The same happens indoors as the heat goes on and up. Key symptoms of “autumn skin” include dryness, fine lines, dull and sallow skin tone, sun and age spots, flaking and irritation as well as the flare-up of some chronic conditions. “Your skin can remain beautiful and glowing, however, if you treat it correctly and make some minor adjustments to your beauty regime to account for the change of seasons,” Dr. Fox says.

During the fall, the skin needs extra nourishment and protection. “Three things that everyone should do to protect their skin in the autumn include drinking lots of water to remain hydrated, applying moisturizer before going outside to give it time to be absorbed and, importantly, continuing to use a sunscreen with an SPF of at least 15,” Dr. Fox says.

“Autumn presents special challenges to the face, body, hands, nails and feet,” he adds, explaining the specific issues facing each body part and offering tips for improving your skin’s appearance in the fall.

Face/Head: Despite the waning sun, it is still important to use sunscreen in autumn. Moisturizing is more important than ever, regardless of skin type. In fact, even oily skin needs a moisturizer. People with seborrhea, or dandruff, may experience autumn flare-ups. This chronic inflammatory skin disorder is more common in men than women and affects up to three percent of the population. It can be controlled by washing with special soapsand shampoos or topical steroids. If seborrhea does not improve or worsens, a dermatologist can provide additional treatments.

Body/Trunk: Moisturizer that is applied when the body is slightly damp after bathing is one of the most important things we can do to improve the condition and feel of our skin, Dr. Fox says. A body oil or cream should be applied over the whole body, concentrating on rough spots including the elbows, knees and feet. Moisturizers with an alpha hydroxy acid help exfoliate the skin’s outermost layer. Exercise is also a good moisturizer, as sweat provides a natural way of releasing toxins.

Some people may experience a flare-up of conditions such as psoriasis or eczema/atopic dermatitis in the fall. Psoriasis is a chronic disease of the immune system that appears on the skin, usually in the form of thick, red, scaly patches. According to the National Institutes of Health, up to 7.5 million Americans have psoriasis. There are many over-the-counter and prescription treatments for psoriasis. Your doctor can help you find the right one. Atopic dermatitis, or eczema, results in scratching that may lead to redness, swelling, cracking, “weeping” of clear fluid, crusting and scaling of the skin. Intensely itchy patches form, which can be widespread or limited to a few areas. Between 10 and 20 percent of people worldwide develop atopic dermatitis, making it the most common type of eczema. Eczema should be treated by a dermatologist for an accurate diagnosis and appropriate treatment including medication combined with lifestyle changes. There may even be a specific allergen which the dermatologist can discover to help make the eczema better.

Hands/Arms: Sun damage over the years can result in localized spots of hyperpigmentation that appear on the most exposed parts of the body, generally the hands, shoulders and face. Known as age spots or liver spots, these flat, gray, brown or black marks are harmless and don’t need treatment. However, because they may be confused with cancerous growths, any new marks should be checked by a physician. For cosmetic reasons, age spots can sometimes be lightened with skin-bleaching products or completely removed with the use of lasers. However, preventing age spots — by avoiding the sun and using sunscreen — may be the easiest way to avoid these spots.

Another common skin condition that may flare up in the fall is keratosis pilaris, which consists of rough patches and small, acne-like bumps, usually on the arms and thighs. In fact, keratosis pilaris may improve during the summer months, only to later worsen when the weather changes. This condition is not serious but is difficult to treat. Prescription medications and self-care measures including keeping skin moist can improve the appearance of your skin. Though quite common with young children, keratosis pilaris can occur at any age. Often, keratosis pilaris gradually improves on its own.

Nails: It is not uncommon for nails to start cracking or peeling. Avoiding harsh soaps and the more frequent use of moisturizer is usually the answer.

Feet: A major problem associated with the skin of the feet upon summer’s end is dry, cracked heels caused by wearing open backed shoes during the summer. Cracked heel problems can be relatively mild, with dry or flaky skin, to very severe and painful, with hard skin and deep fissures that are prone to bleeding and make walking uncomfortable. Cracked heels can be improved by taking care of the feet by using a natural foot scrub and pumice stone to slough away dead skin and moisturizing with a highly concentrated emollient base, petroleum jelly or a healing, natural oil, such as olive or sesame, urea or alphahydroxy acid. Some prescription creams may be required in resistant cases. If one has certain skin conditions, like psoriasis, scrubbing is not advised.

“While many people look forward to a refreshing, cool autumn after a long, hot summer, it’s important to remember that your skin needs to be treated differently as the seasons change,” Dr. Fox says. “Changing your beauty and skin care routine regularly, depending on the season, and remaining in close contact with your dermatologist, can keep your skin looking beautiful year round.”


HEALTH: AUTUMN-PROOFING YOUR SKIN. JOSHUA FOX, M.D., a leading dermatologist, founder of ADVANCED DERMATOLOGY in New York and Long Island,and a spokesperson for the AMERICAN ACADEMY OF DERMATOLOGY: “As summer turns to autumn and the green leaves turn red, yellow and orange, your skin also changes with the season. While the autumn weather may encourage outdoor activities, your skin will retain less moisture because of the cooler, drier air. The same happens indoors as the heat goes on and up. Key symptoms of ‘autumn skin’ include dryness, fine lines, dull and sallow skin tone, sun and age spots, flaking and irritation, as well as the flare-up of some chronic conditions. Your skin can remain beautiful and glowing if you treat it correctly and make some minor adjustments to your beauty regime to account for the change of seasons. During the fall, the skin needs extra nourishment and protection. Three things that everyone should do to protect their skin in the autumn include drinking lots of water to remain hydrated, applying moisturizer before going outside to give it time to be absorbed and, importantly, continuing to use a sunscreen with an SPF of at least 15.





It’s viral, destructive and oozing into every crevice of our lives. You may already have been infected.

By Maryn McKenna

From the February 2009 Issue


At least once a day, Lisa Pisano feels the itch.

The 30-year-old fashion publicist goes to the reception desk of her New York City office to accept a delivery of clothing samples from a designer. The courier hands over the garments, swings his messenger bag forward on his hip, fishes inside for a clipboard and hands her a pen. And then she feels it: a tickle at the back of her mind. A little rush of disquiet. Oh, my God, she thinks. Where has that pen been?

She imagines the possibilities: tucked behind the courier’s ear. Clutched by a stranger’s hand, which that day had probably touched a bathroom door or a subway handrail. She thinks about the millions of people in New York, eating, scratching, rubbing their noses, picking up bacteria and then leaving it on that handrail, and then on the person’s hands, and then on the courier’s pen, and then on her hand, her face, her lungs, her…. Ick.

Pisano has always been germ-conscious—she wipes off her purse if it’s been resting on the floor and swabs her keyboard, phone and mouse with disinfecting wipes—but the pen problem pushes her over the edge every time. One day, on the way to work, she spotted her salvation in an office-supply store window: a pen made of antibacterial plastic. She bought a handful and now, whenever the messengers buzz for her, she carries one to the door. Her coworkers tease her. She ignores them. “I’m known in the office for being a little nutty about my pens,” she says, laughing but not apologizing. “If you take my pen, I’m coming after you.”

Admit it: You’ve got something in your own life that makes you go ick. Ask any group of women what they do to protect themselves from germs, and the stories will pour out: We open the bathroom door with elbows, punch the elevator buttons with knuckles, carry wet wipes to disinfect the ATM—and we wonder whether we’re going a little too far. Even the doctors we turn to for reassurance aren’t immune. “I’m extremely aware of the potential for being ‘contaminated,’ in and out of my office,” says Susan Biali, M.D., a 37-year-old physician in Vancouver, British Columbia. “I wouldn’t touch the magazines in the waiting room if you paid me!”

When polled readers about their germophobia, more than three quarters said they flush public toilets with their foot, and 63 percent avoid handrails on subways, buses and escalators—all unnecessary precautions, experts say. Almost 1 in 10 say they avoid shaking hands, behavior that may flirt with full-fledged obsession, when your efforts to sanitize your life begin to stymie your day-to-day functioning.

Germophobia, of course, is not listed in the Diagnostic and Statistical Manual of Mental Disorders. But mental-health professionals agree that, in vulnerable people, extreme germ awareness can be both a symptom of and a catalyst for a variety of anxiety ailments for which women are already more prone—including obsessive-compulsive disorder, which often features repetitive hand washing and fear of contamination. Ironically, hands that are dry and cracked from overwashing are more likely to pick up an infection through openings in the skin, says Joshua Fox, M.D., a spokesman in New York City for the American Academy of Dermatology.

Even mild germophobia makes you vulnerable to a vast new industry designed to capitalize on your fears and sell you antimicrobial products. But these have proven no better at germ killing than the original products—and may even be bad for your health. “We have now gone so far over the top in our response to germs that it in and of itself has become something of a scandal,” says Harley Rotbart, M.D., professor and vice chairman of pediatrics at the University of Colorado Denver School of Medicine and author of Germ Proof Your Kids (ASM Press). “We can’t live our lives normally if we are consumed by avoiding germs.”

A germier world

The problem is that—in a time when one outbreak of salmonella can sicken 1,400 people without scientists ever finding the source and staph infections kill more people each year than AIDS does—germophobia doesn’t seem so paranoid. On the contrary, it feels like a reasonable reaction to risks we cannot control. Because of population growth, globalization and the movement of most work to the indoors, “we share more space and touch more surfaces that other people have touched than ever before,” says Chuck Gerba, Ph.D., professor of environmental microbiology at the University of Arizona in Tucson, who has spent 35 years tracking germs in public places. More than 300 new infections emerged between 1940 and 2004, according to the journal Nature. Because of record numbers of airplane flights, diseases globe-trot more quickly, and media coverage keeps us more aware of them.

Organisms that can make us sick are everywhere and take every form: They can be bacteria, which are microscopic single-celled organisms such as staph and strep; equally small fungi such as yeast and parasites such as worms; or even smaller viruses such as hepatitis or flu. We pick them up directly from other people in sweat, saliva, semen and other body fluids; in exhaled breath or skin-to-skin contact; or from contaminated surfaces, food or soil. They enter our body through cuts or abrasions or when we breathe them in, swallow them or transfer them to our mucous membranes by touching our eyes, nose or mouth.

Gerba’s annual sampling routinely turns up disease-causing bacteria on computer keyboards, desks, faucets, picnic tables, purses and more. His 2008 study found three and a half times more bacteria on office computer mice compared with 2005. During cold and flu season, one third of office phones housed cold viruses. The skin infection MRSA (short for methicillin-resistant Staphylococcus aureus) has turned up on the seat-back trays we eat off of on airplanes. And when researchers at the University of Colorado at Boulder studied the microorganisms on college students’ palms, they discovered that women’s hands have significantly more types of bacteria than men’s—even though women reported washing their hands more often. The team isn’t sure why, but one theory is that men’s more acidic skin is less amenable to the bugs, says lead researcher Noah Fierer, Ph.D., assistant professor of ecology and evolutionary biology.

Diane Bates, owner of a marketing and public relations agency in New York City, is more aware of this germ explosion than she ever wished to be. When her twin daughters were 2 years old, they contracted rotavirus, an intestinal infection she believes they caught from an acquaintance whose child had it. Hospitalized for five days, the girls were so sick that Bates couldn’t enter their hospital room without a mask, gown and gloves. “It was very traumatic, and it got me thinking about germs and I started to modify my behavior,” says Bates, 41. Four years later, avoiding germs is almost her household religion: She constantly surfs to check for infectious disease alerts, buys every new air purifier and uses antimicrobial tissues. She doesn’t allow her kids to touch salt shakers in restaurants, skips family gatherings if another child has a cold and scolds her husband when he lets the girls play on jungle gyms. “My friends and family roll their eyes. But I’ll take whatever sarcasm I have to in order to keep my family healthy,” Bates says. “At some point, I know it is more phobic than productive, but I feel if I do every single thing I could possibly do, it might make a difference.”

When bugs aren’t bad

It is hard not to feel under siege, but the reality is that all of this germ exposure is unavoidable—and most of it is harmless. In fact, bad organisms are far outweighed, in the environment and on our own body, by good ones. Our body is covered in bacteria—billions on our skin, trillions in our intestines—that live in friendly symbiosis with us, helping us digest food and absorb vitamins and protecting us from other bacteria that make us sick. “Some bacteria produce vitamin K, which prevents bleeding, and others turn fiber into a compound that helps protect against cancer,” notes Vincent R. Young, M.D., assistant professor of internal medicine in the division of infectious diseases at the University of Michigan at Ann Arbor.

Even when organisms are disease-causing, being exposed to them won’t necessarily lead to an infection. First, organisms have to reach the tissues where they are most likely to reproduce: The bacterium Helicobacter pylori causes ulcers only in the stomach, whereas flu viruses attach to the lining of the lungs. Our body puts plenty of hurdles in a germ’s path. Robert Tauxe, M.D., deputy director of the foodborne, bacterial and mycotic diseases division at the Centers for Disease Control and Prevention in Atlanta, points out that a foodborne germ, for instance, has to live through cooking, survive the antibodies in our saliva and the acid in our stomach, and then escape any protections in our immune system before it can potentially make us sick.

Whether a germ succeeds depends on a long list of additional factors, including how old you are, how strong your immune system is and how many individual germs—called the infective dose—it takes to cause disease. The dose varies with the germ: If only one hepatitis A virus gets past your defenses, it can make you sick (the upside: Most people develop immunity after one exposure). It would take as few as 20 cells of salmonella, many hundreds of cells of campylobacter and E. coli, and perhaps hundreds of thousands of the bacteria that cause typhoid and cholera.

Granted, some bacteria have worked out ways around our multiple lines of defense; because they reproduce every 20 minutes, they have had millions of generations to figure out strategies. The foodborne illness listeria, for instance, has adapted to technology: Although most bacteria prefer warm places, it can also grow in food that is refrigerated. But even in this case, Dr. Tauxe notes, unless you are pregnant or otherwise immune-compromised, “you could probably swallow a large number of listeria organisms of the most virulent kind and not become ill until you got up to around 1 billion or more cells—and then it would give you only fever or diarrhea.”

A research concept called the hygiene hypothesis even holds that allergies, along with eczema and autoimmune disorders such as Crohn’s disease, occur when we are deprived of enough contact with common bacteria, because that exposure teaches our immune system how to distinguish and react appropriately to threats. Research has found that children tend to develop more allergies if they took antibiotics early in life or if their parents made them wash their hands frequently and bathe more than once a day. A 2008 study in the Journal of Infectious Diseases also links lower rates of asthma to infection with intestinal worms and the bacteria that causes stomach ulcers. And what’s true for children is even more so for adults. In 2002, a massive survey published in the Journal of Clinical Immunology showed that hay fever, allergies and asthma are less common in people who have been exposed to hepatitis A, herpes virus 1 (the one to blame for cold sores) and toxoplasma, a parasite found in cat poop.

The idea is that our immune system reacts very sensitively to invaders such as disease organisms and parasites, says Graham Rook, Ph.D., professor of medical microbiology at University College London. What keeps them from overreacting is an internal regulatory system that we developed over thousands of generations, thanks to the interactions between our immune systems and nonthreatening bacteria that were always around us in mud, soil and untreated water. Take those organisms away by making life much cleaner and the internal controls go haywire. The immune system revs out of control, and the result is asthma, allergies and inflammatory bowel disease—and possibly even type 1 diabetes and multiple sclerosis, Rook’s research suggests. “People have to distinguish between the bugs that are dangerous and the bugs that are helpful,” he says. “It makes sense for a woman in her kitchen to make sure she has cooked chicken well. But if a child comes in with a muddy hand from the garden and grabs a sandwich, there is no need to scream and shout and insist he wash his hands.”

Calming germ jitters

Despite all the evidence that bacteria are not always bad for us, the insatiable germ-fighting industry is desperate to strip us of as many bugs as possible. If you weren’t phobic before, contemplating the products could make you that way. You can buy bug-bashing sprays, window cleaners and air purifiers. There is a bracelet that dispenses disinfectant and a key chain unfolds a claw for opening doors and operating ATMs. Enterprising manufacturers have infused washing machines and vacuums, sheets and towels, mattresses, chopsticks, high chairs and toys—more than 700 products, all told—with antimicrobial chemicals.

Yet doctors say the only products you need to fight germs effectively are the old-fashioned ones: soap, the alcohol in hand sanitizer and, for cleaning surfaces, very low concentrations of bleach like those on disinfecting wipes. “It really doesn’t pay to use an antibacterial soap over plain soap,” says Allison Aiello, Ph.D., professor of epidemiology at the University of Michigan School of Public Health in Ann Arbor. Her review of published research, featured in the American Journal of Public Health, shows that people who use antimicrobial soaps have the same amount of bacteria on their hands after washing with them and suffer the same number of colds, fever and diarrhea as people who use regular soaps.

Meanwhile, triclosan—a chemical used in hundreds of “germ-fighting” household products—has been linked in animal studies to liver disease and disruption of thyroid hormones. The Environmental Protection Agency currently regards the chemical as safe, but a new review of its status is due later this year. The Environmental Working Group in New York City has urged the EPA to ban triclosan and consumers to avoid it.

Perhaps most alarming, some scientists also link antimicrobial products to the rise of so-called superbugs such as MRSA and antibiotic-resistant E. coli. Because drugs often have similar chemical structures, bacteria that evolve a genetic dodge around an antimicrobial product can simultaneously acquire what is called cross-resistance to antibiotics, too, Aiello explains. (She does note that so far the mechanism has been demonstrated only in lab studies, not among people using antimicrobial soap.) “And what are we doing in terms of tipping the balance among different types of bacteria living on the skin? We don’t know yet, but we ought to be thinking about it,” she adds.

Instead of investing in unproven antimicrobial products, learning some simple rules of thumb can help you understand what’s paranoid and what’s prudent. Next time you’re seized with germ panic, take a deep breath and remember that.

There are simple ways to avoid most infections. The only place you really need to avoid contamination is on your hands, which transmit infections—especially cold and flu—more effectively than any other part of your body. “Wash hands every time you enter your home, and after any event that involves a lot of hand-to-hand contact, such as a big business meeting, a receiving line or high fives after a softball game,” Dr. Rotbart says. Don’t touch your face before you’ve had a chance to wash your hands, and always keep hands out of your mouth, eyes and—heaven forbid—your nose.

Viruses don’t live very long on dry surfaces. Most colds, flu and common infections are caused not by bacteria but by viruses. And although viruses can travel up to 3 feet when a person coughs or sneezes, they live for only a few minutes to at most two hours if the landing place is dry, Dr. Rotbart says. Exercise more caution around wet surfaces, which provide a friendlier home for viruses, and always dry your hands after washing up.

You can never infect yourself. Your toothbrush is full of germs, but they are yours; replacing it frequently won’t help you avoid illness. It’s sharing of toothbrushes—and towels, shoes, food, kisses—that can get you into trouble. Still, life without kisses and splitting dessert is a sad prospect. Likewise, if you catch a cold this winter, you can’t get sick again from the same germs. “But disinfecting is important to protect others,” Dr. Rotbart says. “Your bedroom, bathroom and kitchen should be washed after an illness using bleach-containing disinfectant, which kills both viruses and bacteria.”

If you’re going to extremes, there’s a problem. People who feel the urge to wash their hands over and over should try setting limits—programming a timer for how long they can wash, for instance—and seek help if they begin slipping into a repetitive pattern, says Pamela Garcy, Ph.D., a clinical psychologist in Dallas. “Don’t allow yourself to go beyond the limit,” she says. “Someone might say, ‘I’ll wash up twice to be extra sure.’ Once you start to feed into irrational ideas, you can develop a habit, and it gets harder to break. If it becomes OCD, it will get worse, not better.”

Germophobic behavior dies hard, as Missy Cohen-Fyffe, a 47-year-old in Pelham, New Hampshire, can attest. She was so repulsed by the idea of a baby teething on the handle of a supermarket shopping cart that she invented a portable cart cover, the Clean Shopper. She knew she had a twitch of obsessiveness; as she puts it, “I come from a long line of germ freaks.” But after 10 years of talking to germ-aware customers, she realizes how mild her obsessions are. “A lot of our people do take things to the nth degree: We had one woman tell us she doesn’t allow her family to enter a hotel room until she has washed it down,” Cohen-Fyffe says. “I have two sons. I have a dog. I have to live in the real world. I can’t be the germ freak I want to be in my heart.”