Dear Dr. Roach: I am a welder, and I often use acetone to wipe minor cuts and abrasions in the workshop. It stings pretty good, but it gets rid of the dirt, grease, etc. What do you think about that?
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D.S.
I think that is not a good idea. Acetone is a powerful solvent, and solvents should never be used directly on skin. They can cause damage to skin 鈥� long-term damage. Workers who were frequently exposed to solvents were found to have a higher risk of dementia and hearing loss, among other problems. Also, the grease (and possibly even more-toxic substances you might work with) can penetrate the skin along with the solvent, which further increases the health risks. Some of these toxins can cause kidney damage; others are carcinogenic (cancer-causing). A 2014 study showed increased breast cancer risk in women who frequently work with solvents.
Gloves and other personal protective equipment are your first defence against chemicals used for occupation or hobbies. There also is a myriad of special products designed to get greasy materials off of hands without damaging the skin or letting the chemicals penetrate your skin barrier. These can be found at hardware and automotive shops, or online.
Dear Dr. Roach: I read in your recent column that in your experience melatonin is not very helpful. I wonder if you are aware that according to a recent review, it has been effective, but it needs to be taken three to five hours before desired sleep onset. It is not effective when taken at bedtime. I have found that patients are unaware of this.
Anita Kraus Lane, MD, FACP
I appreciate Dr. Lane鈥檚 taking the time to write. I also have found that both dosage and timing of melatonin are confusing, so I reviewed the article Dr. Lane referenced, as well as several comprehensive studies on melatonin for sleep disturbance.
I conclude that melatonin certainly does not work for everyone. The biggest review found that taking melatonin increased sleep time overall by only 13 minutes. However, since a few people will get a lot of benefit and some will get none, melatonin is still worth a try, in my opinion.
Secondly, many people are taking a dose that is far higher than the most effective dose; for most people, that鈥檚 between 0.3 and 0.5 mg. I see doses of
1 to 10 mg for sale at pharmacies, and the smaller doses are sometimes not sold at all, requiring a person to break a tablet in half. A few people will benefit from higher dosages, but lower doses should be tried first.
Finally, due to the way the drug is metabolized, younger people are most likely to get benefit from taking it several hours before bedtime; older adults are more likely to get benefit when it is taken an hour or so before bed.
Other readers wrote that a glass of milk was helpful, or that a magnesium supplement helped (I found one study that confirmed this benefit).
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
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