Search for tag: "halloween"

Dr. Tarbox: Hello and welcome to "Skincast," the podcast for people who have skin and want to know how to take the very best care of it. My name is Michelle Tarbox, and I am an associate professor of dermatology and dermatopathology at Texas Tech University Health Sciences Center in beautiful, sunny Lubbock, Texas. And I'm being joined today by . . .

Dr. Johnson: Hey, my name is Luke Johnson. I am a pediatric dermatologist and general dermatologist with the University of Utah.

And we had this idea to create a special Halloween episode of "Skincast." And so, joining us today, we've got a couple of guests, including the person who originally thought of this idea. She's sitting next to me right now. Her name is Lindsay. Lindsay, thanks so much for joining us. Do you want to introduce yourself?

Lindsay: Sure. My name is Lindsay Johnson. I am a physician assistant in family medicine as well as a theater nerd and Halloween person. I enjoy Halloween. Let's just put it that way.

Dr. Johnson: And you happen to be married to me.

Lindsay: And I happen to be married to you, yes.

Dr. Johnson: And, Michelle, you also brought a guest.

Dr. Tarbox: I did. Rebecca, do you want to introduce yourself?

Rebecca: Sure. Why not? So I'm Rebecca Nelson. I am neither a medical professional nor a dermatologist, but I am a professional opera singer and I spend a lot of time in stage makeup. So I will be sharing my experiences of what I know in that area.

Dr. Tarbox: And Rebecca is related to me in the most possible related way possible because she is my identical twin sister.

Rebecca: Yes. I could frame her for murder.

Dr. Johnson: So in terms of Halloween, the most dermatologically relevant thing that might happen is that people put on costumes and makeup. So this might be an episode mostly about Halloween makeup and stage makeup and how to do it right and how not to do it wrong.

For me, my makeup is mostly, I just do a little bit of foundation and guyliner and that's it. So I'm going to kind of step back and let you guys do most of the talking today.

Lindsay: I guess I have a story I could start with of something not to do. So when I was in high school, many moons ago, I played the wicked witch of the west in a production of "The Wizard of Oz." Yes. So that meant I had to start the show as Almira Gulch with normal stage makeup on, and then I had very little time to transform myself into a green witch, which did take some doing. And that meant green cream, probably . . . is it Ben Nye? Am I right? Am I remembering correct?

Dr. Tarbox: Yes. That's the one you talked about.

Lindsay: Cream makeup all over my face and also on my hands, but I did not know at the time how to set the makeup. So it would get all over my costume. You know, I had to not touch anything backstage. I think it got on the dog that was playing Toto. So I have learned since, but I'd like to hear from your two perspectives . . . and I know, Michelle, you also do a lot of community theater . . . what I did wrong and what I should have done instead.

Dr. Tarbox: Becca, why don't you take us through your normal makeup application that you go through and what the most important things you think are? And then I'll contribute some thoughts from the dermatology side.

Rebecca: Sure. So I'm actually going to talk about stage makeup prevalently, because we're talking about Halloween and theater, which is always more exaggerated than, you know, going from day to night with your Maybelline.

So when you're talking about grease-based paint, which is what most Halloween makeup is, there are certain things that you really need to keep in mind.

Number one, for any kind of makeup, is that whatever you are using to apply the makeup to your face must be clean. If it's your hands, they need to be clean. If it's a brush, it needs to be clean. If it's a sponge, it needs to be clean.

If these are implements that are being used by multiple people, that goes double. So it's very important. You can transmit all kinds of bacteria to eyes and things like that if brushes and sponges are not properly cleaned. So that's the first thing.

Also, you want to start with a clean canvas, so your face should be clean before you apply the makeup.

Once you've applied the makeup, it's important to set it, as you mentioned. There's a setting powder that we use in the theater. It's just a very . . . actually when you see those comedies and they're like, "Powder," and there's a giant powder puff that smacks someone in the face, it's a small version of that. And that actually sets the makeup so that it doesn't bleed and get all over everything.

But it's interesting because in some ways the circumstances that you're in when you're in a stage production, you're under heat, you're under lights, you're sweating, are going to be similar to what you might experience with your face in a crazy night out in Halloween. You're running around very excited and you're sweating. So it's important also to think about the aftercare. So once you've had the makeup on and you've done the trick or treating, or whatever, you've had your party, removing the makeup properly is also very important.

So you're going to want to use either micellar water with just a regular cotton pad, or we actually even use baby wipes at the theater, but it is important to start with a clean face and end with a clean face. Those are two of the most important things.

Dr. Tarbox: The theater part of me says the baby wipes actually are pretty helpful because they're also bigger territory. It's a bigger towelette. Whenever you're really putting a lot of makeup on, a normal face wipe for a normal day of makeup being cleansed off is not going to cut it. You're either going to have to use five of those things . . .

Rebecca: You have to use seven of them, yeah.

Dr. Tarbox: Or you just get the one big hearty baby wipe. Now, you want to worry a little bit about gentleness of ingredients in those. The water wipes, Luke, that we've talked about I think on one of the podcast episodes are pretty hypoallergenic, not fragranced, and don't tend to because a lot of irritation because of preservatives and things like that.

There's three big problems with a lot of what most people are going to think about as Halloween makeup, and that's going to be those little kind of pallets with little individual pots of colored paint and usually a character suggestion on the front of a blister pack with a cardboard backing.

So those products, first of all, and most importantly, are not FDA regulated. That means anything can be in them. So they can have stuff that's never intended to be put on faces. It's this weird loophole where those are not subject to FDA regulations. So I've seen some that have known severely irritating chemicals in them and on sale at a local Halloween store and the Halloween aisle at a convenience store. So FDA non-approval is a huge problem.

Second problem is they're usually really cheap, so you get the whole palette for $5 or something like that. So they're using the cheapest ingredients possible. And to get the most bang for the least buck in terms of pigment cost, usually, these are going to be oil-based because that makes the pigments really intense, it makes them stay on well, and it causes the pigment to kind of retain its intensity even with more spread out use. Oil-based stuff, a little bit more likely to irritate the skin, and then cheap FDA non-approved ingredients, problematic.

The third problem is because the FDA doesn't regulate these things, no one is enforcing expiration dates. So if you're not paying attention, there have been products sold on the shelves that have been four years out from their expiration date with inferior ingredients. So name of the game is you get what you pay for.

I advise people, especially those who have sensitive skin, to buy makeup that's intended actually for stage use and never to buy those little palettes that you can get cheaply in the convenient store. It's convenient, but it could create a nightmare you don't want to deal with afterwards. And then just trying to use the theatrical makeup.

There are a lot of different companies that make good, gentle theatrical makeup, and some that even make water-based ones for very sensitive skin. It's not going to be as intensive of a pigment, but you can get the suggestion of a tiger or whatever you want going.

Yeah, I think those are good things to start with. But the cheaper the cosmetic, the more likelihood that you're going to have irritating ingredients that are bad for your skin.

You didn't ever sleep in it, did you, Lindsay?

Lindsay: Oh, no, but I did have a hard time . . . Of course, I didn't know about setting with powder. I also didn't know about either the baby wipes, the water wipes, micellar water, or what I did ended up doing in college theater makeup classes, which was Pond's cold cream.

Rebecca: Oh, yeah. That also works.

Lindsay: Putting that on to get the oil-based stuff off, wiping it off, and then washing with water and soap and stuff.

So I would go home . . . this is high school, so you'd do the show and then you stay out late with a cast party. And I would go home and I would have green stuff all up into my hairline, and it was pretty comical afterwards.

Rebecca: Michelle, if somebody wanted to risk it with the cheap pins and they did a patch test, do you think that would be advisable?

Dr. Tarbox: So that's actually something I wanted to bring forward also. So if you are the risk-taking variety or if cost is an issue and you really want to try to use one of these less expensive topicals, knowing that that might cost you a doctor visit later or potentially be makeup you can't use, you could try what's called an open use test.

So an open use test is sort of the at-home equivalent of patch testing we would do in the dermatologist's office. The way you do a use test is you apply whatever product it is you're trying to test. I usually have people look at their forearms and find a mole or something so that they can do it in the same place multiple days in a row, and you apply it the way you're going to use it. So if you were using a stage makeup, you'd apply it like you'd apply the stage makeup.

You obviously wouldn't apply a cleanser and then leave it on because that would irritate anybody's skin, but if it's something that's intended to be left on . . .

So I have a handy freckle I'm showing you guys on the Zencastr podcast platform with video that I use for my use tests, and I'll just apply something around that little mole for three or four days in a row, and usually at least a week before I actually have to use it, to check to see if I've got a contact allergy to that product or if it's made out of irritating chemicals.

And if you don't get a reaction to that, you could potentially use the topical product, whatever it is, safely.

Now, one thing that I've also talked to people about is trying to set the stage for success with this. So before you would ever start putting the makeup on, face has to be clean, and then it needs to be gently moisturized in a way that's not going to plug up pores. So I like patients to use a gentle lotion that doesn't have any fragrances or anything heavily irritating in it. Something like CeraVe lotion can be used. You could also potentially use some of the really gentle primers. And then kind of putting a little . . .

Rebecca: Yeah, we use primers.

Dr. Tarbox: Yeah. And then putting a little bit of a protective base in place before you put all this makeup on.

So you have some interesting thoughts, Becca, about powder application and long you can leave that stuff on.

Rebecca: Yeah. So it depends on how much you're sweating actually, and what the purpose of the makeup is. But I would say that even if it's for fun and for Halloween, I wouldn't leave thick grease paint on a face longer than three or four hours because your skin needs to breathe.

I have colleagues that are in some really makeup-intense roles right now. We're doing "The Magic Flute," and the guy playing Papageno, who's the bird guy, has really extreme makeup. And he just had too many shows in a row and had a breakout around his eyes, even though he was basically doing the right things. So duration of the makeup on the skin is also a factor. So I definitely wouldn't say, "Let's spend 12 hours in stage makeup."

Dr. Tarbox: As a primary care specialist, Lindsay, I bet you've seen somebody come in with a rash after using one of these things. Have you ever encountered that?

Lindsay: I've heard stories. I don't know if I've seen it directly right after Halloween, but it makes sense that if you leave it on for a long period of time, you know, you're going to plug it up. You absolutely can get acne breakouts and rashes and whatnot.

Dr. Tarbox: And what I've seen personally is some of the para makeup things like . . . I just made up a term, para makeup.

Lindsay: Para makeup.

Dr. Tarbox: So one of the things I've seen is patients who come in after using false eyelashes with cheap adhesive and they have this horrible eyelid dermatitis. So another I think important thing is if you're going to use false eyelashes and want to incorporate those into your costume, even if you want the crazy ones with feathers and sparkers coming off of them that you would never use in everyday life, buy those, fine, but don't use the glue that comes with them. Buy the glue from a cosmetic company like Sephora or something where they're intended to be used regularly. Those are actually regulated by the FDA, unlike the costume products, so that you're not putting something irritant near your eye.

And then also, of course, some people will incorporate the theater contacts, and some of those are not made well. And so, trying to get a theatrical contact from a company that actually makes other reputable lens products is a good idea as opposed to just buying whatever you can kind of find. And you can find all sorts of crazy things on the interwebs these days.

Rebecca: Just generally speaking from a community theater perspective or even just doing the makeup with your friends, there are two types of products that I would say should not be used by more than one person. And that would be any kind of product that goes in the eye or around the eye, so mascara, and what goes on the lips.

So we try and have our own lipstick and our own mascara at the theater because it's just very, very easy to transmit bacteria with those products. So those are two things where it's really not great to share with your friends.

Lindsay: Yeah. I've had a family of kids that came in with impetigo from having face paint put on. All four kids had had face paint applied and all of them had impetigo because there was reuse of the sponge and the makeup for each subsequent kid, and so that's a recipe for disaster.

Rebecca: Yeah. That's why the sponges have to be washed. That's crazy.

Dr. Johnson: So maybe this is a dumb question, but if you use brushes and things, how do you clean those?

Rebecca: So they can be washed with an alcohol mixture. I know that they actually sell specific makeup brush cleansing formulas at makeup stores and stuff like that. But they can be soaked in this . . . I'm not entirely sure what it's made of. I know there's alcohol in it, but I know that beauty supply stores have these.

Dr. Tarbox: And a lot of the time we recommend you just, if you are in a pinch, you cleanse the brush with whatever you use to cleanse your face.

Rebecca: Soap and water also works.

Dr. Tarbox: And then it does have to dry for certain applications. Sometimes in theater, they will use the theater trick of a water bottle with vodka in it, usually cheap vodka, and then you spray that for the clothing, you spray that for the costumes that can't be laundered in between to try to kill some of the bacteria and odor.

Other weird things. Sometimes people have like the little mats to cleanse the brushes, and those are, I think, very helpful. They have a little texture to them.

I do totally agree that the cleansing needs to happen. But anything that's made for your face is usually sufficient to cleanse the brush.

If you have a wooden handle and natural bristles, you want to be careful not to let them stay wet too long because the wood can rot and that can cause problem with the bristles falling out.

And then other weird stuff too. Some of the things that I've seen the most reaction from is fake blood. So the theatrical fake blood that comes especially in the little blister packs is not made well at all.

Rebecca: That's also not FDA-approved, I'm guessing.

Dr. Tarbox: And it can directly interact with the oil-based makeups. So I've seen people come in with like. . .

Dr. Johnson: So use real blood.

Dr. Tarbox: I mean . . .

Rebecca: But stage blood, like actual stage blood, is fine. I have lots of experience with that because I'm a soprano and we get killed all the time. So if it's actual theatrical stage blood, not something sold by Spirit of Halloween or whatever, but actual theatrical stage blood, that is actually tested.

Dr. Tarbox: Yeah, red dyes can be dangerous. If you're in a pinch and you need to make it yourself, you can use food coloring, most people don't have a reaction to that, and mix it with corn syrup and cornstarch. Or you can add a little chocolate syrup to give it some opacity, because real blood . . . you know, Luke and Lindsay, real blood is not see-through. So whenever you see this gelatinous red stuff, you're like, "Sure, that's blood."

Rebecca: That's what you'd like to think it looks like.

Lindsay: I do have one more. I hope this could be a public service announcement for our young men or just men who are in the high school or community theater productions, and moms or whatever, helping out with the makeup and they're playing a straight/cis character but they've got the longest lashes you've ever seen because they've got the mascara and they've got the guyliner. When they're playing a character who doesn't really call for mascara, what should they do for their eye makeup?

Rebecca: Right. So I mean, eyeliner, it depends on the size of the stage. So eyeliner is pretty standard. Obviously not with a little wing or something, but just to make the eyes stand out a little bit. I mean, the opera house that I work at has over 1,500 seats in it, so we want the people who are up in the nosebleed section still to be able to see that we have eyes. But it's not standard practice that the guys use mascara.

So just a little bit of eyeliner to make the eyes stand out a little bit more. And usually, they'll use a base just to even out the skin tone and maybe a little bit of contour just to show jawline and stuff like that.

But if it's just a regular cis male character, you don't see a lot of mascara and stuff like that. Just really very standard, boring, non-shiny eyeliner.

Dr. Tarbox: And I think like a tinted brow gel . . .

Rebecca: Like a pencil.

Dr. Tarbox:. . . is helpful too because re-darkening the brow is sometimes necessary after applying the base face makeup. And men tend to have heavier brows than women, so you can kind of combat some of the feminizing effect of makeup on a man.

Rebecca: If you do that, if you do have makeup in the eyebrows, it's important to remember to remove that makeup in the eyebrows because sometimes people miss that part somehow, and then you can actually get folliculitis in your eyebrows. Look at me using medical terminology. Was that right?

Dr. Tarbox: Good job.

Lindsay: Yes. It was perfect. Great.

Dr. Tarbox: Said the opera singer. Great job.

Rebecca: "Said the opera singer."

Dr. Johnson: Well, that's probably what we've got time for today. So big thanks to Becca and Lindsay for joining us.

Rebecca: It was great.

Dr. Johnson: And I hope you guys all have a fun and safe Halloween. "Skincast" comes to you every two weeks, and you can find our entire archive on Apple Podcasts or wherever you get your podcasts. Michelle, you and I also have another podcast.

Dr. Tarbox: Yes. So we co-host the "Dermasphere" podcast. It is an hour long typically, and it covers upcoming and current topics in our literature. It is directed at dermatologists and the dermatologically-curious.

Dr. Johnson: So if you're a super dermatology nerd like we are, you might check that out. Otherwise, have a great time. See you next time.

Dr. Tarbox: Happy Halloween!

Halloween is a magical time for kids and adults. So how can you continue to enjoy Halloween during COVID? I've got some ideas for you on today's Scope.

Okay. So I admit it, I love Halloween. I was so looking forward to this year because Halloween is on a Saturday and there's a full moon, the perfect setup for the Halloween party we host every year at our house, and then COVID had to happen and mess everything up. Well, not everything. There are still a lot of fun things that you and your kids can do.

For example, we still plan on doing our outdoor decorations. We plan on welcoming trick-or-treaters but in a safe way. Our street is setting up tables that will go from our driveway to our neighbor's driveway across the street, not blocking the road, of course. And we will all be in costume, chairs for family set at least six feet apart, or people are bringing blankets to sit socially distanced on. The houses will all be decorated. We'll be wearing fun Halloween masks, COVID masks, and we'll be passing out individually wrapped treats, but we'll be using hotdog tongs to pick up the treats from the bowls and dropping them directly into the bags of the trick-or-treaters.

We also will have plenty of hand sanitizer available. We also have food and non-food treats. See, we are a teal pumpkin house, meaning we understand about kids with food allergies. I have many food allergies myself. And so we give away things like little tubs of Play-Doh. If kids want to walk past our place and just see all the scary decorations, that's great. If they want treats, we've got them. It's all what parents are comfortable with based on the risk factors that their family has.

So what are some other ideas that can make Halloween during COVID more fun? You can try an outdoor costume parade in the neighborhood or at a park with friends, keeping in mind that the kids still need to have their face masks on and stay six feet apart. And the masks that come with costumes, that's not what I'm talking about. We're talking the regular face masks that you wear every day.

You can also do virtual costume parties if you're good at setting up Zoom meetings. You can have all the kids dress up in their costumes and chat with each other. You can host an outdoor Halloween movie night with age-appropriate movies, or just have a Halloween movie marathon at home as a family. And don't forget decorating and carving pumpkins.

If you're planning on trick-or-treating, remember, again, the masks that come with the costumes are not a good substitute for the double layer COVID masks. Also, have the kids wait at the street if there are already kids at the door. Only go trick-or-treating with your immediate family members. And parents, if you're going with your kids, be sure to wear your masks also. Most importantly, remember this is a time for kids and parents to be creative about ways to celebrate Halloween in a safe way. Happy Halloween.

Interviewer: What is Halloween night like in the emergency room? We're going to find out next on The Scope.

Announcer: This is From the Frontlines with Emergency Room Physician Dr. Troy Madsen on The Scope.

Interviewer: Dr. Troy Madsen's an emergency room physician with University of Utah Healthcare and I'd imagine at certain times of the year, your job gets a lot more difficult, or the ER gets a lot busier. I'd imagine Halloween is one of those kind of things, you got a bunch of kids running around in the dark, in costumes, a lot of times flowing behind them, yes? No? What's the ER look like on Halloween?

Dr. Madsen: You know, it's surprisingly . . . you might think it's crazy, it's surprisingly not that crazy. Like, if I get my schedule for the month of July and I see I'm working July 4th at night, I'm like, "Oh great, here we go." If I get my schedule for October and I see I'm working October 31 at night, I think, "Okay, I guess I don't have to stay at home and hand out candy to kids," but I'm not thinking, wow, it's going to be insane because it's generally not that crazy.

I think a couple factors are in there, I think parents they're good with kids and it's sad, every Halloween, you see horrible stories about maybe a kid getting hit or something, that happens, but those are fairly isolated incidents.

Usually kids are going trick-or-treating a little earlier, I think maybe it's not quite as dark, certainly the Daylight Savings Time, it used to be that Daylight Savings was first of October, now it's first part of November, so it's usually lighter later now on Halloween, that probably makes it safer. Then in terms of other issues, probably the biggest thing we see is kind of the stuff we see on New Year's, it's maybe alcohol-related, maybe some injuries related to that, but it's not even quite to the degree we might see on New Year's Eve.

I think part of that is usually Halloween is falling on a weekday, just by nature of it, it's not a recognized holiday, it's not like people have the next day off of work. It's not like they're out partying, maybe they might, like, they might be on New Year's. So typically, Halloween's not that crazy. A few injuries here and there, most of the stuff we might see that's Halloween-related is related to alcohol with older people or teens that are getting into trouble and doing stuff, but it's not as insane as you might think.

Interviewer: Oh, well, that's good to know. So I guess the takeaway message from this maybe is stay safe like you have been doing, keep the eye on the kids like you have been doing, but maybe if you're out drinking alcohol, keep that in mind.

Dr. Madsen: Yeah, and it's this standard precaution, and again, I think people are doing a good job with that, in terms of kids and candy and issues there, kids on the street, making sure they're well-lit, using flashlights if you're out after dark, all those things in terms of the kids and yeah, alcohol safety, things like that in terms of Halloween parties.

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Interviewer: Three alternatives to handing out candy on Halloween, that's next on "The Scope."

Announcer: Health tips, medical news, research and more for a happier, healthier life, from University of Utah Health Sciences, this is "The Scope."

Interviewer: All right, here's the deal. You've decided you want to make Halloween a little healthier for the trick-or-treaters that show up on your door stoop, how can you do that? Well, we're going to find out right now. Registered Dietician Theresa Dvorak is from the Department of Nutrition and Integrative Physiology at the University of Utah College of Health and, first of all, I've got to know, as a dietitian, what are the gInterviewers and goblins getting at your door stoop on Halloween?

Theresa: A combination of things, I usually do, kind of, a bucket that they can choose out of.

Interviewer: So like, apple slices, oranges, I mean, are you handing out candy?

Theresa: Well, I guess I do more non-food things and then maybe some candy things.

Interviewer: All right, so here's the premise, you're thinking maybe you might want to make Halloween a little bit healthier for the kids in the neighborhood and not get your house TP'ed at the same time. So, let's start with number one here of, like, three candy alternatives, what's your first one?

Theresa: Things like school supplies, so pencils, erasers, that have a Halloween theme to them, keeping within . . . you know, you don't want to send out just a boring pencil or something of that sort, but maybe get ones that are decorated with a Halloween theme.

Interviewer: All right, that's pretty good, I like that. How about a second alternative?

Theresa: Another alternative would be things like trinkets or toys, you know, things like the spider rings or . . .

Interviewer: Ooh, I like that.

Theresa: . . . items of that nature that might be fun to play with.

Interviewer: And what are you going to recommend for candy-alternative number three?

Theresa: And then, third could be something of a healthy choice, a healthy snack like a string cheese or apple slices, prepackaged, healthful foods. Interviewer: Yeah, because that's another one of the tricks, right? Like, I think, well, you could hand out apples, but no you can't because of the safety concerns.

Theresa: Right, just like candy, you want to make sure that it's fully packaged and sealed, so even if it was just those miniature boxes of raisins, those are great things to hand out as well, those dried fruit, individual packages.

Interviewer: Like, what about granola bars? Are those better than candy? Like, little, small granola bars?

Theresa: It depends, a lot of them, honestly, have about the same amount of sugar that a candy bar would, so incorporated into a balanced diet, maybe, but that certainly could be a choice that looks different than, say, a Snickers bar.

Interviewer: And you said that you, kind of, give out a mix of things, so why is that?

Theresa: You know, I like to let the kids choose.

Interviewer: Do they choose the apple slices ever?

Theresa: They do.

Interviewer: Do they?

Theresa: They do, honestly, yeah. I think part of it is just that it's something different that they're not getting at all at the other houses, so it's that unique piece. Yeah, and you know, Halloween too is really just about the experience, right? Going out and trick-or-treating, going door-to-door and dressing up, and out with their friends or family. And so it's the fun of the trick-or-treating and then often, too, the sorting of the items when they get home, right? Putting them into different piles and "What am I going to choose first?" or what have you. That's really the fun of Halloween is the trick-or-treating and the sorting.

Interviewer: So as a registered dietitian, it sounds like you do give out . . . do you give out candy at all?

Theresa: I do, I do a combination.

Interviewer: Yeah but kids will go for the healthier stuff?

Theresa: They do, yeah.

Interviewer: And does your house get TP'ed every year?

Theresa: No, thankfully. Interviewer: No, everything's good, all right, that was very helpful, some, maybe, alternatives to giving out candy or, I like your idea, maybe even giving a mix or giving kids the choice.

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Interviewer: Don't get burned this Halloween. That's coming up next on The Scope.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: Halloween is kind of a recipe for disaster, really. Think about it. You've got a bunch of really candy-motivated kids running around in their costumes, some of which limit vision or are a tripping hazard or are hard to see in the dark. They're not thinking straight because they just want to get to that next doorstep, and they're running on pure excitement and giddiness. A lot of potential dangers and one of those potential dangers could be burn.
Annette Matherly from the University of Utah Burn Center, she's our expert. Let's, first of all, talk about kids, Halloween, and burns.

Annette: Burn injury is one of the most painful injuries that a human body can suffer, both emotionally and physically, and they last a lifetime. Prevention of burn injury is always preferable to treatment. If we can make simple changes in behavior in our environment, then we will be less likely or our loved ones will be less likely to sustain a burn injury.
So this is probably something that many don't think about, but kids love to wear those costumes that trail around with the capes. They love to be superheroes with billowing sleeves and big princess dresses. But what parents need to remember is that those capes and those dresses can touch candles unexpectedly, and that clothing can ignite. So that's really an important factor when choosing a costume for your child.

Interviewer: But I thought most costumes nowadays are fireproof. So why would you even have to worry about that?

Annette: Well, they're not exactly fireproof. They're fire resistant, and what that means is that they will still catch on fire. It will just take them a little while longer. They may catch, and then by the time the child realizes that their cape is on fire, it may be too late and the cape may be engulfed, and then they need to stop, drop and roll. The other thing about that is that homemade outfits will catch on fire. They may not have that fire resistance attributed to costumes that can be store bought.

Interviewer: In the Burn Center, you've seen costumes that have caught on fire?

Annette: Absolutely. Unfortunately, one that I particularly remember is a little boy whose cape caught on fire as he was running around the house. It caught on a portable heater that was just stuck there. Nobody ever expects that. It's just something that catches you out of the blue.

Interviewer: Yeah, so it's not necessarily the jack-o-lanterns with the candles inside. It can be anything.

Annette: Absolutely, although the jack-o-lanterns with the candles inside are a problem, too. Hopefully, everyone remembers that if there is a jack-o-lantern with a candle on it, it should be well away from the walkways of children that are walking to and from the homes collecting candy.

Interviewer: A lot of people like to put up old cornstalks and bales of straw. Keep them away from that stuff in case the wind blows them over or something, I think.

Annette: Oh, yeah. There's nothing more spooky than those cornstalks and the dangly things that are over the doorways, but remember those are not only a fire hazard, but they're an escape hazard too. So exits should not be blocked with any of that stuff.

Interviewer: It's always good to remember the basics, because regardless of the season, I mean, we could talk about Christmas and the fire dangers there, you could talk about a lot of holidays, but it's just important to remember the basics. What are the basics you should teach your family?

Annette: It goes back to kindergarten, right? When we're in kindergarten, we learned to stop, drop and roll. But as an adult, when was the last time that you stopped, dropped and rolled? So this is applicable not only to children, but applicable to adults too. Sometimes we'll see adults come through that forget those basics, and they run when they're on fire, and they don't stop, drop and roll and cover their face. So this is a great opportunity to review with everyone stop, drop and roll.
It's a great opportunity to review home exit drills and the importance of getting out of the home and not returning for anything, no matter what. It's also a great opportunity to test the fire alarms and make sure that they're working so that if something occurs, then everybody will be warned and will be able to get out of the house in a timely manner.

Interviewer: I think it's important to remember we don't need to be alarmist about these sorts of things. We should still enjoy having the cornstalks and the jack-o-lanterns, maybe be a little smarter about it and a little bit more aware. Candles in jack-o-lanterns a bad idea?

Annette: Oh, please, please use a flashlight or use those really cool glow sticks that have those awesome colors. It's just one more danger that doesn't need to exist.

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Scot: Halloween's coming up. That means we're going to see an increase of bites no doubt in the ER. Here with Dr. Troy Madsen emergency medicine of the University of Utah Hospital. Do you see more bites like from the werewolves, the vampires and the zombies around Halloween time?

Dr. Troy Madsen: You know, I don't know. I'm working Halloween this year so I'm really curious what I'm going to be seeing that day.

Scot: All joking aside though I thought this would be kind of a fun way to talk about bites.

Dr. Troy Madsen: Yeah.

Scot: You know, so a werewolf could be a dog.

Dr. Troy Madsen: That's probably the best comparison.

Scot: Vampire could be a vampire bat I suppose.

Dr. Troy Madsen: Yeah, yeah. Some sort of bat.

Scot: I don't know what a zombie would be though.

Dr. Troy Madsen: See I'm going to have to compare a zombie to a Komodo dragon just because I imagine the zombie bite is the absolute worst kind of bite you could get.

Scot: Yeah.

Dr. Troy Madsen: So if I were to pick one sort of bite out there that's just a horrible bite to have, just nasty that's just going to do you in and make you one of the walking dead it's a Komodo dragon.

Scot: All right, let's talk about bites for a second. Let's say you get bit by a dog for example.

Dr. Troy Madsen: Yeah.

Scot: What's the major concern that somebody should have immediately after that?

Dr. Troy Madsen: So the immediate concern right afterward is, you know, just the bleeding. Making sure you stop the bleeding, hold pressure on there, make sure there are no issues with that. Once that's under control then the next big question is does it need to be repaired? Is this a laceration that needs to be sewn up and if it's a gaping thing, if you've got a lot of tissue coming out of it, if it's on your face, if there are cosmetic issues, that's something that needs to be sewn up.
One of the big things for me in the emergency department is do we need to worry about rabies? Now if this is a dog, let's say a werewolf in this situation-

Scot: It is a werewolf.

Dr. Troy Madsen: It is a werewolf, that's what we're talking about here. Absolutely with a werewolf you would be concerned about rabies. And since, you know, you may not get bitten by a werewolf the next concern would be a dog where you just don't know anything about the dog. Those are the situations where we get concerned and we give the rabies vaccine. We make sure you have a series of shots. It's I think down to four shots now. I think it used to be a few more and you hear all kinds of horror stories about rabies vaccines. I've heard people say, "Well, you have to get it injected into your stomach," which sounds awful. That's absolutely not the case.

Scot: Not the case?

Dr. Troy Madsen: No, it's not.

Scot: It used to be the case?

Dr. Troy Madsen: I don't know, not since I started practicing.

Scot: All right. That's good news.

Dr. Troy Madsen: But maybe years ago because that sounds miserable. But yeah the rabies vaccine is not that bad but we give it as a precaution because if you get rabies you can't cure it. It's a horrible thing and it'll kill you.

Scot: All right bite number two that you might get around Halloween, blah, vampire.

Dr. Troy Madsen: That's right.

Scot: What happens if a vampire bites you?

Dr. Troy Madsen: So a vampire, you know, vampires are bats so I think the best analogy there is a bat bite.

Scot: Okay. Do you see a lot of bat bites?

Dr. Troy Madsen: We don't. I very rarely will see one and you know kind of the weird situation is we'll actually see cases where a person wakes up in their bedroom and there's a bat in the room. And this is really interesting because the US Centers for Disease Control has said, "If you wake up and there's a bat in your room you need to assume you've been bitten."

Scot: They made a statement on this.

Dr. Troy Madsen: They have made a statement.

Scot: Okay.

Dr. Troy Madsen: And it's in their guidelines that you need to have the rabies vaccine. Again, it's getting back to that whole rabies thing and that's our big concern with bat bites.

Scot: The last bite you might get around Halloween time, zombie.

Dr. Troy Madsen: Yeah.

Scot: Be turned into the undead. And you compare that to a Komodo dragon.

Dr. Troy Madsen: Yeah, yeah. Komodo dragons. Obviously we don't see a lot of Komodo dragon bites.

Scot: Sure.

Dr. Troy Madsen: But if I had to draw the best comparison I could to a zombie bite I would say a Komodo dragon.

Scot: And why's that? Yeah.

Dr. Troy Madsen: Because it's just the worst bite you can get. It's amazing how much bacteria Komodo dragons have in their mouths. These locations where they actually have wild Komodo dragons there are reports- I mean that's how they kill animals with just the amount of bacteria in their mouth. I mean there's the force of their bite but they're mouths aren't really that big, but they bite these animals and these animals have severe sepsis, like severe bacterial infections and will often die within hours.
So if we were to ever get someone say from the zoo, if you had like a zoo handler that came in after a bite, man, I would give him every antibiotic I could. I'd have him IV antibiotics, admitted to the hospital, because these things are awful.
So Halloween's coming up. Be safe. Watch out for those werewolves, vampires and zombies. And if you do happen to get bitten, I'll be waiting for you in the ER.

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