Haredi Jews and Dermatology

Abstract

To the Editor: Meister and Silverberg1Meister H. Silverberg N.B. Dermatologic considerations in ultraorthodox Jews: an illustrative case series.JAAD Case Rep. 2020; 7: 113-116https://doi.org/10.1016/j.jdcr.2020.11.008Google Scholar presented several dermatologic cases specific to Haredi or ultraorthodox Jews. I would like to present several points dermatologists should consider when caring for this group of patients. First, as with religious Muslim patients, men and women do not touch each other unless they are married. For example, as a male physician, I can touch a female patient during the examination, but I may not offer my hand to shake at the end of the visit. This is also true for women dermatologists treating religious Jewish or Muslim men. Second, Haredi Jews do not schmear or spread topical medications or take oral medications on the Sabbath or on holidays. These rules stem from the prohibition of performing the types of work on the Sabbath and holidays involved in making the Tabernacle during the Israelite’s forty years of wondering in the desert following the Exodus from slavery in Egypt. One type of prohibited work involves memachet or rubbing the animal hides used to cover the Tabernacle. The hides were rubbed to remove the hairs and smooth the surface. Spreading creams and ointments is related to this prohibited activity and is therefore not permitted on the Sabbath and holidays. A dermatologist should remind their Haredi patients to apply topical medications before and after the Sabbath and holidays.This should be discussed with the patient when prescribing a topical medication. Because this rule does not apply to liquids, corticosteroid solutions and oils, as well as steroid and sunscreen sprays, might be permitted. Many Haredi Jews will often dab creams on the affected areas instead of rubbing them to work around this prohibition. The dermatology provider should discuss this with the patient who may then want to ask his/her rabbi for an opinion. Grinding is another activity performed in building the Tabernacle. In the past, medications were made by grinding various substances on the day they were taken, and as a result, oral medications were not taken on the Sabbath or holidays. Haredi Jews hold on to this prohibition of not taking medications even though the medications are already made. If taking a medication is critical to the patient’s health, the patient should be encouraged to take the medication and be reminded that it is most likely permissible. Again, the patient may want to consult his/her rabbi for an opinion. Third, married Haredi women cover their hair in public usually with a wig or sheitel. It is important to ask the patient who cuts her hair, because if the patient cuts her own hair, as is frequently the case, her scalp is never examined. In these cases, it is important to encourage the patient to remove her wig for an examination of the scalp. Finally, using the telephone is not permitted on the Sabbath or holidays. Medical offices should avoid calling patients for appointment reminders and test results on these days. Haredi patients should be reminded that they need to call the medical team immediately for emergencies such as post-operative bleeding, infection, or dehiscence, even if it is the Sabbath or a holiday. None disclosed.