OCD, Anxiety and Handwashing

My son's hands are chapped and bleeding from washing them so much. He is so afraid of "germs" especially since the high profile of H1N1 flu, even though he is vaccinated. He questions everyone if they have washed their hands (home and school). His anxiety levels are rising, it is so hard to watch. He completely lost it a couple of months ago when I told him I would have to walk to the car to get a wipe after using the porta potties at the beach. On the ground. So far no lotions have been able to keep up with the handwashing and Purell use. I consulted with our neurologist and developmental pediatrician this last week, who both thought we should consider medication, as we have maxed out on behavioral approaches. He just shatters before he can even think through his anxiety. I guess we have reached the point of medication trial, as the behavioral approach is not helping enough. Sigh.