It is a "new, unused item." I purchased it for my mother, but I decided it would be difficult for her to continue taking it orally, so it became an unwanted item. The product's size is shown in the third image. Even if you wash it in the washing machine, the neck is snap-on instead of Velcro, so you can use it for a long time. It is completely unused and unopened. I don't think you need to worry about hygiene. I would like to give it to someone who can use it. Thank you very much.