Ask the doctor - embarrassing problems

 

My sister has chronic wind

My sister has a flatulence problem and claims to have no control. What can she do about it?

Encourage your sister to have a medical check-up as soon as possible, as she may have a bowel problem needing treatment. If nothing obvious is found, it may help to avoid ‘windy foods’ that promote formation of smelly sulphur compounds during bacterial fermentation in the large bowel, such as beans, lentils, cauliflower, cabbage, broccoli, Brussels sprouts and onions. Taking a probiotic will improve bacterial
balance, and can also reduce odours and wind. Activated charcoal products (from pharmacies) absorb intestinal smells and reduce flatulence, too. Another option is an extract from the mushroom, agaricus bisporus, which breaks down bowel sulphur and ammonia compounds. Try Champex Body Odour Neutralising Supplement Travel Pack, £11.99 for 30 capsules, from www.carryontravelling.co.uk.

Dr Sarah Brewer, Prima 

 

UGLY VEINS

Summer is the worst time of the year for me as I have unsightly varicose veins, which means I don’t want people seeing my legs. What can I do?

There’s a variety of treatments for varicose veins and a specialist will be able to advise on which is best for you. The most common and traditional method is to strip the veins out, but that causes bruising and discomfort. There’s a new technique called VNUS Closure (visit vnus.co.uk) that involves inserting a thin tube into each vein under ultrasound guidance and heating it to 85°C. This destroys the veins and results in less bruising than the more common stripping and tying method. EVLT (endovenous laser treatment) also uses a thin tube, but this time a laser kills the varicose veins. This is becoming a popular procedure as it can be done under local anaesthetic (visit evlt.com for details). Smaller veins can be treated with sclerotherapy, which involves injecting a chemical into the veins. This scars the veins, which then seal shut when they heal. In the meantime, you need to keep your skin in good condition by moisturising regularly. You could also try wearing compression stockings to relieve any aching.

Dr Louise Selby, SHE 

My legs are so hairy

Like my mother, I have lots of hairs on my legs. I've always shaved them, but it just seems to make the hair grow back quicker. What are my options?

Many people think that shaving makes hair grow back quicker. In fact it doesn't, but the end of the cut hair that grows back is blunt, which may make it look more stubbly. Waxing lasts longer than shaving, because the hair has to grow for longer before it gets back to the surface of the skin. But it can be painful, and cause irritation and inflammation. If you're going to try waxing at home: clean skin thoroughly beforehand; always test new products on a small, less visible area first; and use a moisturiser afterwards (perhaps one with tea-tree oil). Other methods, including electrolysis, laser and IPL (intense pulsed light) can remove hair permanently, but should always be done by a qualified practitioner.
Dr Sarah Jarvis, Good Housekeeping

My painful piles problem

I've suffered from piles since giving birth and can't get comfortable in the car without sitting on a pack of frozen peas. Is this harmful?

 Haemorrhoids can occur at any age from mid-teens onwards and affect both women and men. An ice pack can help shrink piles and have a pain-killing action. But never put an ice pack in direct contact with skin, don't use for more than 15 minutes at a time, and wait ten minutes before reusing to prevent freezer burn. Try using a special cushion with a cut-out that stops pressure building up around the area - for example, Klass Vaki's Haemorrhoid Cushion (£59.95, call 020 8450 7111). The cut-out is hidden by a removable cover for discreet use in public.
Dr Sarah Brewer, Prima

 

Urinary incontinence

Where can I get information about treatment for urinary incontinence? My GP says he can refer me to the hospital, but I’d like to know what my options are before I go ahead.

Urinary incontinence is an incredibly common problem, affecting one in three women at some stage in their lives. Treatment depends on several factors, including your age, whether you've completed your family, whether you have ‘urge' or ‘stress' incontinence and so on. Most areas now have a specialist incontinence nurse adviser, who will be able to give you advice on the right way to do pelvic floor exercises. If they're done correctly, two-thirds of women improve so much they need no further treatment. Have a chat with your GP or practice nurse about being referred.
Dr Sarah Jarvis, Good Housekeeping
 

Thinning hair

I’m 36, and over the past five years or so my hair has become very thin. I don’t have any completely bald patches, but it does seem to be getting worse. What can I do?

Poor you. Hair has such a lot to do with the way we feel about our appearance it's not surprising you're sensitive about this. There are dozens of medical conditions that can affect hair, but your GP should be able to get a clue from the precise way yours has changed. Losing hairs from all over your scalp, with normal skin underneath, for instance, can be related to iron deficiency, thyroid disease or some medications. It can also be triggered by a major illness or stress. If this is the case, a large percentage of your hairs will stop growing, enter the ‘resting' phase, and fall out about three months later. Fortunately, this condition tends to settle by itself. But do talk to your GP about ruling out other causes.
Dr Sarah Jarvis, Good Housekeeping

Stress incontinence

I had my first baby six months ago, and ever since I’ve suffered from stress incontinence when I sneeze or run. Almost worse, though, my vagina feels really loose when my husband and I make love. Are the two connected?

Yes, these symptoms are almost certainly connected and, although it might sound strange, this is actually good news because you can use the same treatment for both problems. When you deliver, the muscles and supportive structures of your pelvic floor take a lot of strain and - unless you're really obsessional about your pelvic floor exercises - stress incontinence can be a real problem. It affects around one in three women at some point in their lives but, fortunately, it's never too late to do something about it. First of all, make an appointment to see your GP, to rule out other causes and to ask about the options. Your doctor may be able to refer you to a specialist physiotherapist, who can give you exercises to practise. Electrical stimulation and vaginal cones of gradually increasing weight can also be very effective.
Dr Sarah Jarvis, Good Housekeeping

Are there any complications with Bell’s palsy?

Three weeks ago I was diagnosed with Bell’s palsy, which has made one side of my face droop. I was given a course of steroids but it hasn’t solved the problem. My GP says there’s nothing else to be done. Is this true and are there any complications?

Bell's palsy is a weakness that affects the nerves - and therefore the muscles - on one side of your face. It's most common between the ages of 10 and 40 - although it can strike at any age - and affects about one in 70 people. Unfortunately, we're not absolutely sure what causes the condition - it's probably connected to some sort of viral infection. Without a cause, it's often harder to find a cure, and there's no routine treatment apart from the short course of steroid tablets you've already had. If your eyelid is also affected, it can prevent it from closing, making your eye prone to damage, in which case, you may need a pad or drops for your eye. Fortunately, about eight in 10 people recover completely in time, although it may take up to 12 months. I can reassure you that Bell's palsy doesn't affect your brain in any way, though, and only one in 100 sufferers ever gets another episode.
Dr Sarah Jarvis, Good Housekeeping

Thread veins on legs

I have ugly thread veins on my legs, around the same area as my varicose veins. I dread spring and summer time, as the veins show through normal tights. Can I get them treated and, if so, how?

Your thread veins are, indeed, connected to your varicose veins. The good news is that these veins don't tend to cause the symptoms you get with varicose veins, such as aching and swelling of the legs, but their appearance can be distressing. The bad news is that treatment for such veins is considered to be ‘cosmetic', and isn't available on the NHS. You can, however, get a variety of effective treatments privately, such as laser therapy or high intensity light treatment, or injecting a chemical to close the veins down. Ask your GP for a private referral to a surgeon, who will be able to discuss the best options in your case.
Dr Sarah Jarvis, Good Housekeeping
 

Facial hair

Earlier this year, I had a series of facial hair removal sessions by a beautician who specialised in laser hair removal. I’ve had about eight sessions but they haven’t worked. What can I do?

As you've discovered, excess body hair can sometimes be a remarkably distressing problem. You don't say whether your hair is dark or fair but it's the pigment cells in the hair follicle that pick up the laser's energy, so if you don't have dark or pigmented hair, the treatment can't work. Electrolysis, which involves putting a fine needle down into the hair follicle to destroy its root, is a good alternative to laser treatment. You could also ask your GP to prescribe a new cream called Vaniqa, the first and only prescription cream clinically proven to slow the growth of unwanted facial hair in women. It's used to complement laser or electrolysis and, as it slows hair growth, you may notice over time that you need treatments less often. Whichever treatment you decide on, choose a reputable practitioner - ask your GP for a recommendation. The British Institute and Association of Electrolysis will also be able to help. A condition called polycystic ovary syndrome (or PCOS) can also cause excess body hair, so if you haven't already been tested for that, talk to your GP.
Dr Sarah Jarvis, Good Housekeeping
 

Blisters

I’m a bit embarrassed because I keep getting blisters on my bottom. It’s happened three times in the past year and my GP says they’re caused by the cold sore virus. However, I’ve always thought you could only get cold sores on your lips. Am I right?

Cold sores are caused by the herpes simplex virus, and although most people associate them with the lips, they're by no means limited to that area. Herpes blisters are commonly found on the buttocks and any other part of the body. There are two key ways of telling if they're cold sores. One is the tingling sensation you get before they emerge and the other is the fact that they usually recur in the same spot. Using an over-the-counter cold sore remedy, such as Zovirax, can help get rid of them more quickly. Just make sure you start applying it as soon as possible - preferably as soon as you get the tingling.
Dr Sarah Jarvis, Good Housekeeping

Urine infections

I’ve had blood in my urine twice in the past 18 months. Both times I felt generally unwell and had a burning sensation when I went to the loo. My GP told me the blood was due to an infection and that I don’t need to worry. But it happened again last week and, although antibiotics cleared it up, I keep thinking it could be something more sinister.

I'm delighted to be able to reassure you. If your doctor has confirmed that you had a urine infection and it settled down with antibiotics, there's no need to worry. Urine infections cause inflammation of the lining of your bladder, which then often bleeds. If you pass blood without pain, though, or if a urine sample shows blood but no evidence of infection, you would need further investigations.
Dr Sarah Jarvis, Good Housekeeping
 

Perspiration

I sweat more than anyone I know. It’s worst when I’m rushing around during the day, and it’s very embarrassing. I know you can have operations to stop you sweating, but is there anything a bit less drastic I could try?

First, if this is a recent problem, you should talk to your GP. Excess sweating can be a sign of having an overactive thyroid gland, as well as beginning the menopause. There are many antiperspirants that contain aluminium - look on the label - which prevents excess perspiration. If you've already tried these, you could talk to your pharmacist about obtaining a solution of aluminium chloride, which you can apply at night and wash off in the morning. An alternative might be injections of botulinum toxin - botox - into your armpits. That might sound rather scary, but it really works. The side-effects tend to be minor, although the treatment should be repeated every few months.
Dr Sarah Jarvis, Good Housekeeping

 
My breasts are wonky

One of my breasts is bigger than the other, and feels heavier and lumpier – but I’m too embarrassed to see my male doctor. Any advice?

It is quite common for one breast to be bigger than the other. However, it is important to have yourself checked, as you may need a mammogram or needle biopsy to investigate the lumpiness. Try not to feel too self-conscious – your GP is used to dealing with ‘embarrassing’ topics. If you would feel more comfortable, ask to see a female doctor if one is available – or ask to see the practice nurse first, who can gently examine you. The nurse can then call in the doctor to assess you, if she feels this is necessary.
Dr Sarah Brewer, Prima
 

Help! I have dreadful dandruff

I get scaly clumps of dandruff on my scalp that fall off in patches. Why?

Dandruff is a form of seborrhoeic dermatitis that produces an itchy, scaly rash on the scalp. It is thought to be triggered by a hypersensitivity to a skin yeast, pityrosporum ovale. A wide range of shampoos and lotions are available containing anti-fungal agents, but in my experience the best is Nizoral (from pharmacies), which contains the anti-fungal agent ketoconazole. Use this regularly, as recommended. At the same time, try to reduce your body’s inflammatory response by increasing your intake of omega-3 fatty acids from oily fish and nuts.
Dr Sarah Brewer, Prima

 

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The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk