I’ve a crimson, flushed complexion throughout my nostril and cheeks, and have seen it is a widespread situation, notably as folks become older. Is there any corrective motion to deal with it at dwelling earlier than going to see a specialist?
Norman Richards, Huddersfield.
What you describe is the widespread inflammatory pores and skin dysfunction, rosacea, which impacts the face, sometimes the nostril and cheeks (though it may possibly have an effect on different areas, even the eyes). It’s characterised by redness or flushing; usually the pores and skin additionally thickens and develops an irregular texture. In some circumstances it may possibly set off acne-like spots.
As a result of it’s a continual situation that can not be cured, and normally will get worse over time, it might appear to be it’s extra prevalent in older folks – however, the truth is, it may possibly develop at any age and is even present in folks of their 20s. These with truthful pores and skin and blue eyes are typically most in danger.
We don’t actually know what causes it: some specialists consider it’s attributable to abnormalities of the blood vessels within the face, with flushing brought on by extra blood provide within the space.
Rosacea is characterised by redness or flushing; usually the pores and skin additionally thickens and develops an irregular texture. In some circumstances it may possibly set off acne-like spots (File picture)
Others suppose the pores and skin’s immune system could also be at fault; the speculation is that it reacts to micro-organisms on the pores and skin, reminiscent of Bacillus olenorius or a mite referred to as Demodex folliculorum, and this response triggers irritation and spots.
Sure life-style elements could cause flare-ups: these embrace robust daylight, spicy meals, alcohol, stress, strenuous train and extremes of temperature.
Therapy choices accessible on prescription embrace antibacterial lotions or gels, reminiscent of azelaic acid or metronidazole; or brimonidine, which was initially designed to deal with glaucoma, however has been discovered to additionally scale back pores and skin redness (presumably by narrowing the blood vessels, and thus decreasing blood move to the face).
An alternative choice is a cream formulation of the drug ivermectin. That is an anti-parasite drug which is used to deal with headlice and has been discovered to additionally suppress Demodex mites.
There are some easy DIY measures you should use to sort out rosacea.
Sufferers with rosacea are likely to have very delicate pores and skin, and so it’s best to clean the face utilizing a non-soap, light cleanser and to keep away from toners, alcohol-based merchandise or harsh scrubbing.
When moisturising, use a light emollient – i.e. a medical moisturiser, reminiscent of Dermol 500 lotion – twice every day.
I have to stress that it’s best to see a specialist with a view to affirm any analysis — that is notably true for pores and skin situations.
A GP or dermatologist ought to normally be capable of inform if it’s rosacea rapidly and can prescribe an efficient therapy.
The muscle in my left arm has shrunk – it now begins 4in above the elbow and aches once I carry any weight. What is that this and may I be involved? I’m 74.
Gerrard Fields, Oakham, East Midlands.
From the outline in your letter, I ponder for those who might need ruptured the lengthy head of the bicep muscle.
The bicep is the big, thick muscle on the entrance of your higher arm. While you contract the biceps, your elbow flexes.
There are two heads to this muscle – ‘head’ refers back to the finish of a giant muscle the place it attaches to your bones.
The bicep is the big, thick muscle on the entrance of your higher arm. While you contract the biceps, your elbow flexes, writes Dr Martin Scurr (File picture)
The ‘lengthy’ head originates from a bony level within the shoulder joint socket; the ‘quick’ head attaches to a part of the shoulder blade.
Muscle groups are connected to the bones through tendons, that are bands of robust, fibrous tissue. The tendon that attaches the lengthy head of the bicep to the shoulder joint can typically spontaneously rupture, inflicting a part of the muscle to drop, making a painless ‘Popeye’ bulge in the midst of the entrance of the higher arm.
I consider this could be what you might be describing.
Such a rupture tends to happen because of age, overuse and in addition smoking – the precise mechanisms are unclear. Taking corticosteroids, an anti-inflammatory remedy, may also trigger deterioration of collagen, the primary structural protein of tendons.
It is a comparatively widespread drawback in older folks and, though normally painful at first, it may possibly happen with minimal discomfort.
Though the arm could also be barely weaker when lifting a weight, you say flexing the elbow just isn’t a significant drawback for you.
I counsel you search the opinion of a musculoskeletal physiotherapist to verify the analysis. Your GP might be able to refer you to a physio for workout routines to enhance the power and performance of your arm.
For my part… Working from dwelling means GPs can’t do important checks
In my expertise, sufferers at all times do higher when there may be continuity of care – therapy by one physician – and when consultations are held face-to-face.
So it’s very worrying that it’s now thought of appropriate and protected for GPs to make money working from home: diagnosing, treating and reviewing sufferers through video hyperlink or a telephone line. Just lately, it was reported {that a} GP was caring for sufferers within the UK from Athens, Greece – apparently sanctioned by the Common Medical Council (GMC), the regulator that imposes requirements.
Rules set by the exact same GMC state that ‘the place essential, the affected person have to be examined’.GPs working on-line will declare that if an examination is critical, this may be performed in the end, or by one other physician nonetheless on the follow web site.
However there are important observations, reminiscent of examinations of the lungs, coronary heart, stomach, ear drums, in addition to many minor, but legitimate checks, which might be integrated into any appointment, which make on-line consultations insufficient. Sufferers mustn’t merely be delegated to any medical skilled who is out there.
How this new permitted model of medical care could be considered acceptable, protected, efficient and reliable, is actually astonishing.
Write to Dr Scurr
Write to Dr Scurr at Good Well being, Day by day Mail, 9 Derry Avenue, London W8 5HY or e mail drmartin@dailymail. co.uk – embrace your contact particulars. Dr Scurr can not enter into private correspondence. Replies must be taken in a normal context and at all times seek the advice of your individual GP with any well being worries.
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