A to Z of Medical Conditions

Leave a comment Posted on A to Z of Medical Conditions

Hirsutism – an overview

Bearded Lady Beats The Bullies

Bearded Lady Beats The Bullies

Hirsutism is excessive hair growth in certain areas of the body. It’s a problem that mainly affects women.

It’s relatively common, although some women may find it embarrassing or distressing to live with.

It’s often a long-term problem, but there are a number of treatments that can help keep it under control.

 

Symptoms of hirsutism

The excessive hair in hirsutism is usually thick and dark, rather than fine and fair.

It develops in areas where men often have hair, such as the:

face

neck

chest

tummy

lower back

buttocks

thighs

You may also have some additional symptoms, such as oily skin, acne, a deep voice, irregular periods or no periods at all.

When to see your GP

It’s a good idea to see your GP if you have hirsutism. They can look for any underlying cause and advise you about the treatments available.

Your GP may:

examine the areas of excess hair growth

ask about any other symptoms

ask about your medical history, such as whether you’re taking any medication

carry out a blood test to check your hormone levels

Depending on what your GP thinks may be causing your symptoms, they may treat you themselves or you may be referred to a specialist.

Treatments for hirsutism

Treatment for hirsutism usually involves techniques to remove the excess hair and treatment to help slow its growth or stop it coming back.

The main treatments are:

home hair removal methods – such as shaving, plucking or waxing

specialist hair removal treatments – such as laser hair removal

eflornithine cream – a prescription cream that can help slow down the growth of facial hair

oral contraceptives, including co-cyprindiol tablets – a type of contraceptive pill available on prescription that can help prevent excess hair growth

It may take a few months to notice the effects of treatment, so it’s important to persist with it. In many cases, treatment will need to be continued indefinitely.

Read more about the treatments for hirsutism.

Causes of hirsutism

Hirsutism is caused by an excess of male hormones called androgens in your body, or by your body being more sensitive to these hormones.

In many cases, it’s not clear why this happens. Some women just seem to develop extra hair growth as they get older, particularly after the menopause.

In younger women, the most common cause is polycystic ovary syndrome (PCOS), a condition that can cause irregular periods and fluid-filled sacs (cysts) on the ovaries.

Less common causes of hirsutism include:

Cushing’s syndrome – a hormonal disorder that causes sudden weight gain and bloating around the face and neck

congenital adrenal hyperplasia – an inherited condition affecting the adrenal glands, the glands above the kidneys that produce hormones

obesity – losing weight may help improve the symptoms in these cases

acromegaly – a condition in which the body produces too much growth hormone

medicines – such as anabolic steroids, used by some people to build muscle and improve athletic performance

a tumour (growth) – that increases the production of androgens and usually affects the ovaries or adrenal glands

Leave a comment Posted on A to Z of Medical Conditions

Halitosis – treating and preventing bad breath

Halitosis

Halitosis

Treatment for bad breath (halitosis) will depend on its cause.

Usually, the most effective treatment is improving your dental hygiene. As part of your daily routine, you should:

floss between your teeth

brush your teeth and gums

clean your tongue

You may want to consider investing in an electric toothbrush, which can make cleaning easier and more effective.

Cleaning your teeth

Your dentist will probably recommend that you brush your teeth at least twice a day using fluoride toothpaste.

Below are some tips on how to brush your teeth and keep your mouth healthy. You should:

use dental floss to clean between your teeth and remove trapped food that could cause tooth decay – brushing on its own only cleans about 60% of the tooth’s surface

choose a small or medium-sized toothbrush with soft, multi-tufted synthetic bristles

replace your toothbrush every three to four months

brush your teeth for at least two minutes – you could keep a toothbrush at work or school so you can brush your teeth after lunch

brush all areas of your teeth, paying particular attention to where your teeth and gums meet – your dentist or oral hygienist may recommend using a special single-tufted brush for specific problem areas of your mouth

use a separate toothbrush or a tongue scraper to lightly brush your tongue – some toothbrushes have a tongue cleaner on the back of the brush head

avoid brushing your teeth for 30 minutes after drinking an acidic drink, such as fruit juice, or eating acidic fruit, such as oranges, to help prevent tooth abrasion

Your dentist may recommend that you rinse your mouth daily using an antibacterial or anti-odour mouthwash. This shouldn’t replace brushing, but can be included as part of your daily routine.

Read more about dental health and how to keep your teeth clean.

Cleaning dentures

If you wear dentures, you should take them out at night to give your mouth a chance to rest. Clean your dentures thoroughly before putting them in the next morning:

don’t use toothpaste to clean your dentures as it can scratch the surface and cause stains

clean your dentures thoroughly using soap and lukewarm water, denture cream, or a denture-cleaning tablet

use a separate toothbrush to clean your dentures

Your dentures should stay clean and fresh if you follow this routine. It will also help prevent the build-up of plaque, which can cause bad breath.

Fresh breath tips

To help keep your breath fresh, you should:

give up smoking

eat a healthy, balanced diet and avoid eating strongly flavoured or spicy food

cut down on sugary food and drink as it can increase the amount of bacteria in your mouth

reduce your alcohol consumption

cut down on coffee

drink plenty of water to help prevent your mouth becoming dry

chew sugar-free gum after eating to stimulate the flow of saliva – this will help clean away any remaining food particles

You should visit your dentist for regular check-ups. Having regular dental check-ups will ensure any plaque and calculus – previously known as tartar – is removed from your teeth, particularly in areas that are difficult to reach.

Your dentist can recommend the best way to clean your teeth and gums, and point out areas you might be missing. They can also identify any signs of gum disease and ensure early treatment.

Gastrointestinal problems

Bad breath can be caused by a gastrointestinal problem, such as an H. pylori infection or gastro-oesophageal reflux disease (GORD). You may be referred to a gastroenterologist.

The treatment recommended will depend on the type of gastrointestinal condition you have. For example, if you have a stomach ulcer, you may need a combination of two or three different antibiotics and a proton pump inhibitor (PPI). This is known as eradication therapy.

Leave a comment Posted on A to Z of Medical Conditions

Itching – what are the best treatments for itching?

Itching

Itching

The best treatment for itching depends on the cause. You may be able to relieve itching and reduce the risk of skin damage caused by scratching with some simple self-help measures.

If necessary, your GP or pharmacist can offer treatments that may help relieve an itch.

General tips

keep your nails clean, short and smooth

try patting or tapping the itchy area, rather than scratching it

wear cotton gloves at night to prevent damage from scratching in your sleep

hold a cold compress, such as damp flannel, over the affected area to cool it down

avoid spicy foods, alcohol and caffeine, as these can affect the blood flow in your skin and make itching worse

Bathing

use cool or lukewarm water, rather than hot water

keep baths to less than 20 minutes

try to reduce how often you have a bath or shower if possible

avoid using perfumed soap, shower gel or deodorants; unperfumed substitutes are often available from pharmacists

use unperfumed moisturising lotions and emollients after bathing or showering to help prevent your skin becoming too dry

dab or pat your skin dry, rather than rubbing it

Clothing and fabrics

avoid clothes that irritate your skin, such as wool and some man-made fabrics

wear cotton or silk whenever possible

avoid tight-fitting clothes

use mild laundry detergent that is less likely to irritate your skin

use cool, light, loose bedclothes

Medication

Some lotions, creams and etc available over the counter from pharmacies or on a prescription from your GP can help reduce itchiness.

Common treatments recommended include:

an oily moisturiser or emollient if your skin is dry or flaky

creams containing menthol to cool your skin or anti-itch ingredients such as crotamiton

mild steroid cream (usually for only a few days) for small inflamed areas – hydrocortisone cream is available from pharmacies over the counter, or your GP can prescribe a steroid cream for you

AH  to help control allergic reactions – check with your pharmacist or GP before using these as they are not suitable for everyone

Some AH tablets can make you feel drowsy. This may be helpful if taken at night to help you sleep, but it’s important not to drive, use power tools or operate heavy machinery after taking them.

If you have itching in hairy areas like your scalp, lotions are available specifically for these areas so you don’t have to use sticky creams.

 

Leave a comment Posted on A to Z of Medical Conditions

Non-alcoholic fatty liver disease (NAFLD) – what you need to know

Non-alcoholic fatty liver disease warning signs

Non-alcoholic fatty liver disease warning signs

Non-alcoholic fatty liver disease(NAFLD) is the term for a range of conditions caused by a build-up of fat in the liver. It’s usually seen in people who are overweight or obese.

A healthy liver should contain little or no fat. It’s estimated that up to one in every three people in the UK has early stages of NAFLD where there are small amounts of fat in their liver.

Early-stage NAFLD doesn’t usually cause any harm, but it can lead to serious liver damage, including cirrhosis, if it gets worse. Having high levels of fat in your liver is also associated with an increased risk of problems such as diabetes, heart attacks and strokes.

If detected and managed at an early stage, it’s possible to stop NAFLD getting worse and reduce the amount of fat in your liver.Stages of NAFLD

NAFLD develops in four main stages.

Most people will only ever develop the first stage, usually without realising it. In small number of cases it can progress and eventually lead to liver damage if not detected and managed.

The main stages of NAFLD are:

simple fatty liver (steatosis) – a largely harmless build-up of fat in the liver cells that may only be diagnosed during tests carried out for another reason

non-alcoholic steatohepatitis (NASH) – a more serious form of NAFLD, where the liver has become inflamed; this is estimated to affect up to 5% of the UK population

fibrosis – where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function normally

cirrhosis – the most severe stage, occurring after years of inflammation, where the liver shrinks and becomes scarred and lumpy; this damage is permanent and can lead to liver failure (where your liver stops working properly) and liver cancer

It can take years for fibrosis or cirrhosis to develop. It’s important to make lifestyle changes to prevent the disease from getting worse.

Am I at risk of NAFLD?

You’re at an increased risk of NAFLD if you:

are obese or overweight – particularly if you have a lot of fat around your waist (an “apple-like” body shape)

have type 2 diabetes

have high blood pressure

have high cholesterol

are over the age of 50

smoke

However, NAFLD has been diagnosed in people without any of these risk factors, including young children.

Although it’s very similar to alcohol-related liver disease (ARLD), NAFLD isn’t caused by drinking too much alcohol.

Symptoms of NAFLD

There aren’t usually any symptoms of NAFLD in the early stages. You probably won’t know you have it unless it’s diagnosed during tests carried out for another reason.

Occasionally, people with NASH or fibrosis (more advanced stages of the disease) may experience:

a dull or aching pain in the top right of the tummy (over the lower right side of the ribs)

fatigue (extreme tiredness)

unexplained weight loss

weakness

If cirrhosis (the most advanced stage) develops, you can get more severe symptoms such as yellowing of the skin and the whites of the eyes (jaundice), itchy skin, and swelling in the legs, ankles, feet or tummy.

Read more about the symptoms of cirrhosis.

How NAFLD is diagnosed

NAFLD is often diagnosed after a blood test called a liver function test produces an abnormal result and other liver conditions, such as hepatitis, are ruled out. However, blood tests don’t always pick up NAFLD.

The condition may also be spotted during an ultrasound scan of your tummy. This is a type of scan where sound waves are used to create an image of the inside of your body.

If you’re diagnosed with NAFLD, further tests may be needed to determine which stage you have. This may involve a special blood test or having another type of ultrasound scan (Fibroscan). Some people may also need a small sample of liver tissue (biopsy) taken using a needle to have it analysed in a laboratory.

Treatment for NAFLD

Most people with NAFLD won’t develop any serious problems, but if you’re diagnosed with the condition it’s a good idea to take steps to stop it getting any worse.

There’s currently no specific medication for NAFLD, but making healthy lifestyle choices can help and treatment may be recommended for associated conditions (high blood pressure, diabetes and cholesterol) or complications.

You may be advised to have regular appointments with your doctor to check your liver function and look for signs of any new problems.

Healthy diet and lifestyle

Adopting a healthy lifestyle is the main way of managing NAFLD. The following can all help:

Lose weight – you should aim for a BMI of 18.5-24.9; use the BMI calculator to work out your BMI. Losing more than 10% of your weight can remove some fat from the liver and improve NASH if you have it.

Eat a healthy diet – try to have a balanced diet high in fruits, vegetables, protein and carbohydrates, but low in fat, sugar and salt. Eating smaller portions of food can help too.

Exercise regularly – aim to do at least 150 minutes of moderate-intensity activity, such as walking or cycling, a week. All types of exercise can help improve NAFLD, even if you don’t lose weight.

Stop smoking – if you smoke, stopping can help reduce your risk of problems such as heart attacks and strokes.

NAFLD isn’t caused by alcohol, but drinking may make the condition worse. It’s therefore advisable to cut down or stop drinking alcohol. Read some tips on cutting down on alcohol.

Medication

There isn’t currently any medication that can treat NAFLD, but various medicines can be useful in managing the problems associated with the condition.

For example, your doctor may recommend medication to treat high blood pressure, treat high cholesterol, treat type 2 diabetes and/or treat obesity.

Liver transplant

If you develop severe cirrhosis and your liver stops working properly, you may need to be put on the waiting list for a liver transplant.

For adults, the average waiting time for a liver transplant is 145 days for transplants from recently deceased donors.

Alternatively, it may be possible to have a transplant using a section of liver removed from a living donor. As the liver can regenerate itself, both the transplanted section and the remaining section of the donor’s liver are able to regrow to a normal size.

Read more about liver transplants.

Leave a comment Posted on A to Z of Medical Conditions

Erythromelalgia – do you know the signs?

Erythromelalgia: This 77-year-old woman with longstanding polycythemia vera had a six-month history of increasingly prolonged bouts of redness, swelling, and burning pain in her extremities. The severity and sites of involvement varied with each episode. At presentation, she was unable to ambulate without assistance. by Herbert L. Fred, MD and Hendrik A. van Dijk - http://cnx.org/content/m14932/latest/

Erythromelalgia: This 77-year-old woman with longstanding polycythemia vera had a six-month history of increasingly prolonged bouts of redness, swelling, and burning pain in her extremities. The severity and sites of involvement varied with each episode. At presentation, she was unable to ambulate without assistance.
by Herbert L. Fred, MD and Hendrik A. van Dijk – http://cnx.org/content/m14932/latest/

Erythromelalgia is a rare disorder that causes episodes of burning pain and redness in the hands and feet, and sometimes the arms, legs, ears and face.  

Cooling the skin or raising the affected hands or feet may reduce the pain.

Symptoms can begin at any age. Some people with erythromelalgia may have had it from early childhood, while some are just affected in adult life.

How severe can it be?

People with erythromelalgia typically suffer episodes or flare-ups of severe pain lasting from a few minutes to days.

Flare-ups usually start as an itching sensation, which worsens to a severe burning pain and tender, mottled red skin.

The hands and feet are most commonly affected, usually on both sides of the body, but erythromelalgia can also affect the arms, legs, ears and face.

The pain can be severe enough to make walking, standing, socialising, exercising and sleeping difficult. It can have a significant impact on work or school life.

What are the triggers?

Symptoms are usually triggered by an increase in body temperature.

They can start after exercising, wearing warm socks, gloves or tight shoes, entering a warm room, being dehydrated, or even consuming alcohol or spicy food.

What is the cause?

For most people with erythromelalgia, the cause is unknown.

However, in some cases, an underlying cause may be found – usually a medical condition or a faulty gene (see below).

Underlying disease

Erythromelalgia sometimes results from an underlying disease, such as:

having abnormally high levels of blood cells – either having too many platelets in the blood (thrombocythemia) or too many red blood cells (polycythaemia)

damage to the peripheral nervous system – the network of nerves outside the brain and spinal cord (this damage is known as peripheral neuropathy)

multiple sclerosis (MS) – a disease of the nerves in the brain and spinal cord

an autoimmune problem – such as lupus or rheumatoid arthritis, where the immune system attacks the body’s own tissues

It may also result from certain medications, such as verapamil or nifedipine.

Genetic cause

In some people with erythromelalgia, the disease is caused by a change (mutation) in a gene. This may have occurred spontaneously or been inherited from a parent, meaning that erythromelalgia can run in the family.

Genes contain the genetic information, or the “instructions”, to make a particular protein in the body. Genetic mutations occur when DNA changes, altering the genetic instructions.

Erythromelalgia can be caused by changes in the SCN9A gene that provides the instructions for a sodium channel in pain nerves.

Changes in sodium channels can lead to them opening more easily and staying open longer than usual. This increases or amplifies pain signals.

It is not currently understood why the hands and feet are affected the most.

Can it be treated?

Cooling the skin and elevation

Cooling the skin with a fan or cold water, or raising the affected hands or feet may relieve the pain.

However, using ice or soaking the hands or feet for long amounts of time isn’t recommended, as this can lead to hypothermia or damage to the skin, causing ulcers.

There’s also a risk that the change in temperature will trigger a reactive flare-up when the hands or feet are removed.

Even though a cool environment is helpful in reducing pain during attacks, the use of cold baths or showers is generally discouraged because of potential skin damage.

Your doctor will discuss treatment options with you, as this will also depend on the type or erythromelalgia you have. Many treatments require referral to a specialist centre so that benefits and potential side effects can be closely monitored.

Products used for other types of nerve pain may reduce symptoms.

Products used for high blood pressure or Raynaud’s disease can encourage the blood vessels to widen, and may be beneficial in some types of erythromelalgia.

In adults, aspirin may relieve symptoms if the cause is an abnormally high number of blood cells (aspirin is not recommended for children).