From tiny spider veins to ‘hot’ red rash – NHS GP Dr Zoe Williams will see you now
THE weather has been a bit iffy considering it’s meant to be summer, but you should still make sure you are well-hydrated – especially if you are heading off on your holidays in sweltering southern Europe.
However, knocking back alcoholic drinks doesn’t count, and be careful with energy drinks too, which have been in the news lately, with a focus on their potentially dangerously high caffeine and sugar levels.
Most of us need six to eight glasses of fluid a day – but this can be significantly more in hot weather, if exercising or when pregnant or breastfeeding. The best way to hydrate is by drinking glasses of cool water and eating lots of foods that have a high water content.
Try adding watermelon, cucumber, courgettes, berries and peaches to your diet, which are all in season and will contribute to your five-a-day too.
Here’s a selection of what readers have asked me this week . . .
Q) I’VE noticed I’m getting tiny spider veins under my skin. What are they caused by and do I need to worry about them? They’re mainly on my chest.
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A) Spider veins — sometimes called thread veins — are small, damaged veins that appear as thin blue, purple or brown lines or branched webs, usually on the legs.
They are very common and are not usually cause for concern.
However, because yours are mainly on your chest, they may be spider telangiectasia. These tend to have a spider-like appearance, with a central red blob (the body of the “spider”) from which fine red lines (the spider legs) extend out.
You can test for them: if you press on the centre, the whole “spider” should disappear, and then when you release the pressure it will fill again from the centre outwards.
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About ten per cent of people will have a solitary spider telangiectasia and this is normal. If several of them arise, then this is worth flagging with your GP.
It can be normal, or caused by circulating oestrogen, which is increased in pregnancy, or by taking oral contraceptives, or in those with liver disease. Your GP may consider a blood test to check your liver.
Other signs or symptoms of liver disease include jaundice, red palms and bright white nails, or a past history of liver problems, hepatitis, or excess alcohol consumption.
Some people choose to pay privately for cosmetic treatments that get rid of them by permanently damaging the small blood vessels, usually with laser treatment.
Q) I HAVE a rash with small red dots on my arm, from bicep to wrist and above my eyebrows. It feels hot to touch. I used E45 cream, which helped a bit. I’ve had it for ten weeks but my doctor cannot see me till October.
A) The term to describe inflammation of the skin is “dermatitis”.
In fact any medical word ending with “itis” means inflammation.
Eczema is another word that also describes inflammation of the skin.
The most common causes of eczema are allergies or irritants.
Some people have atopic eczema, which means they have a tendency towards skin allergies from things such as animal fur or house dust mites.
Even cold weather can trigger eczema.
People with atopic eczema are more likely to also have asthma and hay fever. It usually starts in childhood and there is a tendency for it to run in families.
While the eczema can be anywhere, it often appears behind the knees, inside the elbows and around the face and neck.
There is another type of allergic dermatitis called contact dermatitis, where the skin gets inflamed in response to an allergic reaction that occurs when it comes into contact with an allergen (the thing causing the allergy).
Latex in rubber gloves, or certain chemicals in toiletries or cleaning products are examples of things that can cause this.
This type of allergy tends to affect the skin that has been in direct contact with the allergen the most. It is less likely to run in families and more likely to be present for the first time at a later age.
From the distribution of your rash I wonder if this is the most likely cause and whether the allergen could be something that you have used on your forearms — perhaps a new cream or perfume, or did you wear some long rubber gloves?
Do you have a tendency to touch your face above the eyebrows?
I’m wondering if you may have spread the allergen to that area this way?
I obviously cannot diagnose you based on the information available, but if it is a contact allergy, the treatment would be lots of emollient — such as E45 and a steroid cream.
It would be important to figure out the allergen to avoid it in future. Sometimes this is established with patch testing.
I’d suggest calling your GP back to see if you can email over some photographs of the rash, or ask if you can make an appointment with the nurse practitioner.
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You can also visit your pharmacy who will be able to advise you and supply emollients and mild steroid creams.
RAYNAUD'S IS CAUSING PAIN
Q) FOR the past two years my husband has suffered with Raynaud’s disease, which causes numbness and a cold feeling in some of his body areas.
He will be 80 in December and is very active for his age. He’s spoken to the doctor who has confirmed the condition.
We have silver socks and they do help.
However, in the hot weather he doesn’t want to wear them. When he doesn’t, he wakes up with pain in his toes.
Is there anything else he can use?
A) Raynaud’s is a condition that affects circulation.
Spasms of blood vessels happen in response to cold, stress, or emotional upset.
It’s usually the fingers and toes that are affected, although ears, nose, lips and nipples can be affected too.
The skin might turn white or blue as blood flow is restricted. In darker skin the area may appear more pale.
Your husband is already looking after himself by being active, which is fantastic – and using silver socks to reduce heat loss when appropriate is great.
A medication called nifedipine can help with the circulation, which your GP may consider.
For certain people with the condition, emotional stress can trigger it.
If your husband seems to be tense, try supporting him by recommending calming techniques, such as mindfulness.
Smoking can exacerbate this condition too. If he is a smoker, look into NHS stop smoking services.