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Skin questions? Ask Professor Phelps

For years in my youth, I sunbaked and now I’m paying the price. I’m 70 and the spots vary in size and in colour from beige to grey to dark brown! It looks awful. Surely there is a solution?

There are various cosmetic techniques to remove pigmentation from sun-damaged skin. Options include topical peels, laser, IPL (intense pulsed light), dermabrasion and bleaching creams. A regular skin check for early signs of skin cancer will be essential for you too. One of our GPs can assess you and a cosmetic dermatologist can advise you on the best approach for your skin type.

Is there a way of treating keratosis pilaris?

It’s a common genetic condition where there are rough follicular spots, which may be skin-coloured, red or brown. It is usually on the upper arms, but can be on your back, thighs, cheeks and forearms. Use a non-soap cleanser and rub the affected area gently with a pumice stone or exfoliating sponge in the shower or bath. Then moisturise regularly. Topical retinoid creams may help.

I get terrible reactions to mosquito bites. The other day, my hand blew up and my wrist looked like a pie. I take an antihistamine, which does help with the swelling, but is there anything else I can do?

Some people do react to mosquito bites worse than others. The main strategy is to avoid being bitten, so make sure there are insect screens on your doors and windows, and wear long sleeves and pants when mosquitos are about. Eliminate standing water around your home. You can apply a mild hydrocortisone cream to the sting and take an antihistamine to calm down stronger allergic reactions.

How do I know if a painful rash on my side is shingles?

Shingles is caused by the varicella-zoster virus and is characterised by clusters of painful tiny blisters along the distribution of a nerve. It is caused by reactivation of the chickenpox virus. Pain can persist once the rash subsides. Definitive diagnosis is by a swab testing for virus in the fluid sampled from a blister. Get to your GP within 72 hours of the rash occurring to start treatment with anti-viral medication. Ask about a vaccine available for older adults.

I have white spots on my chest. Are these sun spots? Should I be worried?

White spots could be anything from vitiligo to pityriasis alba. It could also be fungal, dermatitis or sun-related. Obviously, it’s best for your GP to look at it.

I’m 33 and have a pimple on my face that won’t go away. It’s been there for a few weeks now. Is it likely to be skin cancer?

It might be a pimple or a sebaceous cyst. If you are concerned about a lump or a mole that has changed, or a sore that doesn’t heal, you need to see your GP to have it assessed and also have a general skin check.

I don’t sunbake and I protect myself from casual sun exposure, but I do have sunspots. Do I still need to get them checked regularly for skin cancer?

Check your own skin or have a friend do it every three months. Don’t forget tricky areas such as underarms, hands and feet, ears and scalp. An annual skin check with your GP is an important preventative measure. If any sunspots grow, change colour, or itch or bleed, see your doctor urgently. Skin cancer risk rises if you have fair skin, a history of sunburn, abnormal or irregular moles, a family history of skin cancer, weak immunity, or you are ageing. Your sun exposure in childhood has a delayed effect in later years.

I’ve read that having wrinkles on your face is a sign of thin bones. Is this true and, if so, what should I do about it?

Researchers at the Yale School of Medicine tested this theory on women within three years of menopause. They found that the firmer the skin on the face and forehead, the greater the bone density, and more wrinkles meant lower bone density. At this stage, it is just an observation, so bone density testing is still the best way to assess the risk of fracture from osteoporosis.

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