SPENDING a lot of time in the garden at the moment?
Being outside in nature is incredibly good for your physical and mental health, but it can bring you up close with pollen, creepy crawlies and plants that may irritate or even burn your skin.
Dr Zoe Williams answers some health questions sent in by readers
There have been warnings to watch out for giant hogweed – which looks like a huge version of cow parsley – as it can burn, blister and cause lesions.
If you, or someone you’re with, has an adverse reaction after coming into contact with any plant – whether you know what it is or not – it is usually not serious.
But you should wash the area with warm, soapy water, cover it and, if concerned, speak to your GP or pharmacist or call NHS 111 for advice.
Here’s what readers asked me this week . . .
Q I AM a male aged 75 and have been on prescription drugs lamotrigine and primidone for many years.
However, I have heard that these tablets can lead to dementia. Could you clarify please?
A A 2018 study printed in an American journal suggested there was a link between some antiepilectic drugs and both Alzheimer’s and dementia.
Primidone was among the drugs that researchers found to be associated with a 20 per cent increased risk of Alzheimer’s and a 60 per cent heightened risk of dementia.
The researchers didn’t find any link between lamotrigine and dementia or Alzheimer’s.
While those figures sound scary, remember it’s just one study, and there are other studies that have more positive results.
Both of these drugs are primarily used to treat epilepsy, so I’m guessing that you have epilepsy or are prone to seizures, and your medical team has likely decided the benefits outweigh the risks for you.m
Often medications can cause side-effects, so as doctors we have to decide whether a better quality of life and living without seizures is worth the small increased risk of health conditions further down the line, so please don’t panic or worry.
The biggest risk factor for dementia is getting older. Among people 65-69, around two in every 100 have dementia. Risk then increases with age, roughly doubling every five years.
This means that, of those aged over 90, around 33 in every 100 people have dementia. If you’re concerned, make an appointment with your GP or specialist.
There are a lot of anti-epilepsy medications like vigabatrin, tiagabine, lamotrigine, gabapentin, levetiracetam, pregabalin and lacosamide that were found in the study not to increase risk at all.
Q MY husband has his hair cut very short and for the last six months or so he has had an intensely itchy scalp.
He saw the doctor, who couldn’t find anything wrong.
He tried itchy scalp shampoo and shampoo for psoriasis and dermatitis, which both helped for a while, then it came back.
He has been stressed recently, could this be causing it?
A CONDITIONS like eczema and psoriasis can affect the scalp — and stress can exacerbate them both.
There’s a possibility it could be a fungal infection, and symptoms of this can also be made worse by stress.
Fungal infections of the scalp will usually have scaling (flakiness) alongside the itchiness.
Ketoconazole shampoo is what we often recommend as a treatment for this. You can buy it over the counter so there’s no need for a prescription.
If this doesn’t work, then the next step might be for the GP to send off a sample of the scale or plucked-out hairs to the laboratory to identify the type of fungus.
Some types of more severe fungal infection of the scalp require a long course (several months) of oral antifungal medicine, and may mean blood tests to check liver function, as there is a rare side-effect of liver damage with these types of oral medicines.
I know you have spoken to your GP but I would also advise speaking to your pharmacist.
They are able to assist with these sorts of issues and can advise about other products they think might help.
The fact that the dermatitis and psoriasis shampoo helped does suggest it is possible it could be either of those conditions, too.
If his hair has always been longer, it could be a sensitivity to the sun’s UV rays for the first time and using SPF is important.
But if he has been using SPF for the first time, it could be an allergy or sensitivity to that.
If it doesn’t get better with the shampoo, I would suggest keeping a symptom diary and making another appointment with your GP.
Why do my fingers curl?
Q: PLEASE could you help identify what’s happened to my hand?
A: The pictures you sent suggest you have a condition called Dupuytren’s contracture.
It occurs when tissue in the palm thickens.
We don’t know why it happens or what causes it, but it has been linked to smoking, drinking lots of alcohol or having a family history of the condition.
Over time it causes one or more of the fingers to start curling in – as yours do.
There are a few options, the first being to do nothing.
If it’s not impacting on your daily life, you may decide to live with it for now.
You can change your mind later if it starts to affect your day-to-day existence.
The second option is a needle fasciotomy.
With a local anaesthetic on your hand, a needle is inserted along your palm and affected fingers, to loosen and then snap the thick tissue, allowing you to straighten the finger and giving you a better range of movement.
An open surgery fasciectomy occurs under local or general anaesthetic, when a cut is made along your palm and finger so the surgeon can remove the fibrous tissue.
Finally, a dermofasciectomy is the same as the above, but some skin is removed too – you’ll be given a skin graft from another part of your body.
It is usually carried out in people under 40 who have had a fasciectomy in the past.
There’s no cure for Dupuytren’s contracture, so after treatment, there is a chance it can return – in the same hand or the other one.
Your GP can help you decide what to do based on how much it affects your daily life.