Q&A with Dr Chris Steele
Dr Chris Steele joined us in November 2011 to answer your questions about skin problems. He responded to queries on everything from severe psoriasis and stretch marks to scars and blemishes.
Dr Steele qualified as a doctor in 1968 and has worked as a GP in South Manchester since 1970. He has been the resident doctor on ITV's This Morning for the last 23 years and was voted Health Journalist of the Year in 2007.
Q. Melaragusa: My son is 12 and I notice he is starting to get a few spots. I suffered acne as a teenager myself and it blighted my life at the time and probably damaged my confidence in my self-image for ever. Eventually, I took a low dose of antibiotics which sorted it out.
I don't want my son to go through the same. Is there anything that can be done at the onset of teenage acne to at least reduce/control it? All those paint stripper-type anti-acne products never helped. Or maybe there are better products these days?
A. Dr Steele: Your son is one of thousands who will get acne. He's changing from a child to a young man, but at that stage of your life your appearance is so important - hair, clothes, appearance and skin. Nature can be cruel to cause acne at such a sensitive stage of development. I had severe acne so I do understand what he, and you are going through. Personally, I would treat him with antibiotic tablets, which unfortunately will take about 12 weeks to really 'kick in' and have an effect. He must talk to his GP, and not think that his skin problem is not important enough to take up his doctor's time. Both my son's inherited my acne and actually found the Oxy range of products useful, as well as taking their antibiotic tablets.
Q. Madhairday: My 11-year-old daughter has severe Guttate psoriasis on her body and also scalp psoriasis. Sometimes it's so bad it bleeds. We have been prescribed a number of different lotions, creams and shampoos, including steroid creams. Some have been more effective than others, but we have not yet found the 'one' which really clears it or even helps long term. She sees a dermatologist but hasn't been prescribed any further treatment as yet. What would you advise?
A. Dr Steele: Psoriasis is an unpleasant skin condition to have, especially for a little girl. It is also very difficult to treat and I know you say that she is under a dermatologist, who will be far more experienced than me, a mere GP, in treating this condition. But why don't you ask the specialist if he has tried all of the following in attempt to control the condition. This is a list of the various types of treatments used in psoriasis: coal tar preparations, dithranol, immunomodulators, retinoids, Vitamin D analogues and a light therapy called PUVA. Her young age will also influence what types of treatment she can and cannot use.
Q. Stockett: My daughter (two) has molluscum contagiosum on her face and torso, she's had it for ages (at least 12 months) and its getting worse, not better. I understand there's nothing that can be done so we're waiting it out and it's horrible. However, every now and then one of the spots goes brown, shrivels up and drops off, leaving a slightly raised area which is skin coloured and stays for months.
My question is, is it possible that the brown shrivelling spots are something else, and if so, what might that be?
A. Dr Steele: Molluscum contagiosum is a harmless viral infection causing pearly white shiny tiny lumps on the skin. Children are more commonly affected than adults, where the little lumps appear on the face, inside of the thighs and even on the genitals. Most usually clear up in a few months and may leave a small shrivelled spot, which in time usually fades and clears. Of course, if you are still worried ask your GP about possibly seeing a dermatologist.
Q. Googietheegg: I'm 13 weeks pregnant and have been getting acne spots in my hair and around my hairline (thankfully not on my face). What can I do/use to help?
A. Dr Steele: These acne-type spots in your skin are the result of the hormonal changes occurring in your body due to your pregnancy. Use any of the popular over-the-counter acne products, especially those that reduce skin greasiness and use a shampoo that's intended for greasy hair as well. Do not take any acne tablets or for that matter any other oral medications, unless they are safe in pregnancy. An old wive's tale is acne in pregnancy means it's a boy!
Q. Yourmother: I have keratosis pilaris, it's especially a problem on my upper arms but has worsened during and after pregnancy. It isn't painful, just unsightly. Is it worth bothering my doctor, is there anything he/she can prescribe or should I just grin and bear it? What home remedies could I try?
A. Dr Steele: Keratosis pilaris is a common skin condition where a protein in the skin, keratin, forms hard plugs in the hair follicles. It's harmless, and often disappears with age. It's more common in those with a very dry skin or those with eczema. In mild cases, small bumps, like goose bumps, appear on the backs of the upper arms in particular, and sometimes on the buttocks and thighs. There's no need to bother your doctor because you can try my tips:
- Take a good quality Omega 3 fish oil supplement eg Ideal Omega 3, on a regular daily basis.
- Use a good moisturising product such as Bio-Oil, two to three times a day, massaging it well into the affected skin.
Now I realise this is a Bio-Oil sponsored item, but I'm not recommending the product for that reason. The ingredients of Bio-Oil have a strong penetrating effect and do produce a noticeable smoothing effect, in conditions similar to yours. Other strong moisturisers, such as emollients mentioned for eczema, may also help.
Q. GrownupSparkler: With my first pregnancy I gained a lot of weight, in part due to gestational diabetes. This left me with a lot of stretch marks all over my torso and thighs, some of which got to the point of splitting and bleeding because they couldn't take the strain. I have lost a lot of the weight but the stretch marks seem to be scarred and not fading. Is there anything I can do because I have lost my confidence in my body and it's affecting my relationship.
A. Dr Steele: Let me reassure you that you are not alone! Fifty per cent of women have stretch marks, but do they talk about it? No! Many suffer low self-esteem and loss of self-confidence. Many try to hide their stretch marks from friends, family and even their partners. New relationships become nightmares once intimate situations arise. Choosing clothes and beachwear are governed by stretch marks.
You must look at the stories of other women in the 'Skin Stories' campaign, and share your experiences with them. A problem shared is a problem halved - by telling your experiences with other women, you dilute the problem. Have a look at www.facebook.com/biooiluk.
Q. Madlizzy: My husband has recurring eczema on his feet. It is exacerbated by stress. It gets infected and very painful. He is generally given Fucibet and Double Base to deal with it, plus uses oil in the bath. Is there anything else that would help prevent flare-ups? He gets really fed up with it.
A. Dr Steele: The answer to eczema is to keep the skin well moisturised. Frequently applying emollients (strong moisturisers) such as E45 cream, bath oil and wash cream will help. There is a huge selection of emollients, and he may have to find one that does not contain chemicals known as skin sensitisers. His socks should be cotton - not wool or artificial fibres, and avoid using strong detergents when washing his socks. After applying an emollient cream he should try wrapping his feet in cling film overnight - that way the cream is absorbed more efficiently into his skin and won't rub off onto the bedding. Unfortunately, stress does make many skin conditions worse.
Q. Playday:I have been diagnosed with a condition called livedo reticularis. I have it on my feet and knees and it is slowly spreading and is quite painful, so I wear support bandages. Can you give me any advice on how to ease the condition or get rid of it completely. I have had it almost a year and no-one in the medical field seems to be able to offer any solutions to date.
A. Dr Steele: Your condition, livedo reticularis, is quite a common skin condition causing a mottled pattern like a lace-like purplish discoloration of the lower extremities, legs, knees and feet. It is usually a completely benign (safe) condition that mostly affects young women during the winter months. The discoloration is caused by swelling of the medium-sized veins making them more visible.
Unfortunately, it can be caused by so many other different medical conditions, relating to blood disorders, heart diseases, hormone disorders and joint disorders. As you will know, it is aggravated by the cold, so keeping the legs and feet warm is important, especially at this time of the year. Unfortunately, I cannot tell you how to get rid of it completely. Have you asked to be seen by a specialist for further help?
Q. RubyrooUK: I have fertility issues and when I don't ovulate, my skin feels enormously dry and scaly. No moisturiser sorts it out. Any advice for how to deal with this?
A. Dr Steele: Follow the advice I gave earlier to the eczema sufferer - applying lots of moisturisers every day. Bio-Oil has an excellent reputation in moisturising the skin without leaving any 'greasy' feeling, but again you should be using it two to three times a day every day.
Q. Moltisanti: I have had acne since I was 13. It's worse around the time of my period, but generally I always have some spots, blackheads, white heads and red patches. I have tried the Pill, I have tried gentle products on my skin too, but I can never get rid of them. I feel like the world's longest acne sufferer! Is there anything you can suggest?
A. Dr Steele: I don't know your age, but any woman who has acne beyond her mid-20s could have PCOS, which is PolyCystic Ovary Syndrome. Normal acne products don't do much because this is a hormonal problem caused by cysts on the ovaries. The main signs of PCOS include acne, greasy skin, irregular periods, excess facial hair, weight gain, irregular periods and fertility problems. Ask your GP about the possibility of PCOS, because there are thousands of women out there with this condition - undiagnosed!
If your GP refers you to a specialist, either an endocrinologist (hormone expert) or gynaecologist, and PCOS is diagnosed, usually with blood tests and a scan on your ovaries, most of your problems will be cleared by medication. It could transform your life, your figure and your facial acne.
Q. BleedyGhoulzombiez: Dr Steele, do you genuinely think Bio-Oil is any good? I tried it for a total of six months (in two three-month bouts) and found it to be completely ineffective at tackling the skin problems it claims to improve. I know you can't really answer this question as they're sponsoring you, but I am surprised that a doctor would align himself with such a poor quality product.
A. Dr Steele: Please don't ever think that I would align myself with any poor quality product, because my reputation is vital. I've been a TV GP for 24 years and I am very careful in associating myself with any product. I rarely endorse any product, unless there is clear scientific evidence that shows the product to have beneficial effects.
I can reassure you that the research behind Bio-Oil does not claim that it will remove scars or stretch marks, and be very wary of the many products out there that do make such claims. Stretch marks affect nearly 50% of women, either through rapid growth in adolescence, rapid weight gain or pregnancy (the commonest cause). Nothing will prevent or make stretch marks disappear, but their appearance can be improved upon.
The use of Bio-Oil has shown that it can reduce the severity of stretch marks, but also keep in mind that every patient is different and responds in different ways to the same product.
What works well for some patients may have disappointing results in others, even with the thousands of standard, well-researched medications and even surgical operations used by the medical profession.
Q. Paulaplumpbottom: I grew up in Florida and in my teens/early 20s was really stupid about sun exposure. I now have loads of sun damage and a great deal of moles. I think my GP is sick of me going to him to look at this mole or that one. What sort of moles should really concern me?
A. Dr Steele: You are in the right, because you are at increased risk of getting skin cancer. I have had skin cancer twice, once on my cheek and once on my back - both due to overexposure to sunlight when I was younger. In those days, we just didn't know the dangers of UV radiation (sunlight).
So continue to be a 'mole watcher' and look for any change in a mole eg change in size, shape, colour or outline. Does the mole itch or bleed? Are there different shades of colours in any mole? Also any other changes on your skin (apart from the moles) that have been exposed to sunlight must be reported to your GP. I think you should ask to be checked out by a dermatologist, because you are obviously at high risk of skin cancer. There are private mole clinics, out there - just Google them.