Tag Archives: Dr Patricia Thompson

Sun Damage – Short-Term and Long-Term Effects By Dr Kathleen Thompson

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Last time we discussed sunburn and sunscreens. But what if, despite all efforts, you get sunburned?

First reduce inflammation. Take anti-inflammatories (eg ibuprofen) and apply bland moisturisers. Cool the affected skin with wet cloths, and keep hydrated.  (Pure) aloe vera may help.

Vitamin E may reduce on-going skin-cell damage, which can continue even after sun-exposure. Burnt skin should be protected from further sun. If the burn is severe and covers a large area, or you feel unwell, you may need medical advice.

After several days, your skin will appear recovered, albeit somewhat browner. But this isn’t the end of the story. You will have some permanent damage, which will make your skin look older, and put you at more risk of skin cancer.

Sun UV is responsible for 80% of skin-aging – reduced elasticity (causing sagginess), skin texture changes, wrinkles, hyper-pigmentation and yellowish discolouration. A recent study has shown that regular sunscreens significantly reduce these effects.

More worrying, it is estimated that, in the UK, sun is responsible for 70-90% of the main skin cancers – malignant melanoma (MM), squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).

Intermittent severe (blistering) sunburn, particularly when young, is probably the major cause of MM. In fact, five severe sunburns between ages 15 to 20 years increase risk by 80%. Conversely, SCC and BCC are related to chronic long-term sun. Fair-skinned people are at greater risk as they have less protective melanin. Some people are also genetically susceptible.

Our immune system always attempts to remove damaged skin-cells, in order to prevent cancer, so any immunodeficiency increases risk. To help your immune system, eat plenty of fresh fruit and vegetables.

MM arises from melanocytes (melanin-producing cells). MM may look like a new mole, or a change in a pre-existing mole – such as increased size, irregular edge, colour changes, asymmetrical shape, itching, pain, bleeding or crustiness. Melanoma is aggressive, but can be cured if caught early, so do see your doctor if you notice any skin changes. It can develop from melanocytes anywhere – any skin and, rarely, even the eye.

MM is the most dangerous skin cancer, but BCC is the commonest (75%) and SCC is next commonest. Unlike MM, which can appear on skin anywhere, BCC and SCC generally develop on sun-exposed skin. Either may resemble a sore, which won’t heal, a reddish patch, sometimes with crusting or bleeding. BCC sometimes forms a shiny bump of various colours, or an irregular scar. SCC can look like a wart, or a raised growth with a central dip.

Most BCC and SCC can be removed successfully, but if ignored, they can invade deeply, causing serious disfigurement and sometimes can spread elsewhere in the body, particularly SCC.

The best solution is to avoid sunburn and prolonged sun exposure. However once the damage is done, do maintain a healthy immune system and watch your skin carefully for any changes, or odd lumps or bumps which won’t going away – early treatment can cure.

Further Information:

http://www.skincancer.org/prevention/sunburn/facts-about-sunburn-and-skin-cancer

http://www.cancerresearchuk.org/about-cancer/causes-of-cancer/sun-uv-and-cancer/sun-facts-and-evidence

Note: These articles express personal views. No warranty is made as to the accuracy or completeness of information given and you should always consult a doctor if you need medical advice

 

 

Sun Protection – Should We or Shouldn’t We? By Dr Patricia Thompson

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Each summer, work-weary, sun-starved Brits look forward to baking under a hot foreign sun, wearing nothing but a piece of lycra or two, and a thin layer of suncream.

But what are the facts about sunburn and sunscreens?

Sunburn has two components: The initial ‘burn’ is unpleasant enough, but the long term damage is more serious, including skin cancer and (quelle horreur) wrinkles and saggy skin.

Sunburn is caused by UVB ultraviolet light-waves. They also release free-radicles, which damage skin-cell DNA, and hence can cause skin cancer. On the plus side, they trigger late tanning.

UVA waves penetrate deeper. They tan (nice), but age the skin (bad), and also contribute to skin cancer (very bad).

A sun-tan is our skin’s natural sunscreen, but doesn’t prevent damage from prolonged sunbathing, hence the need for commercial sunscreens. These either form a barrier to, or absorb UV.

But which to choose?
Check the ‘Sun Protection Factor’ (SPF). SPF 15 delays burning by 15-fold (eg from 20 minutes to 5 hours) and filters 93% of UVB. SPF 30 delays burning  by 30-fold and filters 97% of UVB.

UVA protection uses a star system (1 to 5). This indicates protection relative to UVB, so 5 stars for SPF 15 is less than 5 stars for SPF 50. European labelling will change soon, to a simpler ‘Low’ to ‘Very high’.

You should apply at least 2mg/cm2 exposed skin. For those who don’t pack mini-scales and a planimeter with their beach-towels, this means the average adult needs around two table-spoons. Apply at least 20 minutes before sun exposure, and reapply 2 hourly, or after swimming/sweating/towelling yourself, even for water-resistant products. Some swimwear (Spinali Design) contain UV sensors to remind you, via your smartphone, when to reapply.

Some sunscreen ingredients have safety question-marks. Oxybenzone have oestrogen-like effects and retinyl palmitate causes cancer in rats (both, at high doses). Some sunscreens actually increase free-radicle release in the skin.

These safety concerns may not be material in practise, but, regardless, using sunscreens isn’t carte blanche for excessive sun-worship. They don’t give 100% protection, and limiting intense sun exposure, by wearing hats and sun-protective clothing is also necessary. Consider UV-filter sunglasses too, as UV can cause cataracts.

Our skin uses sunlight to make vitamin D, and excessive sunscreen use can interfere. Vitamin D may help prevent cancer. Although it is present in some foods, skin production is still important.

How about sun-tan alternatives? Tanning beds frequently expose users to even more UV than natural sunlight and should be avoided.

Many ‘self-tans’ use chemicals which react with skin protein, turning them dark. They’re probably safe, but can also enhance free-radicle production in skin, so you must use sunscreen after them.

The verdict? Do use sunscreen, and do enjoy the sun, but be sensible and stay safe.

Next time I’ll advise on treating sunburn, and discuss long-term effects of too much sun.

Further Information:

http://www.nhs.uk/Conditions/Sunburn/Pages/Introduction.aspx

https://www.aad.org/media-resources/stats-and-facts/prevention-and-care/sunscreen-faqs

Note: These articles express personal views. No warranty is made as to the accuracy or completeness of information given and you should always consult a doctor if you need medical advice

 

 

Meningitis By Dr Patricia Thompson

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A new vaccine, for Meningococcus B, will soon be available for babies. What, another vaccine? Do we really need it?

I would say – absolutely yes.

Meningococcus causes meningitis, and blood infection (septicaemia) – sometimes leading to limb amputation or brain damage. Approximately 1:10 people affected die.

As a paediatrician, I’ve seen healthy children become seriously ill within hours. Most recover, but, inexplicably, some don’t, and I’ve had to tell shocked parents that their child may not make it through the night.

Meningitis is an infection of the meninges – the thin protective layer covering the brain and spinal cord. It can affect any age, but predominantly under fives, and, particularly, under ones. Teenagers/young adults are also susceptible.

In the UK, it’s usually caused by a virus –and recover is generally complete. However bacterial meningitis is far more dangerous – and the Meningococcus bacteria, of which there are several strains, is the main culprit. It normally lives harmlessly in the nose and throat, but sometimes invades the blood, causing the illness.

The UK vaccination programme already protects against some meningitis types – the bacteria – Haemophilus, Pneumococcus, Meningococcus strain C, and the viruses – Measles and Mumps.

A new vaccine against Meningococcus A, C, W and Y will soon be offered to young adults, plus the new B vaccine for infants.

Meningococcal vaccines are between 85 -100% effective initially – much less so in young children. They are usually safe but can cause pain/redness, vomiting, headaches, drowsiness or irritability. Occasionally, allergic reactions, or, rarely, neurological problems may occur. Protection wanes over time, so teenagers are given boosters. However, vaccination reduces the number of people carrying the bacteria, thus reducing infection risk for the whole community.

If you think someone may have meningitis, look out for:

Headache, stiff neck, photophobia (dislike of bright light), vomiting, drowsiness or confusion and fever. The typical rash (called petechial) is red but doesn’t fade when pressed. It isn’t always present, but if you see it, you must seek medical help urgently.

symptonsof Meningitis By Dr Patricia Thompson

Sometimes, particularly youngsters, are so ill, that the classic signs aren’t obvious. The child may have a temperature, but, equally, may seem cold. They make look blue, cry incessantly (often high-pitched), refuse feeds, have convulsions or become unconscious. In young babies, their fontanelle (‘soft spot’) may bulge and feel tense.

It is important to treat rapidly. Antibiotics will kill the bacteria, but, if severe, intensive care may be necessary.

To give some perspective – approximately 3000 people will get bacterial meningitis/septicaemia in the UK this year. The incidence has decreased due to vaccination.

Knowing the signs could save a life. Always have a low index of suspicion – an unnecessary visit to A&E is far better than delayed treatment. I myself rushed my young son there, late one night. Embarrassingly, he made a miraculous recovery a soon as the doctor (my colleague) examined him – I did eventually live it down at work.

Further Information:

http://www.meningitis.org

http://www.nhs.uk/conditions/Meningitis/Pages/Introduction.aspx

Note: These articles express personal views. No warranty is made as to the accuracy or completeness of information given and you should always consult a doctor if you need medical advice

 

 

An Aspirin a Day Keeps Big C Away? By Dr Patricia Thompson

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doesasprinlowercancerriskDaily aspirin and cancer has been in the news again. So what does it all mean?

People have been investigating whether aspirin protects us against cancer for many years. The first few study results were confusing – some showed a beneficial effect – others didn’t. This is the problem – you often don’t get a clear answer until many thousands of people have been studied. However, a group of medical researchers from Queen Mary University, London, have analysed the results of a large number of clinical trials, involving over a hundred thousand people in total, and the evidence is now clear.  Taking 75-325mg aspirin daily (between a quarter and just over a full tablet) for at least five years, can reduce risk of getting certain cancers (particularly bowel cancer), heart attacks and strokes.

Before you dash out to the nearest pharmacy – I should explain that a small percentage benefit was seen after studying a very large number of people. Whether you, as an individual, would gain, depends on many factors, including your age, sex, what other medical conditions you have, and how prone you are to the types of cancers which seemed to show the most effect. Aspirin does have some serious side-effects, including gastric bleeding and bleeding into the brain, and you should always discuss with your doctor before taking long-term regular aspirin.

What is interesting though is why aspirin works – and are there other ways we can reduce our chances of cancer, without taking a tablet every day?

We know that inflammation is important in the development of cancer, and at least part of the reason why aspirin protects, may be its ability to suppress inflammation.

Inflammation is the body’s protective response to damage, and to invasion by infections, such as bacteria. Normally it is a good thing as it involves our immune system destroying and removing infective organisms and dead cells and promoting repair of the damaged tissues.

Cancer cells appear in our bodies on a fairly regular basis. Normally they are discovered and destroyed by cells of our immune system and never cause us any harm.

However sometimes cancer cells manage to avoid discovery. Then they can turn our normal beneficial inflammatory response against us, to help them grow and spread. They do this in various ways, for example using aspects of the inflammation to grow new blood vessels, which provide the tumour with a source of food and oxygen.

So, although short bursts of inflammation can be protective, long term inflammation is certainly not. In fact some chronic inflammatory illnesses are known to predispose us to cancer, for example, inflammatory bowel disease can lead to bowel cancer.

Is there any way we can damp down inflammation naturally, without resorting to tablets? Absolutely yes – the best way is probably diet. See the Table for examples of simple changes you can make.

In addition to cancer, reducing inflammation can also protect us from heart disease and joint disease. Worth making an effort eh?

 

Examples of foods which promote inflammation and suggestions for avoiding them:

1. High sugar foods eg sweets and cakes – switch to fresh fruit (whole – not juice)
2. Trans fats (fried food, margarine, processed foods) – switch to olive oil, flax oil)
3. Many ‘Ready meals’ – switch to fresh vegetables, garlic, Herbs
4. Red meat – switch to fish, particularly oily fish
5. Refined carbohydrate (white flour, white rice) – switch to whole grain bread, brown rice

 

‘These articles express personal views. No warranty is made as to the accuracy or completeness of information given and you should always consult a doctor if you need medical advice.’

 

 

 

Early Miscarriage by Dr Patricia Thompson

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miscarriage A miscarried pregnancy can be a devastating experience. The woman has already experienced pregnancy – nausea, swollen, tender breasts, just ‘feeling pregnant’.  The couple are sharing a cosy, exciting secret – visualising their anticipated offspring, they may well have chosen some names.

Then, abruptly, hopes are shattered. It can happen in several ways – sometimes there is bleeding, cramping pain, the woman may just not feel pregnant anymore, an ultrasound scan may show that the baby has stopped growing, or there is no heart-beat.

However it happens, both partners usually feel devastated.

And yet, approximately a fifth of pregnancies end as early miscarriages, meaning during the first three months. Sometimes the woman didn’t know she was even pregnant, just experiencing a ‘late period’, other times the couple are very aware, and can experience deep pain and loss.

The baby frequently has a serious genetic/chromosomal abnormality in these cases, and would have been incapable of surviving.

An early miscarriage is usually a one-off event, and the next pregnancy will be successful. However, if it happens during the first one, the couple may feel uncertain whether they can have a child. Nothing will convince them except a subsequent normal birth.

A few couples (around 1%) have recurrent miscarriages – defined as at least three in a row. Even then, three-quarters of these will eventually have a normal baby.

A few unfortunate couples may never succeed – possibly due to a particular genetic problem, but often a reason isn’t found, and it is very upsetting.

Late miscarriages – during the middle third of pregnancy, are less common (only one pregnancy in fifty), and may be due to illness in the mother, or womb or cervix abnormalities. Depending on the cause, treatment may be possible for future pregnancies.

So what if you have an early miscarriage? Firstly, nobody is to blame.  Too much exercise, stress, or having sex, for example, do not cause miscarriage. Healthy pregnancies are pretty resilient.

The pregnancy tissue may be lost naturally, through your vagina. However, the hospital may suggest removing any remnants, using a gentle vacuum under anaesthetic. This prevents possible infection, which can be serious, and could compromise future pregnancies.

The experience can impact both partners for a considerable time. The woman experiences physical changes, and both are affected emotionally. The man sees the distress of his partner, and feels he should be the strong one, and yet he is suffering too.

It is important to talk, and grieve together, and, if possible, to share with close friends and family. People can appear to forget very quickly, or don’t even know you’ve had a miscarriage. They expect you to be ‘back to normal’ and don’t always understand your continuing pain.

Specialists and groups are available should you experience difficulty in getting through the grief.

Importantly, don’t forget, if you have had a miscarriage, you are highly likely to have a successful pregnancy next time.

Useful information sites:

http://www.nhs.uk/conditions/miscarriage/Pages/Introduction.aspx

http://www.babycentre.co.uk/a252/understanding-miscarriage

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These articles express personal views. No warranty is made as to the accuracy or completeness of information given and you should always consult a doctor if you need medical advice.