STRESS ECZEMA

Q Whenever I am under the weather I get terrible eczema on my body. Washing is uncomfortable and only dries it out further. do you have any suggestions for a gentle way to speed up the healing? D Brookes, Cambridge

DR DAN RUTHERFORD WRITES:

A Eczema, as you rightly point out, is primarily a dry skin condition and rehydrating the skin is a key part of treatment. the simplest moisturising creams are often as good as any of the expensive brand names – the main point is to use enough of them.

Try using emulsifying ointment as a soap substitute and aqueous cream as a moisturiser. be generous with both – they are cheap and available from any high street pharmacy. Skin surface bacteria play a part in eczema so preparations such as the Dermol range, which include a mild antiseptic, are a useful step up.

Although scratching gives temporary symptom relief it also triggers skin inflammation that then promotes the itch. Breaking this itch-scratch cycle may need more powerful preparations, including those containing steroids. Steroid creams can make a huge impact on eczema and many people are too shy of using them. when used sensibly they are perfectly safe.

GETTING OVER a COLD

Q Is it true that you should feed a cold and starve a fever? Sarah Crisp, via email

SARA STANNER WRITES:

A this saying probably came about simply because people who have a fever typically lose their appetite, while those with a cold, which usually does not come with a fever, do not. but it has been suggested that the loss of appetite may be a behavioural adaptation to alter the immune system in such a way as to fight bacterial infections (associated with fevers), while eating food has been shown to stimulate a localised immune response suited to fighting viral infections (colds are generally viral in origin).

The best thing to do when you have a fever or a cold is to drink plenty of fluids as the amount you need increases due to sweating or mucus production. if you aren’t hungry, then you shouldn’t worry about eating.

As long as you are drinking enough fluids, you should be fine without eating much for a few days (you could consider taking a multivitamin/mineral supplement for this time). but the immune system requires energy and micronutrients to function properly so don’t deny your body the nutrients it needs if you do still have an appetite.

ASPIRIN USAGE

Q What are your thoughts on taking aspirin daily? I know a few people who take it as a preventive measure and wondered if I, aged 50, should be doing the same. Michael R, via email

DR DAN RUTHERFORD WRITES:

A a very topical question. the benefits of low-dose aspirin for people who have had a heart attack or the commonest type of stroke (due to blood vessel blockage) are well established as they reduce the chance of having another of these attacks. What we still don’t know for sure is whether people who have no significant past medical history should take aspirin as a preventive.

There has been much publicity recently about the potential aspirin has to reduce bowel cancer risk. this information comes mainly from pooling the results of clinical trials of aspirin used to protect against cardiovascular diseases, so this is not the “average” population. the benefits appeared only after five years of aspirin intake – so it is no quick fix.

Most important is that we have no way of confidently predicting which people will get a significant stomach bleed from long-term aspirin use. Until we can do that, aspirin’s benefits will be demonstrable by statistics from experts taking an overview of large numbers of people, but it will remain difficult to know at the level of an individual person whether it is a good idea.

I think we are going in the direction of recommending low-dose aspirin for most people in midlife and beyond, but we are not there yet.

SECOND OPINION: DR JAMES LE FANU

Pregnancy flu fear

According to the usual official sources, we are now facing the prospect of “the worst flu outbreak in 10 years”. this time it is not the numbers that are apparently normal for this time of year, but rather allegedly the severity of the illness, warranting an admission to intensive care for the treatment of some cases of lung complications.

Britain’s chief medical officer, Professor Dame Sally Davies, has singled out pregnant women as being especially at risk and insists they should have the flu vaccine and be prescribed Tamiflu at the first sign of developing symptoms.

This might seem sensible. the flu, as we all know, is an illness best prevented or treated – with the implication that if such measures are “safe and effective” for pregnant women, so they must be for everyone else. And so they might be, but the “evidence base” to back it up is scarcely compelling. It is, after all, a wise precautionary principle based on the Thalidomide and similar tragedies that pregnant women should, in general, except in grave circumstances, avoid being immunised or taking medication lest it harms the developing foetus.

And although the flu vaccine reduces the incidence of complications in the elderly, it is mere conjecture to infer this can be extrapolated universally to pregnant women. they are entitled to know this.