By Paul G. Donohue M.D. February 03, 2011 12:00 AM

DEAR DR. DONOHUE: will you please do a column on dementia and address its various symptoms and treatments?

“Dementia” is a word that encompasses many conditions, all of which have in common a deterioration of mental functioning. Memory loss so profound that close relatives and friends become unrecognizable, an inability to perform simple arithmetic skills like balancing a checkbook, becoming lost in familiar places, struggling to express oneself with the right words, the incapacity to deal with unexpected situations and, in the extreme, a descent into infantilism, where people cannot dress or feed themselves, are all elements of dementia.

Personality changes also are common.

Alzheimer’s disease accounts for 60 percent to 80 percent of dementias. other dementing illnesses are Lewy body dementia, frontotemporal dementia, vascular dementia (dementia caused by a series of small strokes) and Creutzfeldt-Jakob disease. this is only a partial list.

Medicines for each particular dementia vary. Aricept, Razadyne and Exelon are three used for Alzheimer’s disease. They’re not cures. they increase the brain level of acetylcholine, a chemical messenger involved in the transmission of information from one brain cell to another. A fourth Alzheimer’s drug is Namenda. it prevents an overstimulation of brain centers that can prove toxic to brain cells. these drugs are sometimes used in other dementias.

Medicines that address certain problems unique to a particular dementia also are available. Again, none is a cure. Medicines for anxiety, panic and personality disorders frequently have to be given.

For every case of dementia, doctors have to look for the few curable causes of it — brain tumors, brain infections and conditions like normal pressure hydrocephalus.

DEAR DR. DONOHUE: I would like some information on genital herpes. I heard that there is no known cure and that it is easily spread and is widespread.

What you heard is true. Genital herpes is easily spread and is widespread. no cure exists, but suppression of outbreaks is possible. the possibility of spread is greatest when there’s a visible outbreak. However, even when an outbreak has not occurred, spread is possible. Condom use reduces the risk.

If recurring outbreaks are numerous, they can be suppressed by Zovirax (acyclovir), Famvir (famciclovir) or Valtrex (valacyclovir).

Herpes isn’t the end of life or of intercourse. Infected people can have children.

DEAR DR. DONOHUE: my problem might be unique. I am an 85-year-old man, active and employed in white-collar work. I have pimples on my neck, shoulders, chest and nose. I had them as a young man too. To control this blight, I wash these areas thoroughly with soap and water, and often apply alcohol. my doctor put me on testosterone a few months ago. I also take lisinopril, simvastatin, Trilipix, Plavix and get B-12 shots. Could any of these medicines be involved?

Testosterone can lead to pimples. Did you have them before you started treatment with it? And B-12 is another possibility. that surprised me.

Don’t scrub the skin; it makes matters worse. Wash with a gentle cleanser like Dove or Cetaphil skin cleanser. In all drugstores, you’ll find acne medicines containing benzoyl peroxide. some names are Clearasil, and benzoyl peroxide 2.5 percent wash. choose one and follow label directions. If you don’t see clearing in six weeks, pay a visit to the family doctor. you might need prescription treatments. And you might not be dealing with pimples.

Readers may write to Dr. Donohue or request an order form of available health newsletters at P.O. Box 536475, Orlando FL 32853-6475.

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