ASK DR ZOE
I had a horrible itch I thought was thrush down below that spread to my backside – please help!
Dr Zoe Williams has all the answers to help you sort those niggling health worries
VIRUSES and diseases we once associated with tropical climates are increasingly cropping up in Europe.
These include West Nile virus, dengue fever and even malaria.
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For example, the European Centre for Disease Prevention and Control reported transmission of West Nile virus in eight European countries.
There are no vaccines against these viruses – the best thing you can do is to protect yourself from mosquito bites, even though the risk of catching a tropical virus is deemed low.
Preventing bug bites while on holiday will avoid itching or swelling, too.
A good-quality insect repellent is one that contains at least 20-50 per cent DEET, details of which you will find on the bottle.
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This ingredient prevents bugs such as mosquitoes from landing on you. DEET can be bought from high-street chemists, camping shops and online.
Travel-size bottles can be kept in your handbag.
Check travel advice at .
Here’s what readers have asked me this week. . .
Most read in Health
Hip gyp from standing still
Q) I AM 78 and have a similar problem to the reader in your Sun on Sunday column on August 11 about hip wear and tear.
I have had an X-ray and was told it is mild arthritis.
Sun Health Explainer: Fat jabs
I had a triple bypass 47 years ago and hold the Guinness World Record for longest-surviving triple heart bypass patient.
I play walking football twice a week, a little golf and can ride my racing bike up a steep hill.
What does surprise me, though, is the bike ride does not seem to affect my hip pain.
It seems to come on when standing around too long or walking long distances.
I think I need to lose weight, would that help?
A) Congratulations to you on the world record, and it is really wonderful to hear that you are so active as this is absolutely the best thing that you can do to continue to look after your heart and general health.
It may surprise you that exercise is also incredibly important for maintaining the health of your joints.
In fact, studies have shown that cycling, because it is a non-weight bearing non-impact form of exercise, can actually be a highly effective treatment for alleviating the symptoms of hip osteoarthritis, so this may go some way to explain why you find it so comfortable.
Walking football is also a great way of being active while not putting too much impact through the joints, with all its added benefits from the social point of view.
There are a number of options available to you which include painkillers, physiotherapy, joint injections and, ultimately, it may be the case that hip replacement surgery would give you long-term relief from your symptoms.
While you may think that having had heart surgery all those years ago would make surgery risky, the fact that you are so cardiovascularly fit means you are likely to do well – and most likely have a healthier heart these days than many people who have never had cardiac issues.
If you feel like weight loss is possible, even a small amount can make a significant difference to osteoarthritis hip pain.
If you are struggling, book an appointment with your GP, to see if they can offer any help.
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Q) I HAD symptoms of what I thought was thrush and used two tubes of Canesten.
It gradually spread to my anus so I used medication thinking I may have threadworms. But it’s been five weeks and it’s driven me mad.
It’s quite sore at the top of my vagina. It’s not related to sex. Could it be stress-related?
A) Thrush of the vagina (internal part) can be easily diagnosed with a swab from your GP practice. A telephone appointment or e-consult would be sufficient to arrange this test if you are unable to get a face-to-face meeting.
Vaginal thrush is usually best treated with a pessary – a tablet inserted into the vagina.
Sometimes you may be given an oral tablet too, called fluconazole.
It sounds like your symptoms are affecting your vulva (external genitals) and perineum (area that extends towards the anus), which would normally be amenable to antifungal cream treatment, for example Canesten.
But we do sometimes see resistant fungal strains that may not respond to certain types of antifungal, so a second type of cream may be required.
I would also highlight that declining levels of oestrogen can also cause this symptom, around the time of the perimenopause, menopause and beyond.
There is also an inflammatory skin condition called lichen sclerosus, for which the cause is unknown.
It mostly affects genital skin and the skin around the anus and is most common after menopause. It can cause itching and white or pale patches to appear, and the tissue can be more delicate and prone to splitting.
It cannot be cured, but it is important to have it diagnosed as it can be controlled with potent steroid ointments such as clobetasol.
A small number of people who have this skin condition may develop vulval cancer.
It’s thought that the inflammation caused by lichen sclerosus increases the risk of vulval cancer developing.
However, this rarely happens when the condition is well controlled.
Please do not be embarrassed as GPs see these issues frequently.
I think in your case it’s worth booking a GP or nurse appointment to be properly assessed and doing some swabs in the meantime.
If there’s a wait for the appointment then you could try an alternative thrush treatment from the pharmacy in the meantime.
How can I lose ugly blemishes?
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Q) ALONG with many people, particularly as we age, I suffer with seborrhoeic keratosis. I’m now 70.
The blemishes are unsightly, frequently itchy and just keep multiplying. I’ve had a few removed over the years – mainly around my bra area.
I found that using wart remover, such as Bazooka, made them less crusty and less dark. However, I’m wary of using such products at the moment, as I’m having immunotherapy following removal of a cancerous kidney.
My partner is also developing more of these blemishes, as well as skin tags. Is there no antidote to these unsightly warts?
I wondered if they are related to HPV, for which teenagers now receive preventative vaccines?
A) Seborrhoeic keratoses are harmless lesions on the skin that have a warty appearance and can feel as though they are stuck on, a bit like barnacles.
They are a sign of skin ageing and are very common.
In fact, by the age of 70 almost everybody has some, but there’s a huge variation in how many a person may have.
It’s thought that genetics plays a part in determining this, as well as sun exposure over a person’s lifetime.
Despite their appearance, they are not actually warts and have no connection with the human papilloma virus – they’re simply a build-up of skin cells.
I understand some people dislike them cosmetically, while others don’t mind them, and I’m afraid that I don’t have a magic answer in terms of how to get rid of them.
From a physical health standpoint, they are harmless and cause no symptoms, therefore treatment is not usually funded on the NHS.
If people choose to remove them for cosmetic purposes, this can be done privately.
Options include freezing them with liquid nitrogen (cryotherapy), laser removal and scraping them off (curettage) under a local anaesthetic.
TIP OF THE WEEK
ALWAYS keep an eye out for changes in moles on your own skin, as well as your partner’s, in areas such as their back, shoulders and so on.
You can track the size of a mole by taking a picture of it next to a ruler.
Always see your GP about any you know have changed in size, colour or shape.
‘Drug resistant’ sex disease cases are cause for alarm
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CASES of treatment-resistant ‘super gonorrhoea’ are rising and health chiefs fear they may become ‘untreatable’.
Here’s all you need to know . . .
RECORD HIGH
CASES of gonorrhoea are now at their highest level in England since records began in 1918. The latest figures for England show there were 85,223 cases of gonorrhoea diagnosed in 2023.
A similar picture is seen across the UK. There were 5,999 diagnoses in Scotland in 2023, a six per cent increase on 2022, and 5,292 in Wales, a 27 per cent increase on 2022.
JUMP IN RESISTANT STRAINS
AS well as a rise in cases of the STI, health officials have also found an increase in treatment-resistant gonorrhoea. Since the superbug was found in England in 2015, there have been 31 cases – with 15 occurring in a two-year period from June 2022 to May 2024.
The superbug is resistant to ceftriaxone – the first-line antibiotic for gonorrhoea. Seven cases, of which two were diagnosed in the two-year period, were “extensively drug-resistant”.
Dr Helen Fifer, consultant microbiologist at UKHSA, said: “Gonorrhoea is becoming increasingly resistant to antibiotics, risking the possibility of it becoming untreatable in the future.”
The World Health Organization reports that the UK was the first to report a case of double-drug resistant gonorrhoea. It warns: “This suggests that reports of treatment failures and drug resistance in wealthier areas are only the tip of the global health burden.” .
WHO IS AFFECTED?
ALL the drug-resistant detected cases have been among heterosexual people, mostly in their 20s, according to UKHSA.
Most of them had acquired the infection abroad. But other age groups can also be at risk. Anyone who has had sex with a new partner is recommended to get tested if no protection was used.
Dr Fifer warned: “Untreated gonorrhoea can lead to serious health issues, including pelvic inflammatory disease and infertility. Condoms are the best defence, but if you didn’t use one with a recent new or casual partner, get tested to detect the infection and prevent onwards transmission.”
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Almost half of women with gonorrhoea, and one in ten men, do not show symptoms, highlighting the importance of testing.
Typical symptoms of gonorrhoea include a thick green or yellow discharge from the vagina or penis, pain when urinating and, in women, bleeding between periods.
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