MEN'S HEALTH MATTERS:Your health questions answered
Q I have a rash affecting my scalp, and was told by my doctor it is a yeast infection of my skin. I get a red, scaly rash on my eyebrows, nose and chest as well. What is causing it?
AThis sounds like seborrheic dermatitis. This is a common harmless rash, which affects the face, scalp and chest, though it can also affect the armpits and groin. It occurs very commonly within the eyebrows, on the edges of the eyelid, inside or behind the ear, and in the creases at the side of the nose.
It may or may not be itchy and the severity of it can vary from day to day.
It is thought to be due to sensitivity to a normal skin bug, a type of yeast called malassezia. In most people this bug just causes dandruff, but in people who get seborrheic dermatitis they seem to be more sensitive to the toxic substances that the bug produces and they develop red, irritable, scaly skin.
It is not contagious or related to diet but it can be made worse by illness, stress, and tiredness and there are certainly medical conditions with which it is associated.
It can be very persistent, though it can be kept under control, rather than cured, with regular use of anti-fungal agents and the occasional use of topical steroids.
Try using a medicated shampoo containing ketoconazole, selenium sulphide or salicylic acid. Use this two-three times a week for at least a month, and make sure that you massage it well into the scalp. Do not wash it off immediately but leave it work for a few minutes.
Most of these shampoos are available over the counter so ask your pharmacist. If it is affecting the face or chest you may need to use an antifungal cream with or without a steroid if it is very itchy and red.
Q I am 55 years old and have high blood pressure. I recently went to see my doctor who told me that my creatinine is raised and that I have mild kidney failure. What does this mean?
AMost people, as they get older, develop high blood pressure, often called hypertension. About 50 per cent of people over 50 years of age and 65 per cent of those over 65 may be unaware that they have high blood pressure. High blood pressure increases the risk of heart failure, heart attack, stroke and kidney damage. Kidney damage makes blood pressure harder to control.
Kidney damage is often detected by a blood test that detects how well the body eliminates a compound called creatinine. This compound varies considerably between people.
It is possible to calculate or estimate your percentage kidney function based on creatinine. If your kidney function is 60 per cent of the predicted function then you are described as having mild kidney failure.
It is generally not associated with any symptoms and the most that these patients have is high blood pressure.
People with mild kidney failure do not require specific diets but they require regular check-ups to ensure their kidney damage is not progressive.
If your kidney damage is more severe (moderate kidney failure means your kidneys have less than 30 per cent of the predicted function), there is a need for a strict diet and additional medication.
The majority of patients with mild kidney disease do well and do not develop worsening kidney damage. Dialysis is very rarely needed. The risk of further kidney damage will depend on the cause of the kidney damage, how well controlled blood pressure is, and how much protein is leaking into urine.
Your doctor will usually do a kidney ultrasound to check for structural damage to the kidneys, check the urine for protein and do a blood test for diabetes and fasting cholesterol.
Heart disease is more common in patients with kidney disease so the heart needs to be checked out with a heart-tracing (ECG) or a cardiac scan.
Blood pressure control is often difficult and you may need more than one tablet (usually three) before good control is achieved. Avoidance of salt and weight loss can help minimise the need for treatment.
This column was edited by Thomas Lynch, consultant urological surgeon, St James's Hospital, Dublin, with contributions from Dr Patrick Ormond, consultant dermatologist and dermatological surgeon, and Dr George Mellotte, consultant nephrologist