For years I’ve suffered with swollen, itchy lips when I go out in the sun. I’ve tried putting factor 50 suncream on but it doesn’t help. Do you think it could be an allergic reaction?
Dr Ellie Cannon replies: While uncommon, it is possible for people to be allergic to the sun. This condition – known as solar urticaria – can cause a rash, normally on all sun-exposed parts of the skin.
However, it is possible that some patients, who have a mild case of solar urticaria, are only affected on their lips, as this skin is more sensitive.
Trying a daily allergy tablet, called an antihistamine, would be a low-risk option.
It is possible for people to be allergic to the sun, writes Dr Ellie Cannon. This condition, known as solar urticaria, can cause a rash
These are generally very safe and available over the counter. There is also the added benefit that, if you take the pill and the irritation goes away, then you can conclude that the cause is an allergic reaction. A good one to try would be fexofenadine.
Another reason why the lips may be irritated is a reaction to the heat – hence why suncream doesn’t help. In fact, it is possible it may even be a reaction the suncream itself, which is known to trigger the itchy skin condition dermatitis.
The best cream to calm down irritated lips is petroleum jelly – such as Vaseline – or a beeswax-based lip balm. If these don’t work, then a steroid cream may help. However, this would need to be prescribed by a GP.
During a check-up I gave a urine sample which turned out to contain traces of blood. The GP asked questions about my bladder habits – I said I do need to go all the time – and booked me an appointment with a specialist in October. Should I be concerned?
Dr Ellie replies: Blood in the urine is something that we always take seriously.
GPs should not be so remote
Booking GP appointments has changed massively over the past five years.
Since the pandemic, it has become far more common for surgeries to encourage patients to book via a website, the NHS app or email.
However, it’s important that patients should still be allowed to request an appointment by phone – or even walk in to book one in person. After all, not everyone has a smartphone and some people are not comfortable using the internet.
My surgery allows patients to phone in, walk in or fill out an online form. However, I’ve heard worrying stories from friends who say that their local surgeries are no longer taking phone calls, and are forcing people to send an email if they want to see the GP.
Has this happened to you? I’d love to know if this is becoming widespread and its effect on your health or your relationship with your doctor.
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If the blood is visible – the urine is pink, red or dark brown – it can be a sign of bladder cancer, so a referral to see a specialist within two weeks should take place.
However, if there are only traces of blood – which cannot be seen but are picked up in a urine test – this is less likely to be cancer.
Other causes of blood in the urine include a urinary tract infection. This would usually be accompanied with a burning sensation during urination, a high temperature, cloudy pee or lower back pain.
Kidney stones can also lead to blood in the urine. Again, this would likely have other symptoms, including pain in the sides, back or groin as well as nausea.
In order to find out the cause, a specialist may carry out a more invasive investigation, including a cystoscopy, which is a thin, flexible camera that is inserted into the bladder via the penis.
Another trigger of blood in the urine is an enlarged prostate, a common condition in men over 50, which makes it difficult to pee or leads to a sensation of needing to pee suddenly and often.
If this is the cause, treatment would include drugs that shrink the prostate and, if necessary, surgery to remove excess tissue.
Whatever the cause, a urologist should be able to help you with your overactive bladder.
There are medicines which can help reduce the urge to pee, as well as nerve treatments, which use electrical currents, which have the same effect.
I was diagnosed with arthritis in my hands and I’ve been told to take 600mg of ibuprofen up to three times a day. My doctor also suggested rubbing ibuprofen gel into the joints. Do you think this is an unsafe amount of the drug to take?
Dr Ellie replies: The usual recommended dose of ibuprofen is 400mg taken three times a day. Consuming more may be dangerous.
The anti-inflammatory drug is effective at reducing joint pain and stiffness. In some cases, such as dental pain, menstrual cramps or arthritis, doctors may prescribe a 600mg dose that can be taken four times a day.
However, it is important that patients do not combine the maximum dose of tablets with ibuprofen gel, as this can raise the risk of side effects. Too much ibuprofen can irritate the stomach, leading to nausea and vomiting. In large amounts this can also trigger painful stomach ulcers.
Taking high doses over long periods can also increase the risk of stroke and heart attack.
If ibuprofen does not help, there are other options. The painkiller paracetamol can safely be taken alongside it, while many find that creams which either heat up or cool down the hands – such as Deep Heat – have a positive effect.
Some patients also benefit from hand physiotherapy, which helps to reduce stiffness through exercises and stretches. Finally there are prescription anti-inflammatory tablets, which tend to be more effective than ibuprofen, such as etoricoxib and celecoxib. However, they would need to be discussed with a rheumatologist, as they carry a number of risks, including raising the risk of heart disease and strokes.
Do you get five a day, or more like one a month?
It seems that a shocking number of Britons are not eating enough fruit and vegetables.
Research by the food tracker company My Fitness Pal has revealed the average person can go as long as three weeks without a green vegetable passing their lips, while most go a whole month without eating a single piece of fruit.
I know from my own patients that many people in this country have a terrible diet, but even I was taken aback by these findings.
It’s long been said that everyone should eat five portions of fruit or vegetables a day.
What is a portion, you might ask? Most consider it to be 80grams – which is roughly a handful.
So how often are you eating five handfuls of fruit or vegetables a day?
Please write in using the email address at the bottom of the page and let me know your thoughts.
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- Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk
- Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.
