DON’T BE HELD BACKdoc.mediaplanet.com/all_projects/4936.pdf · advice for others – with asthma,...

PHOTO: ISTOCKPHOTO.COM

Think positivelyOlympian Adrian Moorhouse on living with asthma

Find the answerFrom wheezing to prickly heat, we can help

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DON’T BE HELD BACKFeel free this summer: Your comprehensive guide to coping with

allergies and asthma.

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Act on allergies now

Are you aff ected by asthma or allergies? With asthma aff ecting one person in ten, rhinitis one in four, and eczema, food allergies and anaphylaxis all becoming more common in many parts of the world it is likely that you suff er or know someone who does.

Over a hundred years ago al-lergic patients were a rarity – in the last 50 years, there has been an aller-

gy epidemic. This short timeframe means that although allergy runs in families and there is an undoubt-ed genetic component, the environ-ment is probably more to blame for the increase.

All sorts of theories have been proposed - but there is evidence that decrease of certain infections may be relevant, as well as other possible factors such as lack of vita-min D, traffi c pollution, stress, and allergen contact by the wrong route – i.e. by skin or nose rather than by mouth. The answer is likely to be multifactorial - and may be diff er-ent in diff erent populations.

Allergy has become a huge chal-lenge: although some sufferers have fairly minor reactions, oth-

ers have potentially fatal allergies - such as anaphylaxis to food or very severe asthma in response to aller-gens breathed in, such as moulds. The potential side eff ects of allergy, from educational to psychosocial, are countless for all concerned.

Not only are allergies increasing but they are also becoming more complex, with most suff erers hav-ing more than a single allergic problem. Drug allergies aff ect 6.5 per cent of all hospital admissions and investigations are complex and time-consuming.

What’s the solution? Firstly an accurate individual diagnosis is needed followed by appropriate ad-vice and treatment. We need more fully-trained allergists – present-ly we have roughly one per 2 mil-lion of the population in the UK, far fewer than in most of Europe. We have time to see only the very se-verely aff ected or those with com-plex problems.

Most allergy patients will be cared for by their GP or referred to another kind of specialist. Fortu-nately some are well versed in al-lergy diagnosis and treatment and there are many patient organisa-tions that provide very valuable as-sistance. However even with these provisions there remain many who have not been adequately diag-nosed and often go without proper treatment.

Allergy services must be im-proved – in the meantime, improv-ing awareness for all through edu-cation and research is vital.

Dr Glenis ScaddingConsultant allergist, Royal National Throat Nose and Ear Hospital, London

“There are many steps that you can take to avoid allergens in the home”

Home ImprovementHow little changes can make a big difference to you and your family.

PAGE 8

ASTHMA AND ALLERGY, 2ND EDITION, APRIL 2010

Country Manager: Willem De GeerEditorial Manager: Danielle StaggBusiness Developer: Darren ClarkeLayout: Triin Metusalet

Responsible for this issueProject Manager: Faye GodfreyPhone: 0207 6654410E-mail: [email protected]

Distributed with: The Guardian, April 2010Print: Guardian Print Centre

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Question: How can children with asthma and allergies lead lives without obstacles?Answer: Knowledge, exercise and organisation are the key to a normal, active life.

“What is wheezing?” asks Professor John Warner, professor of paediatrics at Imperial College, London. That, he says, is the most important question that a par-ent of a child with asthma or allergies should ask. “Wheezing is the main symp-tom that will highlight whether asthma exists but it’s often surrounded by confu-sion,” he says. “When a parent is asked if a child wheezes, they will often say yes – but studies show that up to 30 per cent of parents use the phrase inappropriately and it is not always being communicated properly in primary care”.

Real wheezing, says Prof Warner, is a sound of musical quality, heard best when breathing out and heard deep down with-in the chest. It can be immensely alarm-ing for parents - yet wheezing in ear-ly childhood or infancy does not always

equal a subsequent diagnosis of asthma or allergies, Prof Warner points out. “Asth-ma is extremely common, but a great deal of wheezing which occurs in infancy does not go on to develop into asthma – it could simply be virus-associated wheezing for instance,” he says.

The school of thought that exercise is off -limits to children with asthma and al-lergies holds no ground with Prof Warn-er. Sport can be tremendously benefi cial for the child’s respiratory health, as well as off ering countless psychological bene-fi ts, and an asthmatic child is certainly not necessarily at a physical disadvantage – he points to the disproportionate number of athletes with asthma, such as David Beck-ham.

Most of all, preparation and information, particularly as the hayfever season gathers pace, brings a real diff erence to the quali-ty of life. Pollution, for instance, is a prob-

lem, especially when combined with pol-len; Prof Warner points to a “remarkable” study in Japan which showed that people who lived on a road lined with cedar trees suff ered more from their allergies as a re-sult of the combining of the pollen with the diesel fumes from the traffi c than those who lived in the middle of a forest. In another study, asthmatic children taken to the Alps and the Dolomites showed a dra-matic lessening of symptoms.

“Establish a treatment plan that covers every aspect of a child’s life and make sure that all involved in the child’s life is aware,” says Prof Warner. “Knowing what might trigger an attack, and how to deal with an attack, will enable good management and a vastly improved quality of life”.

The power to prepare and protect

EMILY DAVIES

[email protected]

CHANGE

”Knowing what might trigger an attack will enable good management and a vastly improved quality of life”Professor John Warner,Professor of paediatrics at Imperial College, London

CHILD’S PLAYBy understanding triggers and symptoms we are more equipped to help children living with asthma.PHOTO: ISTOCKPHOTO.COM

INSPIRATION

Be pro-active

1Once the diagnosis has been es-tablished treatment is highly ef-

fective and safe. It should allow virtu-ally all children to have a normal ac-tive life. The treatment involves a com-bination of avoidance of triggers such as allergens and pollutants and the use of inhaled preventer and reliever ther-apy. If there’s any doubt with diagno-sis, insist on a referral to a paediatric respiratory or allergy specialist.

Be active

2Nearly 17% of the U.S. athletes who participated in the 1996 Ol-

ympics had asthma. And 30% of those won medals.

Cut triggers

3It’s not just smoking in pregnan-cy that aff ects the child’s air-

ways. Passive smoking is hugely dam-aging to children and impairs an asth-matic’s response to inhaled treat-ment.

Make a plan

4Having a written action plan for all eventualities is also very im-

portant - this should be drawn-up by agreement between doctor, parents and child. Ensure that everyone in-volved in a child’s life, from grandpar-ents to teachers, has a copy of the plan – and review it regularly.

TIPS FROM PROF WARNER

4PROMOTE UNDERSTANDING

1TIP


Adrian Moorhouse, the British Ol-ympic swimmer who won the 100m breaststroke gold medal at Seoul in 1984, is today managing director of the management and leadership consultancy, Lane4 Management Group, that he co-founded. He has been asthmatic since childhood.

“As a child I remember spending many frightening nights having to sleep upright and feeling like my chest would cave in, struggling to breathe,” says Adrian, 45, who lives in Cookham, Berkshire, with his wife Liz and three children Evie, 4, Thomas, 2, and one-year-old Daisy.

“I was diagnosed by a specialist who was proactive and along with inhaler treatment encouraged exer-cise, particularly swimming, with a view to improving lung capacity and strengthening my lungs.”

Lung capacity tests would always give me an extremely poor read-

ing, much lower than that of eld-erly people. There were certainly a couple of times when I had to stop a couple of international races be-cause I couldn’t carry on but gener-ally I achieved my success partly by carefully managing my symptoms and by maintaining regular, rigor-ous exercise.”

As well as using his salbutamol (Ventolin) inhaler as advised, Adri-an pursued exercise from swim-ming to land-based workouts such as circuit training and weight train-ing. “I also knew what to avoid: the triggers such as pet hair and house dust mites, all of which I still try to stay away from”.

For Adrian, asthma was no obsta-cle and that’s a result he attributes to the attitudes of those around him – and his own. “I didn’t feel limited in my teens or growing up and my attitude was very much - how far can I push this?”. His “de-fi ning moment” came during a cross-country run which he want-

ed to run, with the help of his inhal-er: his sports teacher was less keen. Adrian ran it.

“I think sometimes people can hide other insecurities behind asthma – especially kids, who can become so susceptible to steer-ing,” he says.

“I’ve always felt strongly that I will not be told what I can and can’t do - I know my own limits, and that’s the cornerstone of my advice for others – with asthma, without asthma, in sport and be-yond. Know your own limits – and test them. With the right attitude, advice and control, you can suc-ceed”.

Now, Adrian rarely needs his in-haler and its occasional use en-sures an eff ectively asthma-free life: “I did a half-marathon the other day and simply used it be-forehand and pre-emptively for the fi rst couple of miles”.

Don’t be beholden to an illness, he says: “There will always be peo-ple that will always do stuff you can’t do – why not be one of the few who can?”

Question: Why was asthma so signifi cant for one Olympic athlete?

Answer: It was an impetus to test his limits - and push for per-sonal and professional success.

EMILY DAVIES

[email protected]

HOW I MADE IT

Expand and enjoy your abilities

LIVING LIFE TO THE FULLGold medalist Adrian wasn’t going to let asthma stop him reaching his goals. PHOTO: PRIVATE

Adrian MoorhouseMD of consultancy fi rm Lane4, Olympian gold medalist and anasthmatic

INSPIRATION

DON’T LET IT HOLD YOU BACK

2TIP

The most important issue is to have the condition diagnosed as there are still many people who have symptoms sugges-tive of hayfever, but for whom the diagnosis has never been confirmed by their GP.

Once diagnosis is confirmed, it is important in all those with anything more than mild or very infrequent symptoms to ensure that they are on an ap-propriate preventative treat-ment and that they maximise their benefits from it as early as possible.

This should ideally be start-ed a couple of weeks before the anticipated start of the hayfe-ver season and should be used regularly. Ensuring the correct technique of using nasal sprays is also important and it is a fail-ure to pay close attention to this which is a major reason why symptom control is some-times inadequate.

Keeping an eye on pollen forecasts and use of wrapa-round sunglasses as much as possible can also be helpful.

PROFESSOR AZIZ SHEIKH IS THE ROYAL

COLLEGE OF GENERAL PRACTITIONERS’

CLINICAL CHAMPION IN ALLERGY AND PROFESSOR

OF PRIMARY CARE RESEARCH & DEVELOPMENT

CENTRE FOR POPULATION HEALTH SCIENCES:

GP SECTION, UNIVERSITY OF EDINBURGH

PROFESSIONAL ADVICE

Don’t suffer with hayfever this summerHow can everyone fore-arm themselves against the onslaught of hayfever, whether they have other allergies or asthma or not?

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There are many steps that you can take to avoid allergens in the home. For example, if you are aller-gic to the house dust mite then sim-ple measures such as damp dusting, vacuuming with a vacuum clean-er that has a HEPA (high-effi ciency particulate air) fi lter, and using an-ti-allergen bedding will all help to reduce allergen exposure.

Rooms should be well ventilat-ed and not kept too warm (warmth and moisture encourage the house dust mite) and leave your beds to air during the day rather than mak-ing the beds in the morning.

Washing bedding at 60 degrees or above will destroy allergens in bedding. In a child’s room try to minimise the number of soft toys as these will also attract house dust

mites - these should be washed reg-ularly and if they can’t be washed at high temperatures, place them in the freezer overnight before washing at the recommended tem-perature.

Hard fl ooring rather than car-pets, and blinds rather than cur-tains make rooms easier to clean and discourage the house dust mite. Consider an air purifi er that removes allergens to help overall management.

Mould allergy is very common.

Bathrooms, kitchens, windowsills - anywhere that is damp or collects moisture is a potential source of mould. Plants can also be a breed-ing area for moulds - a layer of pea shingle on top of the soil will pre-vent this.

Good ventilation is essential; try not to dry washing indoors or over radiators. In bathrooms try to keep a window slightly open or fi t an ex-tractor fan to remove steam when having baths or showers. There are proprietary brands of cleaners that will remove mould from bath-rooms or kitchens but a weak so-lution of bleach and water and an old toothbrush will remove mould from corners of the bath or win-dows.

Pet allergens are in animals’ sa-

liva, urine and skin fl akes (dan-der) and can be very diffi cult to re-move from the home, particularly cat allergens as they are very light and will cling to every surface. Try to limit where pets are allowed in the house - make upstairs and bed-rooms in particular no-go areas.

Wash down walls and hard sur-faces regularly and use a vacuum cleaner with a HEPA fi lter - there are also now products available that you can use on your pet’s coat that help to remove the allergen, and specifi c cleaning products that remove allergens from hard surfac-es to help to keep levels of pet aller-gen down in the home.

LINDSEY MCMANUS

[email protected]

Question: How important is allergen avoidance in the home when trying to keep asthma or allergies under control?Answer: Home management is key – and it is important to know what you are allergic to, so having your allergies confi rmed by an allergy specialist should be your fi rst step.

KNOW YOUR ENEMY

Lindsey McmanusAllergy UK

NEWS

MODIFY YOUR ENVIRONMENT

3TIP

MAN’S BEST FRIEND?By considering the triggers around your home you can become a healthier you.PHOTO: ISTOCKPHOTO.COM

“I use mattress protectors to help reduce the eff ect of dust mites, and wash the bedding with non-bio washing powder on a high wash.

“I have used air purifi ers to keep the air clean - it makes it eas-ier to breathe - and our laminate fl oors are cleaned with chemical-free cleanser to stop the dust (car-pets are a nightmare for me!).”

Gilly StevensWest London

“My eldest daughter Ella, 9, has asthma which is exacerbated by dust mite and cats. In her bedroom we immediately removed the carpet and laid laminate fl ooring - in fact we mostly now have solid fl ooring rath-er than carpets. She used to be par-ticularly bad in spring and autumn when the pollen and mould spores were released, so we have an air puri-fi er which we sometimes use. We use a HEPA vacuum cleaner, only aller-gy-friendly bedding and I wash the sheets at 60C to kill any dust mites.”

Sarah StonehamKent

HOW WE DO IT


When you are what you eat

A DELICATE BALANCEKnowing the right diet for you is key to your well-being, says Coeliac UK.PHOTO: ISTOCKPHOTO

“Food allergy and intolerance is a very topical area,” points out Nor-ma McGough, registered dietician at Coeliac UK. “There’s more discus-sion that ever before - but there’s also a great deal of confusion”.

“Really be sure of your diagnosis – this is crucial,” she says. Coeliac UK estimate that only 10 to 15 per cent of those 1 in 100 who should be diag-nosed with coeliac disease, are. As Norma points out, coeliac disease – an auto-immune disease that most typ-ically manifests within the gut but can also manifest itself with other or-gans causing, for instance, skin and neurological problems – at least has a clear process of diagnosis, beginning with a blood test to detect antibodies followed by an endoscopy and biopsy.

But for allergies and intolerances, as Norma notes, the lines are more blurred. This is because the process for diagnosis is less clearcut. For in-stance, anyone who chooses to fol-

low a gluten-free diet in an attempt to improve their digestive symptoms and then has a blood test for coeliac

disease will not receive a true read-ing – the lack of gluten in the diet re-moves the key factor. There have al-so been issues with poor recogni-tion of coeliac disease in primary care tests, Norma says – for example, it’s often misdiagnosed as irritable bowel syndrome, with which it shares some symptoms. It’s hoped that the situation will be improved by the guidelines on the diagnosis of coeliac disease released by the Na-tional Institute for Clinical Excel-lence (NICE) last year. It’s a situation that’s exacerbated by the lack of aller-gy specialists in the NHS.

While the food industry has ad-vanced, Norma says, in “huge strides”, with specialist gluten-free products now widely available, eating out is still a huge issue for people with coe-liac disease, largely dependent on the need to trust that requirements have been met – which Coeliac UK’s re-search has shown has a huge impact on social habits.

“It is important to understand food labels,” says Norma. “Diagnosis is key and once that’s achieved it’s plainsail-ing – it’s a question of trying to dimin-ish the impact of coeliac disease and sustaining confi dence.”

EMILY DAVIES

[email protected]

There is no cure; the only treat-

ment is life-long adherence to a gluten-

free diet

Coeliac disease is not a food aller-

gy but an autoimmune disease caused

by intolerance to gluten, a protein found

in wheat, rye and barley. Some peo-

ple are also sensitive to oats. Damage

to the gut lining occurs when gluten is

eaten.

At least 1 in 100 people are esti-

mated to suffer from coeliac disease in

the UK and also 1 in 100 in Europe, with

some evidence to support that only 10-

15% cases are diagnosed.

If a gluten-free diet is not fol-

lowed, the disease can ultimately

lead to malnutrition, osteoporosis,

bowel cancer and also cause infertil-

ity problems.

SOURCE: COELIAC UK

COELIAC DISEASE - THE FACTS

NormaMcGoughRegistered dietician, Coeliac UK

NEWS

WATCH YOUR DIET

4TIP

Question: Why are coeliac disease and food intolerances and allergies so signifi cant?

Answer: Vast numbers of people with coeliac disease are undiagnosed and there is much confusion over symptoms – and treatment.

QUESTION & ANSWER

How common are allergies in children?

!“About 40 per cent of UK children have a diagnosed

allergy – from a food allergy, hay-fever, asthma or eczema – and in the past two to three decades we’ve seen a huge increase. The most common reason for referral to our clinic is food allergy - prin-cipally milk, eggs or peanuts, with milk most common. Six to eight per cent of children in the UK have a diagnosed food allergy.”

What’s the relationship with asthma?

!You rarely see a single aller-gy in isolation. Once we’ve

seen a child with one allergy, we expect their return with another – known as the allergic, or atopic, march. It starts with eczema, fol-lowed by food allergies, asthma, rhinitis or another respiratory al-lergy - which makes understand-ing the cause vital. The close link between asthma and allergies – a child with hayfever is seven times more likely to develop asthma – leads many parents desperate to know what they can do to prevent their child developing asthma: so far, the answer is to desensitise.

What can be done?

! Much hope is currently pinned to immunotherapy

treatment, or desensitisation. It’s an old idea back in favour with newly refi ned methods of deliv-ery. It was previously a series of injections and still can be – but now a more child-friendly meth-od has been developed for the treatment of severe hayfever (sea-sonal allergic rhinitis), in which a squirt of liquid grass pollen or a tablet is placed under the tongue. Signifi cantly, this tackles the un-derlying cause rather than just the symptoms, with rapid bene-fi ts.

Dr Adam T FoxConsultant andhonorary senior lecturer in paediat-ric allergy, Guy’s & St Thomas’ Hospitals NHS Foundation Trust


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A simple self-test will reveal whether you have a genuine allergyImutest allergy tests are safe and easy for you to use at home and can identify whether you are genuinely allergic to common triggers such as dust mite, pollen, cats, milk and eggs.

Imutest is the only self-testing range of kits avail-able to detect raised levels of the ‘true’ allergy antibody, Immuno globulin E (IgE) and is quick, simple and safe to use:

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The new Imutest Airborne Screen is specially designed to pick up the three most common airborne allergens (cat, dust mite and grass pollen) all in one simple test.


For any asthmatic the most impor-tant things to know are to be able to diff erentiate between reliever and preventer inhalers, to know how to use inhalers and then to use these as recommended by your GP – says Aziz Sheikh, professor of pri-mary care research and develop-ment, University of Edinburgh.

“All of these issues should be in-corporated into the asthma man-agement plans, which most peo-ple with asthma should have,” says Prof Sheikh.

“Most people run into problems either because of a failure to use preventative (steroid-based) treat-ment regularly or having a poor technique; the majority of those using a metered-dose inhaler should be using a spacer to aid de-livery.”

A recurring issueIt is very common to experience problems using inhalers, point out Asthma UK, who advise talking to your doctor or asthma nurse spe-

cialist who can check technique or give you a diff erent inhaler.

Asthma UK recommends consid-ering a large volume spacer, avail-able on prescription: these make

aerosol inhalers easier to use and more eff ective.

Find the right inhaler for youIf you have arthritis in your hand,

or have diffi culty holding the in-haler, a device such as the Hale-raid or Turboaid might be useful. The Haleraid fi ts onto some spray-type inhalers. It allows you to re-lease medicines by applying pres-sure with the palm of your hand. This can be easier than pressing the canister down. Your doctor or asthma nurse will be able to advise further.

Reliever inhalers are medicines taken immediately to relieve asth-ma symptoms. They quickly relax the muscles surrounding the nar-rowed airways, which allows the airways to open wider, making it easier to breathe again. Preventers control the swelling and infl am-mation in the airways, stopping them from being so sensitive and reducing the risk of severe attacks. They build up over a period of time so they need to be taken every day, even when feeling well.

Treatment usually begins at the appropriate level to control symp-toms; once this has been achieved the treatment will be reduced to the lowest possible dose. Prevent-er inhalers usually contain a ster-oid medication. There are several kinds of inhaled steroids, but they all work in the same way.

Learn to breathe easy

A HELPING HAND. Inhalers provide both treatment and security for those with asthma, however knowing how to use them properly is key. PHOTO: ISTOCKPHOTO

EMILY DAVIES

[email protected]

5.4 million people in the UK are

currently receiving treatment for asth-

ma: 1.1 million children (1 in 11) and 4.3

million adults (1 in 12).

Asthma costs the NHS over £996

million per year

People who do not have a written

personal asthma action plan are four

times more likely to have an asthma

attack requiring emergency hospital

treatment

An estimated 75% of admissions

related to asthma are preventable.

SOURCE: ASTHMA UK

FACTS

NEWS

UTILISE ALL AVAILABLE AIDS

5TIP

It is estimated that 5.4 million people in the UK are currently receiving treatment for asthma.1 The most commonly used inhaler is a pressurised metered dose inhaler (pMDI) despite the fact that many patients cannot use these inhalers correctly.2

One study showed that 86% of asthma patients when first tested were unable to use their pMDI correctly. Asthma control can be compromised due to poor inhaler technique.3 Common problems associated with pMDIs include inhaling too fast and poor co-ordination between pressing and breathing.2

Asthma UK state that it is essential that patients undertake regular inhaler reviews to ensure good technique and good compliance with their inhalers is maintained in managing their asthma symptoms. Patients are encouraged to discuss and have their inhaler technique checked with their GP, nurse or pharmacist and if the patient is unable to use the device satisfactorily an alternative should be found.

Getting the best from your Asthma

Treatment

References: 1. www.asthma.org.uk website accessed Jan 20102. V Giraud and N Roche, Misuse of corticosteroid metered dose inhaler is

associated with decreased asthma stability. Eur Respir J 2002;19:248-251 3. A Hardwell et al, Technique training does not improve the ability of most

patients to use pressurised metered dose inhaler. Poster presented at BTS Winter Meeting, London, England, 3-5 December 2008

Brought to you by

Med/10/208 Date of preparation March 2010

Question: Inhalers are the key to a life without symptoms – but how can I make the most of them?

Answer: Understanding what you need and when you need it is crucial to maximising the benefi ts you will feel.


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To review symptoms and measure lung function is important, but will not reveal the inflammation which is the underlying cause of asthma.

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Airways


People frequently ar-rive at my door dis-heartened – often after a circuitous route of many refer-ral and having got nowhere with other

treatments. By the time they reach me they often think that there is no cure, therefore there is no treat-ment – this is not the case. Even without a cure, you can almost al-ways get a skin complaint under control.

The biggest challenge is estab-lishing what the cause of the com-plaint is, and thus ascertain how to treat it. For instance, is it endog-enous, that is, coming from within you? Or is it exogenous, caused by an external factor?

Patients often come into hospi-tal with urticaria, a surface skin irritation that is alarming them greatly – they often think they’re going to die, which is usually un-likely. One of the biggest miscon-ceptions is that urticaria, or hives, is always allergy-related. It could

be caused by an allergic reaction (whether recurrent or one-off) such as to stinging nettles, cer-tain foods such as nuts or shellfi sh, waspstings or animal contact, or it could be caused by an infection. The response to nettles, for in-stance, is not an allergy but it does provoke an overactive response by the immune system.

Eczema is commonplace and has many causes, from a hereditary el-ement to a food or contact allergy. Steroid treatment is extremely ef-fective but there is a great deal of anxiety about steroids, principally because they are mistaken for the anabolic steroids taken by com-petitive weightlifters, a fear which leads to eczema being undertreat-ed. They are not the same - and a steroid suppressant cream has a dramatic eff ect on eczema. It’s true that they can cause skin thinning and atrophy – but lowering usage should protect against developing skin thinning and retain its effi ca-cy. There is also a group of new, im-munomodulator, drugs which hold

How to heal your skin

Skin consultations account for 15 per cent of GP consultations and skin complaints and skin allergies can come in so many diff erent forms, from eczema and urticaria to prickly heat. Knowing why a complaint has arisen is the key to knowing the treatment.

much hope for treatment.Prickly heat is most common

in teenagers, and more common in women with up to 15 per cent diagnosed with it. It’s triggered by the fi rst strong sunlight expo-sure of the year, usually on holiday. The bumps and irritation that ap-pear on sunexposed skin can then spread to non- sunexposed areas.

The treatment options are to ex-pose slowly to solar radiation by covering up at fi rst and using high SPF – also the best solution against ageing! It’s possible to have medi-cally prescribed sunbeds that use UVB rays (unlike the cosmetic ver-sion found on the high street), with the aim of gradually desensitis-ing the skin. The other option, and probably the most user-friendly, is to take oral steroids for four days, as it occurs, to pre-empt further development.

As well as achieving an accurate diagnosis, patients must check who they are seeing: if in doubt, ask - are you a consultant derma-tologist?

“Even without a cure, you can almost always get a skin complaint under control.”

BE PRO-ACTIVE

Dr Jennifer YellConsultant dermatologist at Spire Cheshire Hospital, Salford Royal NHS Foundation Trust and Trafford NHS Trust

PERSONAL INSIGHT

www.lavera.co.uk

for very sensitive skin

100%NATURALORGANIC

AND

01557 870266

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