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Ask Dr Emma
Each month, we give a group of women the opportunity to ask London based doctor Emma Amoafo-Mensah the health questions that have been on their mind but they haven’t gotten the answers to. Here are Dr Emma’s top 3 picks.
Question 1: What can I do about excessive sweating?
Sweating is a very normal and beneficial function of the body. Sweat is a key part of temperature regulation – the sweat sits on top of the skin and as it evaporates, it carries heat away from your body with it. However, excessive sweating can cause embarrassment and significant social issues for some. The medical term for excessive sweating is hyperhidrosis, and the most commonly affected areas are under the arms, palms, soles and head.
Even without hyperhidrosis, most people will need a suitable deodorant and/or antiperspirant (NB deodorants and antiperspirants are not the same – deodorants target unpleasant smells whereas antiperspirants aim to reduce the amount of sweat). There are also a few lifestyle changes you can make, such as avoiding caffeine, alcohol and spicy food. Washing your body with soap-based products should also be avoided as they remove the natural oils from your skin; you should wash with an emollient wash instead. If these do not lead to an improvement, you can see your doctor. They may prescribe you a strong antiperspirant, usually containing aluminium chloride.
If this doesn’t work, your GP may refer you to your local hospital for iontopheresis treatment. This is a really cool treatment which passes an electrical current through your skin whilst it is immersed in water, and this leads to a reduction of sweat production. It may sound a bit Frankenstein-ish but the treatment is well known and perfectly safe. If this is beneficial, you can buy your own iontopheresis machine so you can continue the treatment at home long term.
There are also some medications that can be taken as tablets for hyperhidrosis. These are known as anti-cholinergics. Whilst they are effective for hyperhidrosis, they can cause significant side effects such as dry mouth, constipation and urinary retention. The decision to start these should be after a thorough discussion with your doctor and after careful consideration.
Lastly, some hospitals in the UK offer Botox injections for hyperhidrosis. This is a specialist treatment and sometimes may need to be paid for privately. Evidence shows that Botox injections are only beneficial for hyperhidrosis under the arms and the effects wear off after 3-6 months.
For more information, check out the Hyperhidrosis UK website, which has lots of detailed explanations and helpful tips – hyperhidrosisuk.org
Question 2: What can people of colour do about hyperpigmentation on their skin?
This is a really commonly asked question and I think the person to find a true cure for hyperpigmentation would be sure that their great great great grandchildren would never have to work a day in their lives.
Melanin is the pigment that gives skin its colour. The more melanin there is, the darker the skin. Melanin plays a very important function in protecting your body from the harmful effects of UV light. Now, here is the key point – the more melanin there is in the skin, the more likely you are to get hyperpigmentation. This is why people of colour are often affected by hyperpigmentation the most.
A lot of the hyperpigmentation people complain about happens after the skin is inflamed in some way – literally, post-inflammatory hyperpigmentation. This initial inflammation may be from acne spots, burns, eczema or even minor trauma like picking the skin. Once the initial inflammation goes, the post-inflammatory hyperpigmentation is left behind and can persist for a very long time.
There are lots of commercial services offered that claim to be able to treat hyperpigmentation, such as chemical peels and lasers. These may work but it’s important to take note that even the minor trauma from the peel or laser may cause more hyperpigmentation.
In my opinion, the two most important things to do to prevent hyperpigmentation is: 1. prevent inflammation from happening in the first place and 2. protect yourself from the sun. If you’re prone to acne or have other skin conditions such as eczema, it’s important to treat these as soon as possible, to prevent the hyperpigmentation that follows. At this point I want to give a special shout out to acne. Acne is not something that ‘everyone just needs to go through’ – if you can’t get on top of your acne with a good cleanser, you should get help from your doctor because there are many treatments that can be offered. For the second point, everyone should be wearing sunscreen, this will reduce the UV rays that reach the skin and thereby reduce the need for the skin to put out more melanin.
Question 3: How do you know if you’ve caught an STI?
There are many different types of sexually transmitted infection, with slightly different symptoms for each. However, many of the symptoms overlap, so the things you should look out for are listed below:
Abnormal vaginal discharge – it’s normal for all women to have some clear or white discharge, but you should start to think about whether you may have an infection if the discharge changes colour or consistency, increases in amount, or starts to smell offensive
Itching down below – this can sometimes be accompanied by warts or blisters
Pain during sex – this can be pain felt either superficially or deep inside during penetration
Unusual vaginal bleeding – for example in between periods, or during/after sex
Somewhat worryingly, many of the common STIs don’t cause any symptoms. For example, chlamydia has been reported to be asymptomatic in up to 70% of women. I say this is worrying because left undetected, STIs can cause chronic pain and problems with fertility. For this reason, it’s always worth being seen in a sexual health clinic after you are sexually active with new partners without a condom, or if your old partner is sexually active with new partners.