Why should I have my moles/lesions checked?

by | | Dr Yasir Azim Mirza, Useful Information

National screening programmes like breast and colon cancer do not exist for skin cancers. Skin cancer is the most common and fastest-growing cancer in the U.K. Basal Cell Carcinoma is the most common skin cancer followed by Squamous Cell Carcinoma. Malignant melanoma is one of the most common cancers in the young age group aged 15-34 years. The more moles one has the higher the risk of melanoma. Other risk factors include skin that burns easily, increased freckling, red-blonde hair, blue-green-hazel eye colour and a high number of sunburns in the past. Previous history of melanoma significantly increases the risk of developing another melanoma. Early diagnosis improves the outcome significantly. Annual screening by a professional is recommended for all. Individuals who spend greater amounts of time outdoors and exposed to UV radiation for prolonged periods of time (outdoor workers, outdoor sports, with sports enthusiasts, gardeners etc.); those with personal or family history of skin cancer and immunosuppression will benefit the most for skin cancer screening through a total-body skin examination.

Why am I losing so much hair?

by | | Dr Yasir Azim Mirza, Useful Information

Losing excessive hair is distressing both for men and women. In the absence of any disease men generally start losing hair from their crown in their 40’s along with receding hairline but this can start at an earlier age especially if there is a family history. Hair loss in women in the absence of any disease presents as thinning of hair on the front top part of the scalp along with increased shedding and notice wider parting. This is called Androgenetic Alopecia and affects 70% of men and 30% of female. This is not a disease and is related to declining hormones and hair follicle ageing as long as there are no underlying hormonal abnormalities like excess androgens.

Another common cause of hair loss is telogen effluvium. This can be caused by stress, rapid weight loss, fad or starvation diets, thyroid dysfunction and low iron. Generally, we lose approximately 100 hair per day which is normal but in this condition, we lose more hair due to the underlying triggers.

Traction Alopecia is a condition which affects afro Caribbean scalp mostly and is related to traction or tight hairstyles like braiding or ponytails and chemical or heat treatments.

Alopecia Areata is an immune-mediated condition which causes patchy and shiny bald areas on the scalp and other hair-bearing sites (mostly eyebrows, beard area). It affects 2% of the population and is one of the most common conditions seen in dermatology clinics.

There are conditions like frontal fibrosing alopecia, lichen planopilaris, folliculitis decalvans and lupus which can cause scarring alopecia. Early recognition and treatments help prevent disease progression.

There are medical treatments available for most of the conditions mentioned above. Multi-vitamins rich in zinc, selenium and biotin help with pattern hair loss. Another effective treatment for pattern hair loss is Minoxidil foam. Telogen effluvium generally improves spontaneously if the underlying triggers are removed or treated. Treatment of traction alopecia involves loosening the hairstyle and avoid traction. Alopecia Areata can be treated with steroid cream or steroid injections. There are specialised treatments available to stop the progression of various forms of scarring alopecia.

Do I need to be tested for food allergy?

by | | Dr Yasir Azim Mirza, Useful Information

This is not needed in the majority of cases. Most children with mild to moderate eczema which respond well to treatment do not have a food allergy especially if there has been no link identified by parents with a flare-up of eczema with a particular food. In such cases, no investigations are recommended. Allergy testing should be considered in children with mild to moderate eczema that does not respond to treatment, children with moderate to severe eczema, children with co-existing gastrointestinal symptoms (diarrhoea, vomiting, reflux, colic etc.) and if eczema is associated with a perioral flare when eating and perianal erythema. Food allergy can also manifest as hives/urticaria, angioedema and anaphylaxis. This is seen with peanuts, tree nuts, shellfish, white fish (e.g. cod), egg white, cows milk, soya, wheat and sesame seeds. These are called type 1 or immediate hypersensitivity reactions as the reactions occur within minutes of ingesting or contact with an allergen. Most of the time patient or parents in case of children are able to identify the cause. If it is not clear from history then allergy testing is recommended to identify the potential allergen. Patients with nut allergies, often have multiple allergies and usually require further investigations.