DR ELLIE CANNON: Will HRT help by daughter’s menopausal hair loss?

My 59 year old daughter is losing her hair. Would HRT help? She does not go to her family doctor because it is not easy to make an appointment while she is working.

The short answer is yes. Hair loss is common after menopause, when the hormones estrogen and progesterone, which are vital for regulating fertility and many other bodily processes, decline.

It may be a general thinning or just in the front and temples. Hair loss can begin during perimenopause (the years before menopause, when hormone levels first begin to fluctuate), but it also occurs many years later. This may be due to genetics or may be related to the increased effect of testosterone on the body once estrogen decreases.

Taking HRT, which increases levels of female hormones, can help slow or even stop hair loss, but it doesn’t always work. The only approved medication for hair loss in women is a lotion applied to the scalp called minoxidil. It is available without a prescription, but it is always preferable to discuss the pros and cons of any drug treatment with a doctor before deciding to start.

One of the main causes of hair loss is poor nutrition: women often find that when they lose a lot of weight, their hair thins. Your GP should be able to offer blood tests to check for low iron levels or detect any problems with your thyroid, both of which are linked to hair loss.

Certain medications, such as tamoxifen or aromatase inhibitors, for women with breast cancer, are thought to cause weight loss.

Many people are reluctant to talk about hair loss with anyone, not even a doctor. Despite affecting four in ten women and up to eight in ten men, there is a certain stigma around the disease.

It’s a complicated topic to broach, so it’s best to wait for them to say something and then offer advice on how and where to seek help.

It can also be difficult for people with busy working lives to visit a GP, but telephone consultations have become normal since the Covid pandemic. In-person appointments can be made well in advance so you can plan your free time, or you can book consultations online. Some GP surgeries also offer weekend and evening appointments.

Yo I have a big lump on my wrist. I write a lot and wonder if it’s just wear and tear from the pressure against my desk. It is not painful but it is unsightly. Can you help?

A lump like this on the wrist is often called a ganglion cyst.

This can develop in any joint, but it typically appears on the back of the wrist. They vary in size, from quite small to very large, and feel like a soft lump. Although it feels solid, it is actually a collection of fluid that bathes the joint.

The nodes are usually not painful or harmful, but of course they can be unpleasant in appearance.

They can occur at the same time as a repetitive strain injury while writing, but they usually develop for no clear reason.

It was previously thought that these cysts could be treated by hitting them with a large book to disperse the fluid, but no doctor now recommends that. Unless the cyst causes pain and limits your daily activities, the NHS is unlikely to fund your treatment.

One solution is a treatment called aspiration, in which a syringe is used to remove fluid from the lymph node. This is usually painless, but in half of the cases the cysts return at some point. Surgery may also be an option, but it is more invasive. A lymph node may shrink naturally within a few years.

Swelling in the wrist can also occur due to trauma, injury, or arthritis, but this is usually painful.

I have noticed a brown spot, irregular in shape, similar to a mole, on my belly. It’s crunchy and dark brown, but it doesn’t itch or hurt. A GP friend looked at him and said he shouldn’t worry me. That’s right?

IF you notice something new on your skin that seems abnormal, it’s always worth getting it checked out. This is particularly true if it changes over time.

It may be worth taking a photograph of the area each week to spot differences. Any growing skin tag should be examined.

In older people, a crusty brown mole could be something called seborrheic keratosis. This is a common and harmless skin problem that can appear as we age.

It is typical to see it on the belly or any part of the trunk, although they also develop on the face.

They are not normally treated on the NHS, but can be removed privately with a liquid nitrogen freezing treatment.

There are some signs to look out for that could indicate that a mole is skin cancer. An irregular shape or uneven edges is one of them.

Other worrying signs would be a mixture of colors instead of a uniform color, a mole larger than half a centimeter, and any change in shape over time. Also, watch for symptoms such as bleeding, itching, or scabbing.

Patients can have a skin lesion checked at their GP surgery.

Most online GP surgeries will allow you to upload photographs. This can be a very effective way for your doctor to decide if your skin problem is potentially harmful, along with the information you provide.

Many regions also offer a service called teledermatology, where you can send photos to a dermatologist for review.

Why I support banning some vaporizers, but not all

I’ve long been an advocate for e-cigarettes, or vaporizers, so you might be surprised to know that I’m also 100 percent behind a proposed ban on disposable vaporizers.

E-cigarettes are great for smokers: countless studies have shown that their use can help smokers ditch cigarettes and are much less harmful. Those looking to quit smoking tend to use more expensive refillable and refillable vaporizers, which will remain available after the ban.

The problem is cheap, disposable vaporizers that come in fruity flavors and fancy packaging, and are often placed near candy or on store counters, with the goal of promoting them to children.

All vaporizers have many disadvantages: they contain nicotine, which is highly addictive, and we still don’t know what the long-term effects of inhaling vapor are.

Pediatricians I speak to are concerned about young people’s lung health, and schools are seeing challenging behaviors in children addicted to nicotine from vapes. The habit is too normalized and should be limited to what it was originally designed to do: help adults quit smoking.

It’s not too late to get an MMR shot

Please tell everyone you know to get the MMR vaccine, if they haven’t already.

I was alarmed to read last week that once again children are being forced into isolation to protect others from an infectious and deadly disease.

This time it is not about Covid but about measles, a potentially deadly and very contagious virus. But it can be prevented with the MMR vaccine, which is usually given to children.

A staggering rise in recent cases has prompted two London councils to tell unvaccinated young people to isolate themselves for three weeks if a classmate has the disease. Acceptance of the MMR vaccine has fallen so low that the government expects around 160,000 people to soon be infected with measles.

We desperately need to boost vaccination to reach levels of herd immunity, when the entire country is protected. You can get the vaccine as an adult; just ask your GP.