Solutions to weird health questions

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We’ve all avoided discussing an awkward or simply downright weird health question with our doctor before – and I invited all you beauties to share your experiences with this particularly embarrassing topic in a recent forum.

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Even though I’m not a qualified doctor, I know some people who are, so I reached out to them to help answer your questions! Watch the video above to find out the answers to five strange health questions from Dr Ilana Galgut, Associate Doctor at enRich Dermatology and Cosmetic Surgery Clinic and Dr Craig Plumridge, Sports Podiatrist at Pro Feet Podiatry.

Body acne

Q: I have boob acne (gross I know!). I have tried acne cream but my poor sensitive skin pretty much burned (literally) whenever I applied the cream multiple days in a row to the point where it was even too sore to touch, was red like bad sunburn and was peeling. I would love to know if there is an acne body wash out there that won’t burn my skin and will get rid of most of the acne.

A: Acne on the body is very common, affecting predominantly the back and chest. Treatment is along the same lines as for face acne. The area should be kept clean and dry so wearing breathable clothing is important. Changing sweaty clothes and showering after exercise are also helpful.

Medical treatment can be either topical or oral. Topical antibiotics or creams that thin the top layer of skin and unblock the follicles is a good starting point. However, some of the creams can irritate [the area] so building up to daily use can be helpful. Unless the acne is severe, two to three months of topical treatment should be tried. If this doesn’t help or the acne is more severe, oral antibiotics may be needed. – Dr Ilana Galgut

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Painful pap smears

Q: I get severely painful pap smears – they seem to be a not so pleasant side effect of menopause. I had no idea it could even happen until it did, and I hit up Google for info and found it’s actually a fairly common problem – just that women don’t talk about it. Why does this happen and can it be fixed?

A: As we age, and go through menopause, our hormone levels change and women become relatively oestrogen-depleted. Just as sexual intercourse can become uncomfortable after menopause, and necessitate using a bit more lubricant than before, pap smears can elicit similar concerns for some women. However, this isn’t a given – in fact most women tolerate pap smears just as easily before and after menopause.

First up, if you have had discomfort from a previous smear, advise your doctor so he/she is aware you are concerned and can work a little more slowly and gently. The speculum is usually not lubricated prior to insertion into the vagina. However, a small amount of lubricant can make all the difference, without compromising the quality of the smear. Wetting the speculum with water can also ease insertion.

However, occasionally, instructing the speculum is just too unbearable. Selecting a smaller speculum may be helpful. In fact, there is a range in speculum sizes so choosing smaller may make life easier.

If this still doesn’t allow you to leave the room with a smile, it may be worth asking your doctor whether you can have a prescription for some topical vaginal oestrogen cream to use either regularly or for a few weeks prior to your smear test. Regular use will reduce the number of urinary tract infections and allow [for] better lubrication during intercourse. Whatever the cause, all concerns should be communicated to your doctor so you are working as a team to achieve the best possible outcome. – Dr Ilana Galgut

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Lumps and bumps

Q: My husband has a hard, subcutaneous lump on his arm about the size of a golf ball, which is usually covered up by shirts. It hasn’t increased in size, isn’t painful or attached to the bone. It’s like a hardened cyst. It just doesn’t look pretty. How would this lump be removed? Could a GP remove it under local anaesthetic?

A: Lumps and bumps are common on the skin. A lump that has been present for a long time and that doesn’t change at all can be left alone. If, however, it is bothersome, or cosmetically unacceptable, it can be removed.

There are several possibilities as to what a lump that hasn’t changed may be. Common lumps are sebaceous cysts and lipomas. The difference may be easy to work out by your doctor. A GP who performs lump excision procedures can remove the lump. Otherwise a dermatologist, general surgeon or plastic surgeon will be able to do it.

All excision specimens are sent off to pathology so a detailed assessment of the tissue can be performed, confirming the diagnosis. The pathology result will indicate whether the whole lesion has been removed and whether any further treatment is required, which in this setting, would be uncommon. – Dr Ilana Galgut

Toenail issues

Q: My big toenail on my left foot has been hurting for ages. It looks like it’s detached or something, like my nail has split under the actual nail and it’s bruised beneath. My mum thinks there’s something stuck under it! Do you know what this is? Will I have to get my toenail removed?

A: If there is a history of trauma (eg. stubbing the toe or dropping something on it) then it is likely your nail is exhibiting the remnants of subungual (beneath the nail) bruising. The good news is it is self limiting and won’t get worse, the bad news is the discolouration of the nail will remain until it grows out.

Alternatively [you can get a test] to confirm it is a nail fungal infection leading to discolouration, thickened nail and a build-up of skin beneath the nail increasing pressure and pain during your daily activities. As fungal infections can spread rapidly (making them considerably harder to treat), a healthcare professional’s opinion ASAP is a good idea. – Dr Craig Plumridge

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Wart worries

Q: When we first moved into our new home, my daughter ended up with a plantar wart on her heel. None of us have ever had a wart before but I knew the family who used to live in our home and one of their daughters used to joke about the warts on her feet. Are warts contagious? How are they spread, or how can you end up with them? Also how are they treated?

A: Warts or ‘plantar verrucae’ are extremely contagious viral skin infections and tend to affect children more than any other age group, likely due to their developing immune system. Typically verrucae are spread via droplets of water in showers, pools, bathroom floors and gyms.

Treatment can consist of a number of alternatives but all management options are aimed at kickstarting the immune system within the body to fight the virus from the inside out. Unlike bacterial infections, antibiotics are ineffective at resolving the issue. If you are concerned you have a wart, a professional opinion sooner rather than later will increase the likelihood of a timely resolution. – Dr Craig Plumridge

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