Dear doctor

Q Summer is a bit of a nightmare for me. I get ugly small bumps on my upper arms and thighs that look red and sometimes scabby. The skin feels rough and it means I'm self-conscious about wearing sleeveless tops. Any ideas?

A You've probably got a common condition known as keratosis pilaris. Keratin is the outermost layer of the skin and acts as a protective coating - like the final layer of varnish on a car. Keratin cells surrounding hair follicles can get overactive and make small bumps instead of a smooth surface so the skin feels rough. The bumps can get inflamed and look red and angry. It is hard to treat and almost certainly looks worse to you than it does to others. The best advice is probably to try to be less self- conscious. Anti-acne creams, such as Panoxyl, which reduce keratin, can help roughness. Prescribable creams, such as Calmurid or Retin-A, are the next line of attack. Oral antibiotics like Minocin, also for acne, are useful if the bumps are very red and irritated.

Q I am having hormone injections for prostate cancer. My consultant says I am doing well. I recovered quickly after the operation but I am now exhausted. My wife says it's as though I've lost all my drive and become like an old man overnight. Any advice?

A You are asking a lot of yourself. You have had the psychological shock of being told you have prostate cancer, followed by the physical strain of a major operation. You have been thrust into the role of "patient" and are still having to see a doctor for check-ups, blood tests and injections. It's enough to make anyone feel a bit low, if not actually depressed. And injections (eg Zoladex) themselves are designed to mop up any spare male hormones (androgens) in your system. The lack of androgens starve any residual cancer cells of their fuel. The flip side is that low androgen levels can make you feel like a wrung-out rag. A recent American study of men on injections like yours found that those who underwent a 12-week exercise programme, consisting of three gym sessions a week, were able to improve their upper- and lower-body fitness and also reported that their quality of life was much improved. You may also want to talk to your GP about how you feel; a few sessions with a counsellor may help.

Q I suffer from dreadful PMS and have been told by friends that there is a hormone patch that might help. What is it, and will it help me?

A There is a bit of a vogue for prescribing oestrogen patches like the ones used for HRT. The idea is to iron out those hormonal fluctuations that turn some of us from pussy cats to wild vixen in the few days leading up to a period. Low doses of oestrogen probably do help a bit and I would give it a go if I had bad PMS. If you use oestrogen regularly, you'll also need to take the hormone progestogen to protect your womb. Aerobic exercise and a few sessions of counselling with a cognitive behavioural therapist probably work just as well, though no trial has actually compared one against the other, so far as I know. Anti-inflammatories such as Brufen helps period pains and headaches, though not mood or breast pain. Diuretics that get rid of excess fluid, such as spironalactone, have recently been found to be good for breast tenderness and bloating and anti-depressants like Prozac can make you feel less murderous. Eating small, regular amounts of carbohydrate is also said to help mood swings by boosting "happy" chemicals in the brain. If you want to avoid drugs, the upshot is to exercise, eat carbs and book a few sessions with a therapist. If you've tried that, you could opt for the oestrogen.

· These answers are intended to be as accurate and full as possible, but should never be used as a substitute for visiting a doctor and seeking medical help. If you have a question for Dr Robinson, email or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.

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