Am I allergic to milk?
Q I get frequent headaches and often feel sluggish. I also get very bloated, which makes me feel depressed. My GP has been unable to find a cause, but I think I might have lactose intolerance. Could this be the case?
A Lactose intolerance means you can't digest the sugar in milk products. It is relatively rare in western countries though transient intolerance may be more common after tummy bugs. The best way to diagnose it is through a breath hydrogen test. You are given a dose of lactose and then the hydrogen content of your exhaled breath is measured. Increased hydrogen indicates lactose intolerance. Even people with mild intolerance can usually digest some lactose. Hard cheese and yoghurts contain lots of the good things in milk such as calcium, protein and vitamin B12 but are relatively light on lactose. It may be useful for you to try cutting out one food group at a time for a few weeks, then gradually reintroducing them while keeping a diary of your symptoms. If you feel markedly better when you cut out wheat or dairy products, then you have your answer. If you cut out major food groups for long periods of time, it is worth seeing a nutritionist.
Could I have psoriasis?
Q I get red, shiny patches around my vagina. My GP thought it was thrush but the Canesten cream I was given did little to help. It is putting me off having sex as it looks horrible. I am worried that it may be infectious and have been to a sexually transmitted diseases clinic. All the tests were negative but a doctor there said it might be psoriasis. What can I do?
A It probably is psoriasis which can affect the vulva, pubic area and groin creases. Stress, smoking and drugs such as beta blockers, may all trigger a flare up. Up to 5% of the population has psoriasis, a condition that causes scaly areas as the skin cells develop too quickly. Psoriasis may run in families, it is never infectious and it tends to be a lifelong condition which waxes and wanes. Use aqueous cream as a soap substitute several times a day to keep the skin calm. Add Polytar to your bath and get a combination cream from your GP that contains a bit of steroid - Alphosyl HC or Trimovate. Use the combination cream twice a day until the vulva settles down but keep using the aqueous cream.
Specs or surgery?
Q I am short sighted and have been told that I am unsuitable for laser eye treatment. My optician told me about a reversible operation - as yet unavailable in the UK - where a lens that can be adjusted as my sight changes is inserted into the eye. Can you tell me anything about this?
A At least a fifth of the population is short sighted (myopic) to some extent. There is a plethora of surgical options. The best known is laser surgery, which alters the surface of the cornea to improve vision. The most popular laser technique is Lasik, in which the surface of the cornea is peeled back so that the laser can reach the deeper layers. Another option is called clear lens extraction. This is a bit like the operation done for cataracts and involves removing the lens altogether. The operation you are asking about involves carving a new lens into the cornea. The biggest downside of surgery is that you may not get the desired effect. A good pair of glasses or contact lenses may give you clearer vision. This technique is practiced in the UK, though not on the NHS. In the US, refractive surgery is more common. We will catch up - we almost always do - but many ophthalmologists remain unconvinced that surgery is better than a pair of specs.
· 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 firstname.lastname@example.org 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.