Dear doctor

Every breath you take

Q: I work in a garage repairing motorbikes. The ventilation is very bad and I feel as though I'm inhaling a lot of fumes. My mum mentioned carbon monoxide poisoning. Can I be tested for it?

A: Carbon monoxide is a gas produced when coal, coke, oil or wood burns incompletely. Levels can build up in the air, especially if there is poor ventilation. It's dangerous because it replaces oxygen in your blood so that cells become starved of oxygen. Exposure over a long period of time can cause symptoms similar to those of flu or a tummy bug. In textbooks it says that you turn cherry red in colour; in practice it's hard to spot any change.

You can have a test to measure levels of carbon monoxide (carboxyhaemoglobin) in your blood, but it needs to be analysed quickly and should ideally be taken while you're at work. Your GP can speak to your local hospital to arrange the blood test, or a specialist at the hospital can measure the level of carbon monoxide in the air you breathe out. The health and safety executive (HSE) will advise about safety measures and ventilation - you should contact them for the sake of your workmates as well as yourself. For further information, call the HSE on 08701 545 500.

Bittersweet supplement

Q: I am having horrible hot flushes as I go through the menopause, and often find myself drenched in sweat. I'm not very keen on HRT so a friend suggested I try soya. Unfortunately I don't like the taste of these products. Any other ideas?

A: Naturally occurring plant oestrogens (phytoestrogens) are found in soya and tofu, but to get enough to stop your hot flushes you may need to eat lorry-loads. However Tofupill may be your answer. It contains phytoestrogen derived from concentrated tofu, calcium and vitamin E, which may or may not help protect against ageing. I'm not a great one for supplements, but in your case it is worth a try.

Where's my wig?

Q: I recently became partially bald when lots of my hair fell out due to alopecia. I have been told that there is no cure, but I am terribly self-conscious about the way I look. I think I would prefer to wear a wig, but the ones I've seen in shops are not very realistic. Where can I find a realistic- looking wig, and is there any way I can get one on the NHS?

A: I agree that a wig would be a good idea if you feel uncomfort able about the way you look. There are two types: real hair and acrylic. Real hair wigs are pricey: up to £1,000 each. Acrylic hair is more common now as it is cheap and easy to use. Some people find the acrylic ones more artificial-looking, and they can be hotter and itchier to wear. Also, real-hair wigs last up to three years while the acrylic ones may only last six months.

The NHS doesn't supply wigs but, if a consultant sanctions it, you can pay a prescription charge of just under £50, for which you get an acrylic wig worth about double that. In some cases the NHS will pay for the full cost of a wig. You should ask your GP to refer you to a dermatologist for advice. You can also get useful information from

Nightmare bumps

Q: I have inherited the skin condition keratosis pilaris. I am aware that there is no cure for this as it is considered more of a cosmetic problem. I am fair-skinned, however, and the small bumps extend up both of my arms. This is a nightmare in summer because it is so unsightly. Is there anything you can recommend to reduce the appearance?

A: Yours is a very common skin condition that lots of people probably have without realising it. It causes tiny rough spots on the outer part of the arms and occasionally the thighs. It affects teenagers mainly and tends to become less obvious as you get older. The spots may look red and rough, but they rarely itch and never hurt or become cancerous. It occurs because, as the skin renews itself, old skin cells get stuck in the hair follicles and make a scaly plug of dead cells. Try using a moisturising cream such as Diprobase twice a day, rub your arms with a pumice stone or loofah when showering or bathing, and consider a prescription of tretinoin (Retin-A) cream or gel. For the first few weeks of treatment, Retin-A may cause redness and peeling of the skin, but after that the bumps may flatten out nicely.

• 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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