Sense and non-sense
Q: My sense of smell has completely diminished over the past few years. I've been to the doctor and he can't find a blockage so it's not a sinus/nasal problem. I haven't got around to going to a specialist yet. I'm 27, a non-smoker, vegetarian and am careful about eating a balanced diet. I've tried researching the problem but can't seem to find much info on the subject. The only thing I could come up with is maybe a zinc deficiency. Could this be the case?
A: Loss of smell (anosmia) is usually temporary and caused by a cold or sinusitis. If it persists, you certainly need to see an ear, nose and throat specialist. The usual causes are nasal polyps, allergies or dental problems. Rare causes are side-effects of medicines, insecticide poisoning, radiation treatment for cancers of the head and neck or brain tumours. Deficiencies of copper, zinc or other trace metals have all been touted as causes but are hard to prove. Often, no cause is found and the sense of smell returns as mysteriously as it disappeared.
Q: My children (four and six) are plagued by warts. Our GP says it's a virus called molluscum contagiosum and other than lancing them and dabbing them with iodine (which sounds brutal), there is nothing you can do. Is there anything you could recommend? Are there any homeopathic remedies that might help?
A: Molluscum have joined headlice, threadworm and verrucas as a rite of passage through nurseries and primary schools. You can leave them alone; the body eventually fights off the virus that causes verrucas and warts and they drop off. But children prone to eczema may get irritating patches of eczema round their molluscum, they can become infected, and they spread easily to others.
Dr Richard Aron, consultant dermatologist at the Garden Hospital in North London, says there's no single anti-molluscum drug that works. He applies a cream called EMLA under clingfilm or similar dressing for an hour to numb the skin and then scoops out the moluscum (curettage). He's also investigating whether Aldara cream, used to treat genital and anal warts, works against molluscum. Homeopaths say sucking one thuja tablet a day for a week helps and is safe for all ages. Thuja is widely available in pharmacies and health food shops. See www.homeopathydr.com.
Spot of bother
Q: I'm 27 and have suffered from spots for the past 10 years. I've tried many products, none of which have worked. I keep my skin clean, eat plenty of fruit and vegetables and avoid caffeine and excessive amounts of alcohol, but my skin is constantly spotty. I very rarely have periods, which suggests a hormonal link, but when I tried the contraceptive pill, Dianette, it made me depressed, so I stopped taking it. My ovaries have been checked and appear to be fine so there is no obvious reason why I don't have periods.
A: I'm not advocating it, but you could live on chocolate, coffee and alcohol and find that your skin was no worse than if you ate an impeccable diet. Dianette's good for acne because it counteracts the hormone testosterone that contributes to greasy skin and spots. But if Dianette makes you more depressed than the acne, there's no point taking it.
Dab-on tropical antibiotics such as Stiemycin or oral antibiotics such as Minocin may work. But if your acne is severe or persistent, I'd ask for a referral to a dermatologist to get Roaccutane. This drug gets a bad press because it causes cracked lips and dry, peeling skin which can feel like you've been sandblasted. You can't get pregnant while on it or for a month after finishing the course, but it works better than anything else.
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 email@example.com 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.