Health: Dear doctor

How do I get rid of my scar?

Q I've got an ugly raised scar on my chest from when I had a mole removed years ago. I have to wear quite high-necked T-shirts and tops as I am very self- conscious of the scar. Is there any good way of getting rid of it?

A Keloid scars are the result of over-zealous healing by the body. Cells called fibroblasts produce too much collagen and not enough elastic so the scar is tough but not stretchy or able to lie flat and merge with its surrounding skin.

They are particularly common in the midline of our bodies because we develop as two halves in the womb and fuse down the middle early in development. This line of fusion is a bit of a faultline so anyone wanting to have harmless spots removed should be aware that scarring is more likely down the middle of our bodies than at the edges.

Treatment options abound, which is always a sign that no one treatment is guaranteed to work. They include surgery to cut out the scar and hope the new one is neater, injection of steroids or other drugs that suppress the immune system, freezing with liquid nitrogen or zapping with a laser. A clever new discovery shows that injecting the drug Verapamil, a heart drug which blocks calcium in cells and clobbers collagen, into the scar in addition to cutting it out and covering it with silicone, increases the success rate to 54%.

A more DIY solution is Cica-Care, which is a sheet of silicone gel available on prescription or over the counter that can help flatten and soften raised scars.

Scar Information Service: 0845 120 0022

Gut reaction

Q I suffer from permanent abdominal bloating. A nurse informed me it was due to gas. I have tried altering my diet to exclude wheat and other possible irritants, but nothing seems to offer relief from the discomfort. Any suggestions?

According to some health writers, those of us eating a western diet will have developed intestines and colons encrusted with fats, mucus, food residues and putrefying meat. They advocate remedies such as wholefood diets, fasting, colonic irrigation, and herbal colon cleansing (this last one is a three-month programme of cascara-based laxatives, bulking agents and supplements such as acidophilus).

What do you think of the risks and merits of all this?

A Bloating that comes and goes and is relieved by passing wind, is not a sign of ill health. It is a normal reaction to the build-up of gas in our colons.

Ways to reduce the gas we make are to avoid gas-forming foods such as beans, broccoli and lots of white bread and carbohydrate. Some people have particular foods which make their guts fill up like a balloon; you usually know what they are without fancy tests. Stagnant stool ferments and produces gas so eating moderate amounts of fibre, drinking lots of water and exercising, which all keep your gut contents flowing, help to prevent wind. There are drugs that absorb gas (charcoal), ones that relieve spasm in the gut (eg Colofac, Buscopan) and laxatives (eg Lactulose). But the drugs all have side effects and don't offer a lasting solution.

Colonic irrigation obviously agrees with some, though to me a colon without faeces is like a heart without blood; the organ is well adapted to deal with excretion and wasn't designed to be spring cleaned.

A hangover at 12

Q My son is 12. He recently stayed with my sister, where some idiot gave him alcohol. He got drunk and had a hangover the next day. Exactly how dangerous is this and is there anything I can do to repair any damage?

A Alcohol, like most drugs that can damage the liver, should not be given to children, especially not in adult doses. A one-off exposure to alcohol is highly unlikely to have done him any harm at all. If he hated having a hangover, it may serve as a useful deterrent to alcohol abuse in future. But it is a good idea to seize this opportunity to show him how irresponsible people can cause him potential harm; he will probably be offered alcohol, cigarettes, solvents and street drugs over the next few years and he needs practical advice as to how to assess the risks and say "no" with confidence. Prince Charles obviously used his younger son's brush with dope to good effect. I don't think every child who tries alcohol needs to be taken to a centre for homeless alcoholics, but pointing out the role that alcohol plays in the disintegration of some people's lives will stand him in good stead.

Thanks to who have provided this article. View the original here.


comments powered by Disqus