For 18 months I have been going back and forth to my GP with skin condition – please help!

FOR many, opening up about our mental health is difficult.

One in three of us has decided against seeking mental health support, due to the stigma that still surrounds the issue, a survey by BetterHelp found.

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I want to reassure you that your GP is there to help you navigate mental health issues.

They are issues we hear about daily.

And what better time to help yourself than Mental Health Awareness Week, which began yesterday?

Run by the Mental Health Foundation, this year’s theme is “community” – celebrating the support networks that help us to thrive and feel more connected.

These could be a group at work, a hobby club, volunteering or even a fan group.

Do you have somewhere you can go that gives you a sense of belonging?

Where people can support you through difficult times?

It’s not always a case of diving deep into difficult conversations – sometimes just knowing others are there can help.

Meanwhile, here is a selection of what readers have asked me this week . . . 

Q) FOR nearly 18 months I have been going back and forth to my GP with folliculitis.

At first, I was given Nizoral 2% cream.

Three months later, the folliculitis hadn’t cleared up and I was given more cream.

One year later, it still hadn’t completely gone and I was given Nizoral shampoo as well.

However, some of the condition still remains and it has started to appear on my face where hair grows.

I have seen three GPs at my surgery. I don’t want to keep taking their time, plus this is starting to wear me down. It’s difficult to see a GP since Covid.

The practice has the same number of GPs as five years ago, and I know my town has grown.

A) Folliculitis is a common skin condition where hair follicles become inflamed.

It is visible as small red bumps, pimples, or pustules around hair follicles, and may be accompanied by itching or pain.

It can be caused by bacterial, fungal or viral infections.

There is also a condition called pseudo-folliculitis, or “razor bumps”, which is caused by shaving, and ingrown hairs getting trapped and growing underneath the surface of skin, which causes inflammation.

This is more common in those with afro hair as hairs curl back before exiting the skin.

The active ingredient in Nizoral cream and shampoo is ketoconazole, an antifungal.

While folliculitis can be caused by fungal infection, it is more common for it to be caused by bacteria.

In the majority of cases, a bacteria called Staph aureus is responsible.

This usually lives on the skin without causing harm, but can lead to infection in the hair follicles.

If you think it could be bacterial, the pharmacy can sell you an antiseptic cream or wash with chlorhexidine.

If that doesn’t work, you may need to progress to antibiotic ointment or oral antibiotics.

If a fungal cause has been confirmed, then oral antifungals might be the next step.

I hope this helps, and please do let me know how you get on.

Q) AFTER you revealed last week how a study suggested the ­shingles jab cuts risk of stroke and heart attack, I want to tell my story.

I was pressured by my surgery to go for the Shingrix jab, which protects against shingles.

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This is despite telling staff I never had any childhood illnesses or a varicella ­vaccine (which protects against chickenpox).

I suffered three days of nasty side-effects – yet there was no benefit, as I never had chickenpox.

I am 78 and concerned this jab could be harmful.

Maybe people should be told that, if you never had chickenpox or a live chickenpox vaccine, you can’t get shingles.

A) You are correct that shingles is a reactivation of the chickenpox virus. The varicella-zoster virus is a member of the herpes virus family that causes both chickenpox and shingles.

It causes chickenpox at the time you are infected, then the virus lies dormant in nerves that ­supply the skin.

If the virus reactivates, you get shingles in the area of skin that is supplied by that particular nerve.

The NHS shingles vaccination programme in England was introduced in 2013.

It has evolved with the introduction of Shingrix in 2021. Eligibility for it has been expanding and now includes all adults turning 65, those aged 70 to 79 and those aged 50 and over with a severely weakened immune system.

In people like yourself, it is still generally advised to get the shingles vaccination if you are in an eligible group.

This is because many people who have had chickenpox may not remember it, or maybe had a mild infection without anyone realising it.

So the shingles vaccine can still provide protection even if you never had a documented case of chickenpox.

You are right that you cannot get shingles without having had chickenpox – but if exposed to someone with shingles, you could get chickenpox.

Q) I AM 45, and about three weeks ago I had a choking episode at work, while eating a grape.

I coughed up the grape, but my throat went into spasm, and I needed back slaps.

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A few days later, I felt like one of my medication tablets was stuck in my throat.

I have seen my GP, who has temporarily prescribed 20mg of esomeprazole twice a day, as I have been left with constant belching.

I have also seen a private ear, nose and throat doctor for peace of mind.

They did an endoscopy, and my throat is normal.

I have lost a stone since the episode as I am now struggling to eat.

A) Throat pain and increased belching can be normal following an episode of choking, caused by any trauma, spasm and injury from the incident.

Feeling like your medication is stuck in your throat could also be due to the inflammation left behind following the choking episode.

But three weeks does sound like quite a long time, and your weight loss is certainly concerning, so you should return to your GP.

Do you have actual difficulty swallowing, aside from any pain or discomfort?

If you do, then this is not to be ignored. We call difficulty swallowing “dysphagia” and it should always be investigated, especially when there is also weight loss.

While your ENT examination of the throat is somewhat reassuring, their cameras sometimes only see as far as the voice box, and swallowing difficulties may be due to an issue lower down – either in the oesophagus or stomach.

It’s worth checking if your ENT doctor did see as far down as this, and if not, you may need to be referred for further tests by your GP.