My face is red and itchy all the time – I’ve spent £100s trying to fix it but nothing works

DO you ever feel short of breath or light-headed?

It could be a symptom of atrial fibrillation, a heart condition that can often go undiagnosed.

4

A study of 10.5million US adults revealed that cases could be three times more common than previously thought.

In the UK, it is thought that 1.5million people have AF.

But an estimated 270,000 people are undiagnosed and unaware, according to the British Heart Foundation.

AF is a form of abnormal heart rhythm and those with it may feel like their heart is racing or they have irregular heartbeats.

You should see a GP if you notice any of the symptoms, or if you have chest pain that comes and goes.

But always call 999 if that chest pain spreads to the arms, back, neck or jaw, feels tight or heavy, comes with shortness of breath, sweating or feeling sick, as this could indicate a heart attack.

Here’s a selection of what readers have asked me this week . . . 

Seeing red at flare ups

Q: I AM a 65-year-old woman in good health.

But my problem is the reaction of the skin on my face to certain things.

4

It’s upsetting me so much and I don’t know what to do.

Anything I use on my face either makes it red or itchy.

I’ve spent hundreds of pounds on creams, cleansers and moisturisers, but I seem to have a reaction to everything.

I paid privately to see a dermatologist who said it was eczema.

He gave me a steroid cream and emollient cream.

After four weeks though, my face had a really bad flare-up.

I’ve also paid to see a beautician who deals with acne.

She says it isn’t acne but the products she told me to use have not helped and just caused another flare-up.

It wouldn’t be so bad if it wasn’t on my face. I’ve not had this before.

A: Thank you so much for writing in.

Our face is the very first thing people see when they meet us so I understand how difficult this must be for you.

I’d like to know what the ‘flare-ups’ look like. Is there inflammation?

Or red skin, pustules, spots or itching?

The type of flare-up you’re getting can go some way to helping diagnose the underlying issue.

It sounds from your description as though it could potentially be either eczema or rosacea.

You say you saw a dermatologist privately and you’ve also seen a beauty therapist but you don’t mention taking this issue to your GP or practice nurse?

If you haven’t already, please make an appointment with your doctor, who can refer you to another dermatologist or ask for their advice if necessary.

In the meantime while you wait for an appointment, start keeping a diary so you can see if anything you eat, anywhere you go or anything you are exposed to is making a difference.

It could be that your face flares at certain times of the day or that it’s worse after sunny days, which might indicate rosacea.

Also think about whether you actually need expensive products for your face.

If you are hydrated and eat, rest and sleep well and don’t have dry skin, you might want to consider just using a very simple cleanser and emollient on your face at least for the time being.

Good luck and please don’t give up pursuing a diagnosis.

Q: I HAVE been on carbamazepine tablets for trigeminal neuralgia for a year.

I had a review two weeks ago and was told people should not be on them any longer than 12 months, yet I was given no alternative treatment and instead offered another year-long prescription.

4

I’m aware I can’t just stop them, so could you please give me a safe way to come off them?

I am a man aged 69, and the condition came on suddenly after I contracted Covid.

It’s so bad that I can’t touch the hairs on my moustache without getting an “electric shock”.

I’m at my wits’ end.

A: Trigeminal neuralgia is often described as a shooting pain that affects the face, and many people do liken it to an electric shock.

It affects the trigeminal nerve, which carries signals from the face to the brain and it can be incredibly painful, debilitating and massively affect quality of life so I’m not surprised to hear you’re at your wits’ end.

If carbamazepine is helping then you absolutely can take it for longer than 12 months unless you have major issues with it or side-effects, which can include dizziness, drowsiness, shaking and speech difficulties to name a few.

If you are experiencing any of the side-effects, there are other drugs such as gabapentin and phenytoin which can potentially be tried instead.

The fact you’ve been given another 12-month prescription suggests to me that your GP is aware you can take it for longer than 12 months but it seems there have been some crossed wires somewhere, with you being led to believe it can’t be continued long term.

It’s best to call your GP surgery or request an e-consult for clarification.

If your symptoms are not well controlled with medication then there are a number of minor surgical procedures that can be used to treat trigeminal neuralgia – usually by “damaging” the nerve to stop it sending pain signals – but these are generally only effective for a few years.

Pregnancy has brought on bad IBS

Q: I AM four months into my pregnancy and have developed chronic IBS from nowhere.

I’ve never had it before and wonder what could be causing it.

4

A: Yes, it is possible to develop new-onset irritable bowel syndrome during pregnancy.

IBS is a fairly common condition affecting the digestive system that can cause uncomfortable symptoms that come and go.

Hormonal changes, especially increased progesterone, slow down our digestion, leading to constipation, bloating, and discomfort similar to IBS.

Stress and dietary adjustments during pregnancy can also trigger symptoms, as can the growing size of the uterus putting pressure on the intestines.

While IBS isn’t considered harmful, it is essential to rule out other potential causes of these symptoms which can be more serious – such as infections, inflammatory bowel disease, coeliac disease, thyroid dysfunction, allergies, intolerances or bowel cancer.

So it is a good idea to get in touch with your GP and be checked over thoroughly.

If other causes have been ruled out then managing IBS in pregnancy usually involves taking measures to reduce stress, staying hydrated, and adjusting your diet.

For example, avoid common triggers such as fatty, fried or spicy food and carbonated drinks.

It can also help to eat smaller, more frequent meals to reduce bloating and discomfort.

Staying regularly active is important during pregnancy and certain activities such as pregnancy yoga and Pilates can be very effective at alleviating symptoms of IBS.

You may be able to access a dietician through your GP or maternity team so do share these symptoms with members of your antenatal team.