On the boil...
Q Over the past four years or so, I have periodically developed large, painful boils. Each time they last for about two weeks each, from their onset to my skin more or less healing. When they are about to burst, the pain is almost unbearable. My personal hygiene is good - I shower every day and wear clean clothes. I am very fit and eat very healthily. Although I have noticed a correlation between stressful times in my life and the onset of boils, I can't believe this is the fullest explanation.
A You're in good company; Karl Marx suffered from excruciating recurrent boils, though any links between erupting skin and revolutionary politics can only be guessed at. Boils are pus-filled pockets of bacterial infection in hair follicles, so they crop up in any hairy part of the body like armpits, pubic area, and ears. The bacteria often live in our bodies; 60% of us carry staphylococcus aureus in our noses, 10% of us harbour streptococcus pyogenes in our throats. Why we can carry these bugs for years with no problems, and then suddenly get boils remains a mystery. Any condition that impairs your immunity, such as diabetes, may result in boils. Stress, anaemia, poor diet and lack of sleep probably impairs immunity in some people. I'd ask your GP to take swabs from your nose and throat; use an antiseptic skin cleanser eg chlorhexidine solution; take a suitable antibiotics orally (eg clarithromycin); use an antibiotic nasal cream eg naseptin if you carry bugs in your nose and ask to be tested for diabetes. If the boils keep coming back, ask for a referral to a skin specialist who may in turn refer you for immunological tests to check your immune system.
Will my hair grow back?
Q I recently found a small patch of hair loss on the back of my head near my left ear. I have heard that this is stress related. Will it grow back, and what is the treatment?
A You sound like you have alopecia areata. It's thought to be due to your body's immune system attacking your own hair follicles. It's most common in early adulthood and is more common among people with eczema and with other autoimmune diseases such as thyroid disease. It's not necessarily stress-related. Mostly it happens out of the blue to people who have no other medical problems. Usually hair starts to regrow after a few weeks. A minority of people is less lucky and may even go on to develop rapid and total hair loss. Steroid injections into the scalp can be tried but, unfortunately, there's no one treatment that guarantees success.
I just can't quit
Q I'm desperate to give up smoking but I think I'm a hopeless case. I've tried hypnosis, relaxation tapes, acupuncture, nicotine patches, gum, and tablets. I've frightened myself witless reading all the leaflets my GP gave me. I'm still getting through 40 a day on a bad day. Is there anything that can help me?
A Don't feel too demoralised about your inability to quit. You're dealing with one of the most highly addictive drugs known to mankind: 97% of smokers who try to quit fail. But hope may be on the horizon for you with a new drug called Zyban. It's claimed to curb addiction by working on neuro transmitter chemicals in the brain (dopamine and noradrenaline). You take it for seven to nine weeks, and aim to quit after the first week. It reduces craving and withdrawal effects apparently. Side effects are similar to those you get when you quit smoking: insomnia, dry mouth and headaches. You can't take it if you have epilepsy. It should be in the UK by the summer - though whether it'll be available on NHS prescription remains to be seen.
• 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 drann@dircon.co.uk 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.
