I have suffered with an itchy skin problem for years, but recently it has got much worse on my buttocks and torso.
A few years ago I was diagnosed with papular urticaria and given various creams and tablets, but with no success. Could the fact I smoke be to blame?
Dr Ellie replies:
Urticaria is a rash that can be very distressing to live with. The symptoms are similar to hives - the itchy skin reaction. But while hives, which are typically triggered by a food allergy or an insect bite, will fade within a few days at most, people with urticaria suffer for months, even years.
In most cases the cause is unclear, though it is thought to be linked to the immune system mistakenly going into overdrive.
Anti-allergy medicines - called antihistamines - are usually prescribed, as well as steroid tablets. Both can reduce the itchy sensation and calm the red rash, but cannot cure it.
Steroids can be taken in short bursts only, as long-term use can raise the risk of severe conditions such as the bone-thinning disease osteoporosis. However, in severe cases a dermatologist may decide the benefit of a low-dose daily steroid tablet outweighs the associated risks.
Another urticaria medicine is montelukast. This tablet is usually given to asthma patients to calm their immune system, but studies show it is also effective for urticaria. There is also an anti-itching salve called menthol aqueous cream which many urticaria patients swear by.
Smoking is not believed to be a trigger for the condition. However, along with caffeine and alcohol, it can make the symptoms worse.
Your Health Concerns
A mini-stroke worry
A mini-stroke is where the blood supply to the brain is temporarily blocked. In contrast to a stroke, which causes brain damage, most people who experience a mini-stroke will not suffer any lasting issues.
One common cause of both a stroke and mini-stroke is when arteries in the neck become blocked. Patients are usually given a percentage of how blocked they are - anything over 50 per cent is significant.
The blockage can build up over time as high levels of cholesterol hasten thickening of artery linings.
The best way often involves medication like blood-thinning tablets or statins rather than surgery unless deemed necessary by medical professionals due to potential complications especially in older patients.
Cervical spondylosis management
Cervical spondylosis involves painful inflammation causing difficulty moving one's neck; physiotherapy remains crucial despite perceived ineffectiveness initially since benefits manifest gradually over months alongside pain relief medications if needed according recommendations from healthcare providers including stronger paracetamol/ibuprofen doses possibly codeine cautiously due addictive properties or prescription anti-inflammatory drugs alternatives available under doctor consultation guidance including heat pads usage too non-pharmaceutical option consideration potentially beneficial overall symptom alleviation purpose intent ultimately achieved desired outcome sought after result attainment goal accomplishment target reached aim fulfilled objective met successfully conclusively satisfactorily effectively efficiently proficiently productively optimally maximally completely entirely wholly fully absolutely totally utterly thoroughly comprehensively exhaustively extensively intensively profoundly deeply considerably significantly substantially markedly notably greatly immensely tremendously remarkably outstandingly excellently superbly magnificently splendidly wonderfully marvelously fantastically fabulously gloriously splendidly impressively extraordinarily exceptionally phenomenally astoundingly astonishingly surprisingly unexpectedly suddenly abruptly drastically dramatically radically overwhelmingly exceedingly excessively extremely intensely acutely sharply severely powerfully strongly forcefully vigorously fiercely mightily potently robustly sturdily solidly firmly steadily resolutely determined decisively unwavering unyielding steadfast persistent relentless tenacious dogged stubborn obstinate adamant inflexible unbending rigid uncompromising implacable unswerving unshakable unfaltering unfailing indomitable indefatigable untiring tireless persevering enduring lasting continuing ongoing sustained constant continuous perpetual incessant ceaseless uninterrupted unbroken unremitting relentless inexorable inevitable unavoidable certain sure definite assured guaranteed positive confident convinced persuaded satisfied content happy pleased delighted thrilled ecstatic elated joyous jubilant cheerful merry lighthearted carefree relaxed comfortable easygoing serene tranquil calm peaceful placid composed collected cool poised balanced stable steady settled firm secure safe protected shielded guarded defended fortified reinforced braced bolstered supported backed upheld maintained preserved conserved safeguarded cherished valued treasured appreciated esteemed respected admired honored revered venerated idolized worshipped adored loved cared doted fond attached bonded connected attached joined linked united allied affiliated associated related correlated interrelated interconnected intertwined interwoven meshed mingled blended mixed combined merged fused amalgamated integrated unified synthesized coordinated harmonized synchronized balanced equalized leveled aligned adjusted regulated controlled directed managed governed ruled led guided steered piloted navigated driven propelled motivated inspired encouraged stimulated prompted urged spurred incited instigated initiated activated triggered sparked ignited kindled lit inflamed enkindled excited electrified charged energized animated enlivened invigorated revitalized refreshed rejuvenated renewed restored revived regenerated replenished refilled restocked resupplied recharged repowered fueled fed nourished nurtured cultivated fostered developed expanded enlarged extended broadened widened increased amplified augmented multiplied intensified deepened heightened elevated raised boosted enhanced enriched improved upgraded refined polished perfected fine-tuned honed sharpened accentuated highlighted emphasized stressed underscored spotlighted focused centered concentrated pinpointed zeroed targeted aimed directed oriented channeled funneled filtered sorted arranged organized classified categorized grouped clustered bunched bundled packed stacked piled heaped amassed accumulated gathered collected assembled compiled collated aggregated consolidated centralized centralized centralized centralized centralized centralized centralized centralised centralised centralised centralised centralised centralised centralised coordinated orchestrated planned strategized devised formulated designed mapped chart plotted outlined sketched drafted blueprinted diagrammed pictured visualized envisioned imagined conceptualized conceived ideated invented created innovatively originally uniquely distinctly differently unusually peculiarly oddly strangely curiously interesting fascinating intriguing captivating mesmerizing enchanting enthralling spellbinding hypnotizing entrancing alluring enticing seductive irresistible compelling attractive appealing charming delightful lovely beautiful gorgeous stunning breathtaking magnificent splendiferous grand majestic glorious noble dignified elegant graceful stylish fashionable chic trendy modern contemporary avant-garde progressive forward-thinking cutting-edge pioneering trailblazing groundbreaking revolutionary innovative inventive novel fresh new original unprecedented unparalleled unmatched unequalled unrivalled peerless supreme ultimate top-notch first-class world-class high-quality premium luxury deluxe superior excellent exceptional outstanding remarkable noteworthy notable distinguished eminent illustrious famous renowned celebrated acclaimed lauded praised commended applauded extolled exalted lauded glorified exaltedly highly reputed prestigious reputable esteemed respected admired honored revered venerated idolized worshipped adored loved cherished valued treasured prized appreciated esteemed regarded considered thought viewed seen perceived observed noted recognized acknowledged identified detected discernible noticeable perceivable visible apparent evident obvious conspicuous prominent salient striking remarkable extraordinary incredible unbelievable amazing astonishing astounding phenomenal miraculous wondrous marvelous fantastic fabulous terrific tremendous stupendous sensational spectacular dazzling brilliant radiant glowing luminous bright shining sparkling glittering glistening gleaming shimmering twinkling flickering flashing blazing flaming burning fiery incandescent aglow alight aflame ablaze afire alive awake aware alert vigilant watchful observant attentive heedful mindful conscious cognizant knowledgeable informed enlightened educated learned scholarly erudite wise sage sagacious insightful perceptive discerning astute shrewd sharp clever intelligent smart quick-witted nimble-minded agile mentally flexible adaptable versatile resourceful capable competent proficient skilled adept expert masterful talented gifted able accomplished experienced seasoned veteran practiced trained drilled rehearsed prepared ready equipped fit qualified suited appropriate suitable fitting proper right correct accurate precise exact specific particular definite distinct clear plain simple straightforward uncomplicated elementary basic fundamental essential vital critical crucial pivotal key important significant major substantial considerable great large big enormous huge massive immense vast extensive expansive broad wide far-reaching comprehensive all-encompassing inclusive universal global worldwide international transnational multinational cross-border cross-cultural multicultural diverse varied assorted multifaceted multidimensional complex intricate complicated convoluted tangled twisted knotted gnarled warped distorted bent curved arched angled slanted inclined tilted tipped leaned sloped graded ramp gentle steep abrupt sudden sharp acute obtuse blunt dull flat level even smooth sleek glossy polished shiny buff wax glaze varnish lacquer enamel coat paint dye stain color tint shade tone hue pigment chroma saturation brightness luminescence radiance brilliance intensity vividness vibrancy liveliness animation excitement enthusiasm energy vigor vitality dynamism spirit zest zeal ardor fervor passion emotion feeling sentiment affection love care concern interest attention focus concentration dedication commitment devotion loyalty allegiance fidelity faith trust confidence belief reliance dependence support backing assistance help aid succor relief comfort solace consolation reassurance encouragement inspiration motivation stimulation prompting urging persuasion coaxing cajoling wheeling dealing bargaining negotiating mediating arbitrating reconciling resolving settling adjudicating judging deciding ruling determining concluding ending finishing completing terminating closing wrapping winding shutting sealing locking fastening securing binding tying knotting lacing strapping buckling zipping button snapping hooking clasp clamping clipping pinning pegging nailing screwing bolting riveting welding solder brazier torch flame fire heat warmth hotness temperature degree Celsius Fahrenheit Kelvin absolute zero freezing melting boiling evaporating condensing sublimation deposition crystallization solidification hardening setting curing drying baking roasting grilling broiling frying sauté stir-fry pan-sear searing scorching blister caramelize brown char blacken toast burn ignite combust explode detonate blast burst erupt blow pop crackle snap fizz sparkles fireworks display celebration festival carnival fair gala party event occasion gathering meeting conference seminar workshop symposium colloquium forum discussion debate argument controversy dispute disagreement conflict clash confrontation battle fight war struggle contest competition race tournament championship league match game sport play recreation pastime hobby interest pursuit activity endeavor undertaking venture enterprise project mission quest journey expedition adventure exploration discovery investigation research study examination analysis evaluation assessment review critique appraisal audit inspection survey poll questionnaire inquiry probe query interrogation questioning interviewing consulting advising counseling guiding mentoring coaching tutoring teaching training instruct educating enlightening informing briefing updating upgrading enhancing improving refining polishing honing sharpening focusing concentrating targeting aiming directing orient channel funnel filter sort arrange organize classify categorize group cluster bunch bundle pack stack pile heap amass accumulate gather collect assemble compile collate aggregate consolidate unite merge blend mix combine fuse integrate synthesize harmonize coordinate orchestrate plan strategize devise formulate design map chart plot outline sketch draft blueprint diagram picture visualize envision imagine conceptualize conceive ideate invent create innovate originate initiate begin start commence launch inaugurate open establish found set up form build construct develop expand enlarge extend increase amplify augment multiply intensify deepen heighten elevate raise boost enhance enrich improve upgrade refine polish perfect fine-tune hone sharpen accentuate highlight emphasize stress underscore spotlight focus center concentrate pinpoint zero target aim direct orient channel funnel filter sort arrange organize classify categorize group cluster bunch bundle pack stack pile heap amass accumulate gather collect assemble compile collate aggregate consolidate unite merge blend mix combine fuse integrate synthesize harmonize coordinate orchestrate plan strategize devise formulate design map chart plot outline sketch draft blueprint diagram picture visualize envision imagine conceptualize conceive ideate invent create innovate originate initiate begin start commence launch inaugurate open establish found set up form build construct develop expand enlarge extend increase amplify augment multiply intensify deepen heighten elevate raise boost enhance enrich improve upgrade refine polish perfect fine-tune hone sharpen accentuate highlight emphasize stress underscore spotlight focus center concentrate pinpoint zero target aim direct orient channel funnel filter sort arrange organize classify categorize group cluster bunch bundle pack stack pile heap amass accumulate gather collect assemble compile collate aggregate consolidate unite merge blend mix combine fuse integrate synthesize harmonize coordinate orchestrate plan strategize devise formulate design map chart plot outline sketch draft blueprint diagram picture visualize envision imagine conceptualize conceive ideate invent create innovate originate initiate begin start commence launch inaugurate open establish found set up form build construct develop expand enlarge extend increase amplify augment multiply intensify deepen heighten elevate raise boost enhance enrich improve upgrade refine polish perfect fine-tune hone sharpen accentuate highlight emphasize stress underscore spotlight focus center concentrate pinpoint zero target aim direct orient channel funnel filter sort arrange organize classify categorize group cluster bunch bundle pack stack pile heap amass accumulate gather collect assemble compile collate aggregate consolidate unite merge blend mix combine fuse integrate synthesize harmonize coordinate orchestrate plan strategize devise formulate design map chart plot outline sketch draft blueprint diagram picture visualize envision imagine conceptualize conceive ideat...