DR ELLIE CANNON: Is itchy skin the legacy of my bout of lyme disease?

I have been suffering from an itchy rash for the past two months. I’ve been prescribed antihistamine creams and tablets but neither have helped. I took a course of antibiotics a couple of years ago to treat lyme disease. Do you think it could have triggered the problem?

Lyme disease is a bacterial infection that can be spread to humans via infected tick bites. The condition can cause long-term symptoms, but this usually happens only if the infection isn’t treated early enough.

Symptoms include joint pain, numbness, memory problems and even heart issues – but not usually a rash. One may develop just after a patient has been bitten, but it normally vanishes within a month or two.

Lyme disease is often likened to chronic fatigue syndrome, as both affect the immune system, leading to similar issues. Itchy rashes are one of the most common ailments I see in all ages.

More often than not, GPs, and sometimes pharmacists, can make a diagnosis by simply looking at the pattern of the rash.

For instance, in eczema and dermatitis, the skin appears very dry and cracked. But with urticaria or hives, the skin is blotchy and swollen.

Antihistamines are used to control itching, but unless the rash is related to an allergy they are unlikely to solve the problem.

The most effective treatment depends on the cause of the problem. Medical moisturisers soothe the skin, steroids calm inflammation and there are specific creams for conditions such as psoriasis or eczema. Sometimes, an itchy rash is just a patch of extremely dry skin.

If it is not clear what is going on, a GP may trial a treatment, such as a steroid cream with emollients, to see if it helps. Often this is how a doctor will reach a diagnosis for a skin problem.

But if the rash won’t disappear – even with treatment – GPs can easily refer patients to a dermatologist. We simply take a special, medical photo of the area and send it off to our colleagues.

About 15 years ago I was in a car accident and took a blow to the head. Ever since, I’ve suffered episodes of vertigo, or severe dizzy spells. They’ve eased slightly over the years, but I still get them at night. Is there a solution to the problem – or an obvious trigger?

It isn’t abnormal for head injuries to cause problems that last for many years. Sometimes, they continue for the majority of one’s life.

A head injury caused by a car accident is what doctors refer to as a traumatic brain injury – which includes any bang to the head.

This is especially true in a car because the vehicle stops suddenly, causing the head to move abruptly, which can potentially affect a section of nerves in the brain. It can also lead to broader damage known as diffuse brain injury. Long-term effects depend on the area of the brain that is impacted.

Vertigo causes you to feel as though you are spinning or rotating, even when motionless. There are many potential causes, including a concussion that has affected the inner ear. Doctors can examine vertigo using tests that involve manoeuvres designed to trigger the feeling. Depending how troublesome the problem is, medication may be offered.

If attacks mostly occur at night, when there is no risk of falling over, you might feel pills are unnecessary. The medications include anti-nausea tablets and antihistamines.

The charity Headway has good information about brain injuries on its website headway.org.uk.

My eyes have been permanently gritty and sore for several years and no treatment seems to work. I struggle to read for more than a few minutes or do anything involving focusing my eyes. Are there any remedies?

Problems with dry, strained eyes obviously can have a detrimental impact on a person’s quality of life. When patients have tried many treatments to no avail, they ought to be referred to an ophthalmologist. 

The current waiting list time may be lengthy, but it’s worth it. In dry eye syndrome, the eye’s surface becomes inflamed and the tears produced do not sufficiently lubricate the area. Sometimes, the problem is triggered by an underlying cause. 

This could be an allergy, a vitamin A deficiency or side effects of medication such as beta blockers, some psychiatric medication and pills for bladder control. Identifying a cause often leads to the solution.

Many diseases are associated with dry eye syndrome, too. 

Examples include autoimmune conditions, thyroid disease, Parkinson’s disease and rosacea.

Non-drug treatments are important, such as steering clear of contact lenses. Using a humidifier can help, as can avoiding air conditioning. 

If you read or use a computer, try to position yourself to look downwards, as your eyes are less open, so less prone to drying.

There is a range of tear replacement drops and eye lubricants. If one type of drop hasn’t worked after a month, you should be offered a different type, such as one containing sodium hyaluronate. 

Patients should then be referred to an ophthalmologist after three months if they haven’t responded to treatment.

Always on pain pills? It might be a warning sign

Tracking women’s shopping habits by analysing loyalty-card data can help spot ovarian cancer months earlier.

That was the surprising conclusion of a study by Imperial College London that could give women a much greater chance of successful treatment and surviving this disease.

The symptoms of ovarian cancer in the early stages can be indistinct, such as heartburn, bloating and abdominal discomfort, so it is often diagnosed in the late stages when it’s much harder to treat. But Imperial’s analysis of loyalty cards belonging to women who went on to develop ovarian cancer found they were buying painkillers and indigestion remedies as much as eight months before they realised there was something seriously wrong and sought medical help.

I’d be happy to give up my Boots card data if it was used to flag up serious problems, but a scheme like this is some way off. In the meantime, it’s important that women don’t just soldier on. Feeling unwell or in pain for weeks or months isn’t normal and no one should be brushing it off.

Is your 111 urgent care hub shut? 

I’m worried patients are being forced to travel miles on end for simple help with things like nasty cuts or sickness bugs.

When a patient has a problem that is too urgent to wait for a GP appointment, but not necessarily serious enough for A&E, they’ll likely be referred by 111 to what’s called an urgent treatment centre.

These clinics are run by GPs to reduce the load for emergency departments. But, according to what I’m hearing, many people have to go some distance to get one that’s open. And when they get there, they have to queue for hours on end. Apparently it’s to do with a lack of staff, but I’m interested to know how many of you have been affected by this.

Have you struggled to find an urgent treatment centre nearby? Write to the email address and tell me.