How can I get rid of rash on my hands? DR MARTIN SCURR answers your health questions 

I have a rash on both hands for which my doctor prescribed steroid cream and Cetraben, but six months later it is no better. Can you suggest something?

James Edwards, Caernarfon Gwynedd.

A scaly, itchy, widespread rash on the hands is often due to eczema, also known as dermatitis.

Eczema usually occurs in people with allergies and can be caused by triggers such as detergents or even stress.

It leaves the skin dry, red, itchy and can feel cracked and painful.

While I don’t think it’s advisable to diagnose a skin condition without seeing you in person, I suspect this is the diagnosis you were given because the doctor prescribed the standard treatment for eczema: a steroid cream to reduce inflammation and itching. along with Cetraben that moisturizes and protects the skin.

Unless your skin is exposed to something that continues to cause the rash, such as sensitivity to dishwashing liquid or cleaning products, this treatment should clear up the symptoms.

The fact that your symptoms don’t improve with this treatment makes me wonder if it could be psoriasis instead. This is an autoimmune disease that causes the overproduction of skin cells, resulting in patches of scaly itchy skin.

It is caused by a combination of genetic and environmental factors.

Psoriasis can be almost indistinguishable from eczema, but it usually requires more potent steroids like Clobetasol.

However, these stronger steroids have significant side effects, such as burning or stinging the skin, and should be used sparingly and for as short a time as possible.

If this doesn’t help, calcipotriene, a synthetic form of vitamin D that comes as an ointment, may be effective. It stops the overproduction of skin cells, although it’s unclear how exactly.

This too can cause side effects such as burning skin and sensitivity to the sun.

My advice is to discuss your complaints again with your doctor; a referral to a dermatologist may be necessary.

I have had high levels of ferritin in my blood since 2002 (currently my level is 569). Should my doctor consider bloodletting to lower this level?

Steve Poole, Bournemouth.

First, for the benefit of other readers, a brief explanation of the science.

Ferritin is the protein that retains iron in the blood. Iron is an essential part of many systems in the body, but it is especially important in hemoglobin, the pigment in red blood cells that carries oxygen around the body.

Ferritin levels are measured by a simple blood test.

Iron comes from the foods we eat, but some people ingest excessive amounts due to factors such as obesity (inflammation caused by obesity upsets the balance of the hormone hepcidin, which regulates iron).

High levels of iron can be harmful, as it can react in excess with other chemicals in the body, causing widespread tissue damage and inflammation. This can lead to liver, heart and pancreas damage and in turn type 2 diabetes (which you say in your longer letter was diagnosed in 2014).

However, I think your diabetes diagnosis is unlikely to be related to high iron, as widespread tissue damage does not begin until the ferritin level is 600 to 900 ng/ml.

Since your ferritin levels have been elevated for so long (anything above 300 ng/ml is considered abnormal), this suggests that you have the genetic condition hemochromatosis, where iron slowly builds up in the body over many years.

Ferritin levels are measured by a simple blood test. Iron comes from the foods we eat, but some people ingest excessive amounts due to factors such as obesity (inflammation caused by obesity upsets the balance of the hormone hepcidin, which regulates iron)

The treatment for elevated ferritin levels is venesection – periodically taking a unit of blood (500 ml) to remove the excess iron from the body.

This is offered to patients when their ferritin level reaches 500 ng/ml.

Venesection can stop further damage to the pancreas and other organs, although it’s unlikely to fix the damage already done.

I assume your ferritin level has been below this threshold in the past, otherwise you would have had a regular venesection.

However, now your ferritin levels are at the stage where venesection is being considered.

Write to Dr. scurr

Write to Dr. Scurr on Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email drmartin@dailymail.co. uk — include your contact details. dr. Scurr cannot enter into personal correspondence.

Answers should be taken in a general context and always consult your own GP if you have health problems.

In my opinion… A brisk daily walk of 20 minutes could extend lifespan

As regular readers will know, I’m a big fan of the UK Biobank study – and now the latest findings offer even more insight into what really supports long-term good health.

As a reminder, the Biobank study monitors more than 500,000 people (one of whom is my wife) to understand many aspects of our health, which contributes not only to longevity but also to cost savings in healthcare.

New data from the study, published in the British Journal of Sports Medicine, confirms that people who get a lot of exercise and have better diets had the lowest risk of death over the 11 years of the study.

OK, so that’s not the most surprising finding, but it’s another caveat for those who like to tell stories about acquaintances who have exceeded their life expectancy despite avoiding all fruits and vegetables and don’t walk further than to their car on the drive, as a way of suggesting that this can lead to a healthy old age.

This new finding underscores the fact that in most cases this will not be the case.

In fact, it should come as a warning to all of us to watch our diet and get exercise on a daily basis — preferably something that raises the heart rate, even if only for 20 minutes a day.

No one in any age group, despite medical problems, cannot find a suitable activity. I just completed a quick “daily mile” rain or shine. My advice? Just do it.