DR ELLIE CANNON: Will HRT help by daughter’s menopausal hair loss?

My 59-year-old daughter’s hair is receding – would HRT help? She won’t go to her GP for advice because it’s not easy to make an appointment as she works.

The short answer is yes. Hair loss is common after the menopause, when the hormones oestrogen and progesterone dwindle, which are vital for regulating fertility as well as many other bodily processes.

It can be general all-over thinning or just at the front and temples only. Hair loss can start during the perimenopause – the years leading up to the menopause, when hormone levels first begin to fluctuate – but also occur many years after. This can be due to genetics or may be related to the increased effect of testosterone in the body once oestrogen declines.

Taking HRT, which tops up levels of female hormones, can help slow down or even stop hair loss, but it doesn’t always work. The only medication licensed for hair loss in women is a lotion applied to the scalp called minoxidil. It’s available over-the-counter but it’s always preferable to discuss the pros and cons of any drug treatment with a doctor before deciding to start.

One of the major causes of hair loss is poor nutrition – women often find when they lose a lot of weight that their hair thins. The GP should be able to offer blood tests to check if levels of iron are low or spot any problems with the thyroid – both of which are linked to hair loss.

Certain medications, such as tamoxifen or aromatase inhibitors, for women with breast cancer, are thought to cause thinning.

Many people are reluctant to discuss hair loss with anyone – even a doctor. Despite affecting four in ten women and up to eight in ten men, there is a certain stigma surrounding the condition.

It’s a tricky subject to broach, so it’s best to wait for them to say something and then offer advice on how and where to seek help.

It can also be difficult for people with busy working lives to visit a GP, but telephone consultations have become normal since the Covid pandemic. Face-to-face appointments can be made far in advance so you can plan the time off work, or you can book consultations online. Some GP practices also offer appointments at weekends and in the evening.

I have a large bump on my wrist. I type a lot and wonder if it’s just wear and tear from the pressure against my desk. It’s not painful but is unsightly. Can you help?

A bump like this on the wrist is usually something called a ganglion cyst.

This can develop on any joint but it’s typical for it to appear on the back of the wrist. They vary in size, from quite small to very large, and feel like a smooth lump. Although it feels solid, it is actually a build-up of the fluid that bathes a joint.

Ganglions are not normally painful or harmful, but of course they can look unsightly.

They may happen at the same time as a repetitive strain injury from typing but they usually develop for no clear reason.

Previously it was thought that these cysts could be treated by bashing them with a large book to disperse the fluid – but no doctor will now recommend that. Unless the cyst is causing pain and limiting your daily activities, it is unlikely the NHS will fund treatment for it.

One solution is a treatment called aspiration, where a syringe is used to draw out fluid from the ganglion. This is usually painless – but in half of cases, the cysts return at some point. Surgery may also be an option but this is more invasive. It’s possible a ganglion will naturally reduce in size over a few years.

Swellings on the wrist can also occur due to trauma, an injury, or arthritis – but this would usually be painful.

I have noticed an irregular-shaped, brown, mole-like splodge on my belly. It’s crusty and dark brown but doesn’t itch or hurt. A GP friend looked at it and said I shouldn’t worry. Is that true?

IF you notice something new on the skin that looks abnormal, it’s always worth getting it checked out. This is particularly true if it is changing over time.

It might be worth taking a picture of the area every week, to spot differences. Any growing skin mark should be examined.

In older people, a crusty, brown mole could be something called seborrheic keratosis. This is a common, harmless skin problem that can appear as we get older.

It’s typical to see it on the belly or any part of the trunk, although they do also develop on the face.

They are not normally treated on the NHS but they can be removed privately with a liquid nitrogen freezing treatment.

There are some signs to look out for that could mean a mole is skin cancer. An irregular shape or uneven edges is one of them.

Other concerning signs would be a mix of colours rather than one even colour, a mole that is larger than half a centimetre and any changes in shape over time. Also, look out for symptoms such as bleeding, itching or crustiness.

Patients can get a skin lesion checked out at their GP surgery.

Most online GP consultations will allow photos to be uploaded. This can be a very efficient way for the doctor to decide if the skin problem is potentially harmful – along with information you provide them with.

Many regions also offer a service called teledermatology, whereby photos can be sent to a dermatologist for review.

Why I back a ban on some vapes – but not all of them 

I’ve long been an advocate for electronic cigarettes, or vapes, so you might be surprised to know that I am also 100 per cent behind a proposed ban on disposable vapes.

E-cigarettes are brilliant for smokers – countless studies have shown that using them can help smokers to ditch cigarettes and they are much less harmful. Those looking to quit tend to use the more expensive, refillable and rechargeable vapes, which will still be available after the ban.

The issue is the cheap, disposable vapes which come in fruity flavours and fancy packaging, and are often placed near sweets or on shop counters – with the aim of marketing to children.

There are many downsides to all vapes: they do contain nicotine – which is highly addictive – and we don’t yet know what the long-term effects are of inhaling the vapour.

Paediatricians I speak to are worried about youngsters’ lung health and schools are noticing difficult behaviour in kids addicted to the nicotine in vapes. The habit is far too normalised and should be restricted to what it was originally designed for: helping adults to stop smoking.

It’s not too late to get an MMR jab

Please tell everyone you know to get the MMR jab, if they haven’t already.

I was alarmed to read last week that children are once again being forced to isolate to protect others from a deadly, infectious disease.

This time it’s not Covid but measles – a potentially fatal virus that is highly contagious. But it can be prevented with the MMR vaccine, which is usually given to children.

A staggering rise of recent cases has led two London councils to tell unvaccinated youngsters to isolate for three weeks if a classmate has the disease. MMR vaccination uptake has now dropped so low that the Government expects up to 160,000 people will soon be infected with measles.

We desperately need to boost vaccination in order to reach levels of herd immunity – when the whole country will be protected. You can have the jab as an adult – just ask your GP.