From tiny spider veins to ‘hot’ red rash – NHS GP Dr Zoe Williams will see you now

The weather was a little questionable considering it’s summer, but you’ll still want to make sure you’re hydrated – especially if you’re heading to the sweltering south of Europe.

However, skipping alcoholic beverages doesn’t count, and also be wary of energy drinks, which have been in the headlines lately, with the focus being on their potentially dangerously high caffeine and sugar levels.

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Most of us need six to eight glasses of fluids a day, but it can be significantly more in hot weather, when exercising, or when pregnant or breastfeeding. The best way to stay hydrated is to drink glasses of cold water and eat plenty of foods high in water.

Try adding watermelons, cucumbers, zucchini, berries, and peaches to your diet, all of which are in season and also contribute to your five-day meal plan.

Here’s a selection of what readers have been asking me this week. . .

Q) I have noticed tiny spider veins forming under my skin. What causes them and should I be concerned? They are mainly on my chest.

a) Spider veins — sometimes called thread veins — are small, damaged veins that appear as thin blue, purple, or brown lines or branching webs, usually on the legs.

They are very common and usually not a cause for concern.

However, since your condition is mostly on the chest, it could be spider telangiectasia. These tend to have a spider-like appearance, with a central red spot (the “spider’s” body) from which fine red lines (the spider’s legs) radiate.

You can test this: if you press on the center, the whole “spider” should disappear, and if you release the pressure, it fills up again from the center outwards.

About ten percent of people have solitary spider telangiectasia, and this is normal. If several of these occur, it is worth telling your family doctor.

It can be normal or caused by circulating estrogen that is elevated in pregnancy, or by taking oral contraceptives, or in patients with liver disease. Your GP may consider a blood test to check your liver.

Other signs or symptoms of liver disease include jaundice, red palms, and bright white nails, or a history of liver problems, hepatitis, or excessive alcohol consumption.

Some people pay privately for cosmetic treatments, which they eliminate by permanently damaging the small blood vessels, usually with laser treatment.

Q) I have a rash with small red dots on my arm, from my biceps to my wrist and above my eyebrows. It feels hot when you touch it. I used E45 cream which helped somewhat. I’ve had it for ten weeks but my doctor won’t be able to see me until October.

a) The technical term for inflammation of the skin is “dermatitis”.

In fact, any medical word ending in “itis” means inflammation.

Eczema is another word that also describes inflammation of the skin.

The most common causes of eczema are allergies or irritants.

Some people suffer from atopic eczema, which means they are prone to skin allergies to things like animal fur or dust mites.

Cold weather can also trigger eczema.

People with atopic eczema are also more likely to suffer from asthma and hay fever. It usually begins in childhood and tends to run in the family.

While eczema can appear anywhere, it commonly occurs behind the knees, in the elbows, and on the face and neck.

There is another type of allergic dermatitis called contact dermatitis, in which the skin becomes inflamed in response to an allergic reaction that occurs when it comes into contact with an allergen (the substance that causes the allergy).

Latex in rubber gloves or certain chemicals in toiletries or cleaning products are examples of what can cause it.

This type of allergy usually affects the skin that has been most commonly exposed to the allergen. It is less likely to run in families and is more likely to start at a later age.

Based on the distribution of your rash I’m wondering if this is the most likely cause and if the allergen could be something you’ve used on your forearms – maybe a new cream or perfume, or were you wearing long rubber gloves?

Do you tend to touch your face above the eyebrows?

I’m wondering if that’s how you might have spread the allergen to that area?

I can’t diagnose you with the information available, of course, but if it’s a contact allergy, treatment would include many palliatives – say E45 and a steroid cream.

It would be important to find out the allergen in order to avoid it in the future. Sometimes this is determined by patch testing.

I would suggest calling your GP again to see if you can email him some photos of the rash or to ask if you can make an appointment with the nurse.

You can also visit your pharmacy, who can advise you and supply you with emollients and mild steroid creams.

RAYNAUDS CAUSES PAIN

Q) My husband has had Raynaud’s disease for two years which causes numbness and a cold feeling in some areas of the body.

He will be 80 in December and is very active for his age. He spoke to the doctor who confirmed the condition.

We have silver socks and they help.

However, he doesn’t want to wear them in hot weather. If he doesn’t, he wakes up with pain in his toes.

Is there anything else he can use?

a) Raynaud’s is a condition that affects blood flow.

Spasms of blood vessels occur in response to cold, stress, or emotional excitement.

Fingers and toes are usually affected, but ears, nose, lips, and nipples can also be affected.

The skin may turn white or blue due to reduced blood flow. Darker skin may make the area appear paler.

Her husband is already taking care of himself by being active, which is fantastic – and when it’s appropriate to wear silver socks to reduce heat loss, that’s great.

A drug called nifedipine can help with blood flow, which your GP may consider.

In certain people with this condition, emotional stress can trigger the condition.

If your man seems tense, try to support him by recommending calming techniques like mindfulness.

Smoking can also make this condition worse. If he is a smoker, look into NHS smoking cessation services.