ASK THE DOC
Specialist surgeon and lecturer Dr Sarah Rayne responds to queries about dizziness, rosacea and hair loss.
Q: I woke up one day and when I turned my head I became dizzy to the point of nausea (like I was falling through space). It took nearly a week to go away, and I still feel slightly spaced out. What is wrong with me? I am 45.
A: You’re describing vertigo: the horrible sensation of moving when you are standing still. You should see your doctor and have a full examination.
There are fluid-filled sacs inside your ear. Information about a change in the levels of this fluid is transmitted via a nerve and helps your brain figure out if you are upright, upside down or spinning round. Inflammation of the sacs (labyrinthitis) or inflammation of the nerve (vestibular neuritis) causes this type of sudden vertigo. As the inflammation subsides, the symptoms improve. Debris in the fluid can also cause vertigo, which happens when you move your head (think of a snow globe).
This often happens after a viral infection like a cold or ear infection and will get better, but it is important to have it checked out now, even if it has resolved.
Q: I am a 57-year-old woman and I’ve developed rosacea on my face. My medical aid doesn’t cover consultations with a dermatologist. Can you recommend a treatment?
A: Rosacea is quite a common skin condition that usually affects women in middle age. As the name suggests, it causes inflammation and redness of the face, around the forehead, cheeks, chin and nose, but it can also result in unsightly blood vessels, bumps and pus-filled spots.
There are a few key things to know about rosacea. First, there are triggers: alcohol or hot drinks, cold or hot temperatures, strong sun and stress are common ones. Getting to know and avoid your triggers can really help, so start keeping a journal to track when it gets bad.
Second, there are simple measures that can help prevent a flare-up, such as always using sunscreen, wearing a broad-brimmed hat when you’re outside and avoiding soap or harsh cleansers – rather use unscented cleansers and emollients.
Third, there are topical preparations that a GP can prescribe. And if they fail to control the rosacea, all tertiary state hospitals have a dermatology clinic. It might take a long time to get an appointment, so it’s worth asking your GP to refer you early.
Q: I have been on antidepressants since 2000, and I am now on Serdep and Dopaquel. But my hair has been falling out. How can I stop the hair loss?
A: Depression is linked to hair loss because of the mechanisms of stress and low mood. Unfortunately, antidepressants are also linked to hair loss.
I wrote last month about telogen effluvium, which is when you lose your hair because the hair follicle ‘rests’ for too long, often due to stress. This problem can also be caused by antibiotics, contraceptives, hormones and even blood pressure medicines.
I won’t comment on the medications that you are on, but a recent study found a link between hair loss and specific antidepressants. I’d raise your concern with your psychiatrist and work with him or her to find the right medication for you. Rest assured, most of the effects usually resolve when you stop or switch medication.