Could Botox injections really be the cure for my twitching eyelids?
‘Treatment is available on the NHS as it is a medical issue’
QI’VE developed twitching eyelids and just can’t stop it. Is there any treatment? I’ve heard that it could be treated with botox injections but I presume I’d have to go private for this and doubt I could get an appointment now anyway.
AIT SOUNDS as if you have developed a condition called blepharospasm, where the orbicularis oculi muscles in the eyelids repeatedly go into spasm. Most people blink 10 to 20 times per minute (a little less when looking at a computer screen) but with blepharospasm this increases.
In some the spasms last just a few seconds but in others they last minutes, causing disabling interruption of vision.
It tends to occur more over the age of 50 and affects women more than men. It may be linked to having dry eyes, or inflammation of the eyelids, in which case treating the underlying eye disorder can often help the excess blinking.
However, more commonly it is thought to be caused by abnormal functioning in the basal ganglia, an area in the brain that helps coordinate movements. Occasionally it can run in families.
Bright light can trigger blepharospasm and as we go into the summer months it can be helpful to wear sunglasses to protect your eyes. Some people also find pulling or touching the eyelid helps.Yawning, humming or singing can also stop the twitching.
The best treatment for blepharospasm in injection of botulinum toxin (botox) into the orbicularis muscle, which is helpful in 90 per cent of patients.This treatment is available on the NHS as it is being used to treat a medical, rather than a cosmetic issue.
Injections are usually placed at four spots along the upper and lower lids and effects are seen within about three days of treatment, reaching a maximum two to three weeks later. Most patients need repeat injections every three months and again this is available on the NHS.
Unfortunately at the current time it is unlikely clinics providing botox will be running, but they should be later in the year.
In case you haven’t already been told, any driver with blepharospasm must inform the Driver andVehicle Licensing Agency (DVLA) and failure to do so may invalidate your insurance.The DVLA will assess your condition further (usually by writing to your doctor) and if your condition is mild, or treatment is successful, it is likely you will be permitted to drive.
QI’VE had cold sores occasionally on my lower lip but after the last attack, a couple of days later I developed a painful blistery rash next to the nail on my right middle finger. I thought you could only get cold sores round the mouth or genitals. Can you get them elsewhere?
AHERPES outbreaks usually occur in or around the mouth or in the genital area.They are caused by two types of the herpes simplex virus, HSV-1 and 2, and though traditionally HSV causes cold sores on the mouth and HSV-2 causes genital herpes, it’s now known that both types can affect both areas.
Both types of virus can also spread to the fingers, where it causes an outbreak of painful blisters, known as a herpetic whitlow. This type of infection is often seen in children with cold sores who suck their thumb. But it can occur in adults too, especially if you touch a cold sore or an area of genital herpes and there is broken skin on one of your fingers, which allows the virus an easy entry route.
Like all herpes infections it can be treated with antiviral medications, such as acyclovir or valaciclovir, but these are most effective if taken as soon as symptoms start.
The blisters in herpes lesions are full of virus particles and very infectious, so you need to take care not to touch anyone else until the skin has healed.
The herpes virus can lay dormant in the nerve root that supplies the original infected area and may become active again at a later date, causing a recurrent attack.Though this is usually in the same place as