The Doc Replies

Our expert answers your medical questions

I get very sudden, sharp pains in my face, usually when washing or cleaning my teeth. It’s like an electric shock. I looked up my symptoms online and think I may have trigeminal neuralgia.

Trigeminal neuralgia is nerve pain involving one or more branches of the trigeminal nerve. This is one of the nerves which carries sensation from the face and mouth to the brain.

Pain is felt most commonly around the cheek or jaw area. It can run in families and is unusual under the age of 40. It is usually only felt on one side of the face and is caused by something pressing on the nerve, like a loop of blood vessels.

Much less commonly - around

1 in 10 cases - can occur as a symptom of another condition such as multiple sclerosis, a skull abnormality, or a tumour.

It is a neuralgia pain, a sudden, stabbing pain, a bit like an electric shock. It usually lasts no more than a couple of minutes but it is very sudden and very severe. It could be minutes or hours between attacks, but the area is tender afterwards.

It may be triggered by touch or a draught of air, or even by eating or brushing teeth.

The usual treatment is carbamazepine, a drug that suppresses nerve impulses. Normal painkillers are not effective. If carbamazepine doesn’t work there other medicines and surgery.

My teenage son has really bad, infected spots on his face. He has tried over-the-counter treatments without success. Should he see a doctor?

If the pharmacy treatments are not working, see your GP for antibiotics which come as a lotion or tablet. They work particularly if you have inflamed acne spots.

You need to also use an acne lotion which unblocks the skin’s pores at the same time.

My 12-year-old daughter had a nosebleed out of the blue. She has never had one before. Is this normal?

Yes. Nosebleeds are very common in children but are more worrying in elderly people.

You can treat the child’s nosebleed by pressing on the side of the nostril.

With older people the bleed can be further back and more difficult to stop. If it is severe, or continues for a longer time, go to hospital.