ASK SARAH From our GP
QI used to take tablets from my GP to keep my weight down, but he won’t give me any more. There are lots of adverts for them online – is it safe to buy them?
AThe short answer is almost certainly no. Until 1983, nearly all medicines, including ibuprofen, needed a doctor’s prescription. Since then, over 150 products have been made available without prescription. There is one weight-loss drug, Alli®, which you can buy with pharmacist advice.
There have been many weight-loss drugs on prescription, but the rest have all been banned on safety grounds. Despite this, there’s a multibillion pound industry in fake medicines online. Drugs for erectile dysfunction are most popular, with weight-loss drugs a close second.
Online pharmacies can issue prescriptions, but only if they have an electronic or paper copy of the prescription (emailing a scanned copy isn’t enough). Some carry out online consultations with a GP or pharmacist, who can issue some prescriptions. But buying prescription medications online is a recipe for disaster. In a recent investigation, more than two in three were found to be substandard, counterfeit or both. You wouldn’t dream of buying drugs from a street corner – this is the same thing.
QSince the summer I have noticed small white marks on both lower arms. They’re not raised and don’t cause discomfort, but with a tan from a recent break, they’re quite noticeable.
AThere are three possibilities that seem most likely. Pityriasis versicolor usually appears as pale patches, which are more noticeable when you tan, because the affected areas stay pale. The condition is caused by a yeast-like infection with a germ called malassezia. It can be slightly itchy, and your skin may be mildly rough and scaly, but there are usually no other symptoms.
Vitiligo is less likely, because it causes complete loss of pigment of the skin. It’s an auto-immune condition in which your immune system, which usually helps you to fight off infection, turns on part of your own body. In vitiligo, it is the melaninproducing cells of the skin that are affected.
Following inflammation (due to skin conditions such as eczema or dermatitis) it is possible to get a condition called post-inflammatory hypopigmentation. This usually settles within a few weeks or, at most, months. To avoid it returning, the key is to treat the original condition effectively.
See your doctor for a definitive diagnosis, as the treatment for each condition would be different. For pityriasis versicolor, they may recommend ketoconazole shampoo, selenium sulphide shampoo or an antifungal cream. It doesn’t make a difference immediately, and the pale patches are likely to remain until your tan fades. Vitiligo can’t be cured, but there are some treatments that may help. If you do have vitiligo, it’s important to avoid too much sun, as affected skin can’t tan and can only burn. If inflammation was the cause, regular moisturising and treating flare-ups early are crucial.