Dr Bernadette Carr is here to answer your questions

My sister developed white patches on her skin recently and has been diagnosed with vitiligo. I have never heard of this, could you explain what it is?

Vitiligo is a condition that causes flat white patches to develop on the skin due to a lack of the pigment melanin. It affects around 1% of the world’s population, with both men and women equally affected. The onset usually occurs before 20 years of age in 50% of patients. It is common and tends to appear on the parts of the skin that are exposed to the sun — face, neck, and hands. Patches of the white skin can appear on the same places on both arms or both legs.

The skin consists of two layers, the epidermis (upper) and the dermis (lower) and in the dermis there are cells called melanocytes which produce melanin which colours the skin and helps to protect it from the rays of the sun. It is melanin which causes the skin of fair skinned people to tan.

If the melanocytes are either destroyed or damaged, they will not produce enough melanin, it is possible that the body’s own immune system destroys the cells. Colour of the skin is lost so that white patches, such as your sister has experienced, appear; there are no other symptoms and you do not feel unwell.

The severity varies from person to person, so some people will have small patches which develop slowly and then stop, others will develop a number of patches which develop quickly and gradually become bigger. It is important to cover any white patches whilst in the sun and to avoid being out in the sun in the hottest times of the day as the lack of melanin makes you more susceptible to sun burn. There are a number of treatments which may help to improve the appearance of the skin and your sister’s GP will be able to advise on best management.

I had a bad cold last week with a headache and I still have pain over my cheeks. Could this be sinusitis? Is there any way to prevent getting sinusitis again?

Any pain in the face can be very uncomfortable. The sinuses are small air-filled spaces inside the cheeks (maxillary sinus), the bridge of the nose (ethmoid sinus) and the forehead (frontal sinus). They make small amounts of mucus which drain into the nose through small channels. The most common cause of a sinus infection is a viral infection such as a cold (as in your case) or flu. The sinuses become inflamed and depending on which sinus is involved, cause facial pain, pressure or fullness, blocked nasal passages and sometimes accompanied by purulent discharge or a headache. There are other causes of sinus infections and these include:

An allergy such as allergic rhinitis.

Nasal polyps, these cause a blockage in the sinuses which prevents them from draining properly.

Asthma.

Previous injuries to the cheeks or nose.

Following tooth extraction or tooth abscess.

In the majority of cases, sinusitis will clear by itself but this will take longer than a cold, perhaps two weeks. Paracetamol and Ibuprofen will help to bring down temperature and relieve a headache. Decongestants may help to clear a blocked nose and your pharmacist can advise you on the most appropriate.

Avoiding a cold will help reduce the chances of getting sinusitis, here are some suggestions:

Wash hands regularly, particularly after touching your mouth and nose. Take care outside the home when touching door handles or keyboards; carry antiseptic hand gel or wipes.

Avoid sharing cups, glasses or cutlery.

Cover your nose and mouth when you sneeze or cough by using a tissue. Dispose of the tissue immediately.

If you get another infection I would suggest making an appointment with a GP. If you are due for a dental check-up in the near future, you should mention this to your dentist so that he / she can check that you do not have a dental infection.