My skin is constantly itchy. What could be the cause?
Dr Philippa Kaye answers: Itching could be due to a hidden allergy. In some cases, it can also be an early sign of organ failure.
Known medically as pruritis, severe itching can disrupt sleep and lead to skin damage due to scratching.
Some causes of itching are easier to spot than others.
Eczema and psoriasis, two types of inflammatory skin conditions, are common triggers of itching. But both tend to lead to red rashes on the skin, making them fairly easy to identify and treat. This would normally be done using medical-grade moisturiser, called emollients, or steroid creams.
Chickenpox, usually seen in children, can lead to severe itching. The condition, triggered by the varicella-zoster virus, tends to cause red spots across the body. So too does scabies, an incredibly itchy skin problem caused by mites – though these spots tend to only appear several weeks after infection.
Scabies is generally treated using a cream, called permethrin, which kills the mites. If this fails, then the tablet ivermectin might be prescribed.
However, a harder-to-spot cause of itching would be an allergy.
An immune reaction to nickel – often used in jewellery – fragrances and perfumes, soaps, detergents and shampoos, cosmetics and skincare products, latex or hair dyes could all trigger itching.
Meanwhile food allergies, such as to nuts, shellfish, eggs, milk, wheat, or soy, can also have the same effect.
Anyone with undiagnosed itching should seek advice from their GP and consider taking a daily antihistamine – available over-the-counter at most pharmacies – to see if the symptoms lessen. If this happens, then it might be worth asking a GP for a referral to an allergy specialist who can help find the exact cause.
Itching can also be a sign of liver disease. The liver helps remove toxins from the body. When the organ doesn’t function properly, these toxins begin to build up in the body, leading to itching.
Liver disease is often associated with excessive alcohol consumption. However, the majority of sufferers have the problem as a result of poor diet and obesity. Quitting alcohol and eating better can help reverse liver disease when its in it early stages.
However, itching usually only occurs when the condition has progressed to a point at which it may not be curable. Other symptoms to look out for would be fatigue and yellowish skin and eyes, known as jaundice.
Anyone who experiences these problems should see their GP as soon as possible.
Finally, itching can also be triggered by the cold weather. This is because exposure to low temperatures can strip the skin of crucial oils that keep it moisturised. So too can central heating and hot baths or showers.
This problem would normally be treated through regular use of emollients.
I just started taking Mounjaro and I’m worried it could make my osteoporosis worse. What can I do to protect my bones?
Dr Philippa Kaye answers: It is usually safe for osteoporosis patients to take weight-loss drugs – but there are crucial steps they should follow to avoid severe complications.
These medicines, Mounjaro and Wegovy, are appetite-suppressants. This means they stop people from eating as much food, which in turn leads to weight loss. Mounjaro, the most powerful of the jabs, helps patients lose up to a fifth of their body weight.
This has a number of massive health benefits, including reducing the risk of heart disease, cancer and dementia. However, not all the weight lost while on these jabs is solely fat.
Studies show that patients can also lose muscle and bone – particularly if the weight-loss happens rapidly.
And there is now growing evidence that Mounjaro patients are at an increased risk of osteoporosis – brittle-bone disease – and fractures.
For this reason, anyone who already has osteoporosis who plans to take Mounjaro needs to make key safety steps to avoid a life-changing bone break. The same advice applies to those with osteopenia, the early and reversible form of osteoporosis.
The most important of these is that patients inform their GP that they are beginning the jabs. Depending on the severity of their osteoporosis, they might recommend regular bone scans to make sure the condition is not getting any worse while on the jabs.
Another is regular physical activity. All research shows that weight-bearing exercises, such as brisk walking, dancing, tennis and weight or resistance band training, all help halt osteoporosis.
It also happens that these exercises lessen Mounjaro muscle and bone loss, making physical activity twice as important for those with osteoporosis taking the drug.
Balance exercises, such as regularly standing on one leg, are key too as they reduce the risk of falls that can lead to bone breaks.
Osteoporosis patients also must avoid rapid weight loss while on Mounjaro, to limit the risk of bone loss. When patients start taking the jabs, they are started on a low dose, which is gradually increased.
But, for osteoporosis, it might be better for them to stay on a low dose for longer, or to avoid ever taking the maximum strength jab.
Nutrition also matters. A high protein diet is proven to preserve muscle that support the bones, and reduces the risk of falls. Lean meat (like chicken), fish, pulses, legumes, eggs and dairy products are all good, healthy sources of protein.
Calcium, found in dairy, and vitamin D, gained primarily through direct sunlight, are key to bone health. Almost all Britons – but particularly those with osteoporosis or osteopenia – would benefit from a daily vitamin D supplement during the autumn and winter.
