Doc, why does my skin itch after eating proteinous food?


This is called a trigger and here's what causes it.

Dr Flo,

Whenever I take proteins, especially eggs, I get rashes on my skin. What could be the problem?


Dear Patrick,

You have a protein allergy, which means that your body’s immune process reacts quite strongly to protein. This is called a trigger and it can cause itching, a rash or “bumps” on the skin. It may also cause swelling of the lips or face, itching of the nose and eyes, or inflammation along the gastrointestinal tract, leading to bloating, pain, vomiting and/or diarrhoea.
The allergy is usually in the genetic make-up of a person, which means it can be passed from parents to children, and it cannot be completely cured. It can also be associated with other allergy conditions like allergic skin rashes, allergic cough, allergic rhinitis, recurrent itching of the eyes (allergic conjunctivitis) and asthma. Someone may have one or a combination of several of them.
It is advisable to see an allergy specialist for allergy testing, so that you can know the specific protein you are allergic to. The condition cannot be cured, but it can be controlled by avoiding the trigger, which is the specific protein. If the reaction to the protein is mild (protein intolerance), then you can take small amounts of the protein and you can manage any reactions with anti-allergy medicine.

Dr Flo,

Why have I been experiencing frequent headaches?


Dr Flo,

I have been having frequent headaches and have taken MRI and CT Scans, but nothing has been found. I have seen various neurologists, but I still have the headaches. I do not know which other specialist to see since I have also seen an ENT one, who said I have sinusitis and I have been on nasal decongestants, but the headaches are not clearing. Another specialist told me I am stressed yet I feel fine. How else can I clear the headaches?


Dear Ron and Brenda,
Almost everybody gets headaches at some point, and the causes are very diverse. In many cases, headaches are a symptom of an underlying issue.
The most common type of headache is a tension headache. Usually, the pain is on both sides of the head and it may feel as though there is a tight band around the head. It occurs due to tightening of the muscles around the neck and the scalp. It may be triggered by fatigue, dehydration, hunger, light exposure (too little or too much), noise, congestion, stress, too little or too much sleep, or even poor posture. Tension headaches are usually not very severe, and resolve within an hour or so, with or without painkillers. To prevent them, then you need to figure out what your triggers are and address them, for example, rest, take enough water, eat regularly, get adequate sleep, avoid noisy or congested surroundings, wear ear muffs if you work in a noisy place, reduce screen time (computers, tablets and phones), make sure you work in well-lit areas, practise good posture and stress management. Sometimes taking a warm bath may also reduce the headache.
Then, there are cluster headaches, which occur for several weeks at a time, and are very severe and do not respond very well to painkillers. The pain is usually concentrated around one eye, and there may be redness and tearing from the eye or a blocked or runny nose. There are also migraine headaches, which are severe headaches, usually affect one side of the head, and may be accompanied by increased sensitivity to light and sound, nausea and vomiting.
Headaches may also be caused by hormonal changes, medications, too much alcohol, exposure to carbon monoxide, flu, sinusitis, and almost every illness, especially those affecting the head and neck region.
In most cases, headaches are not a serious problem, but if they persist or become worse with time, if they are very severe, if they are as a result of a head injury, or if they are associated with other symptoms like fever, drowsiness, confusion, slurred speech, stiff neck, vomiting and convulsions, then you need medical attention so that the exact cause may be identified and dealt with.
Since the list of possible causes is very long, usually the doctor will start with tests that are easier to do, and targeting the most common causes of headache. The tests get more complicated as you go down the list. If a specific cause for the symptoms is identified, then it is treated. There is medication that helps to prevent recurrent headaches and painkillers can help with the headache. If regular painkillers do not clear the headaches, there are much stronger medications that are prescribed by neurologists.
You also need to identify triggers (e.g. hunger, dehydration, heat, congestion, noise and motion) that may start the headache and the easiest way to avoid the symptoms is by avoiding the triggers. Sinusitis is usually a persistent and recurrent problem and it would be advisable to be on continuous follow up by an ENT for examination, treatment and, if necessary, surgery to decongest the sinuses.

Dr Flo,
One of your response to a pap smear question has had me wondering about how often a person who is HIV positive should do a pap smear.

Dear Sylvia,
Someone who is HIV positive should have a pap smear done every year. This is because, due to the immune suppression caused by the HIV, it is much easier for a human papillomavirus infection to cause damage to the cervix, and once the cells of the cervix start changing, it takes a much shorter time from the initial changes to cancer. That is why the pap smears should be annually, regardless of age, if you have HIV, and in case any abnormalities are detected, the pap smears are done even more frequently and other tests and treatment are also done.

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