DEAR DR. DONOHUE: Please say something about seborrheic dermatitis. I have had it for many years, but nothing I’ve tried has worked. What’s the cause, and what do you suggest for treatment? – T.R.

ANSWER: The literal translation of “seborrhea” is “flowing oil.” Dermatitis is skin inflammation. Seborrheic dermatitis is inflammation of skin that has more than its share of oil glands – specifically, the scalp, eyebrows, eyelids, the creases that run from the sides of the nose to the lips, the ear canal, the skin behind the ear, the cleft between the buttocks and the groin. On the scalp, seborrheic dermatitis is a form of dandruff.

Along with an overproduction of oil, a skin yeast with the name Pityrosporum is believed to play a role in the inflammation.

The skin turns red, has scales on its surface and is greasy. It often itches. The scales fall off, particularly when a person scratches.

Antifungal agents are incorporated into a treatment program to eliminate the skin yeast. Ketoconazole (Nizoral) and ciclopirox (Loprox) are available in foams, liquids, creams and ointments. The choice between preparations depends on the location of the problem. Both of these medicines require a prescription.

Before launching antifungal therapy, calm the skin inflammation with a cortisone cream, many of which are available on drugstore shelves. It quickly resolves the inflammation and the itching, which can drive people crazy.

If you had specified where your seborrhea is, I could have added some other information. For instance, ear-canal seborrhea, whose itching is exasperating, is treated with eardrops.

The smartest course for you to take for long-standing seborrheic dermatitis is to forget about self-therapy and consult a dermatologist.

DEAR DR. DONOHUE: Which foods are the best sources of vitamin B-12? My mom had pernicious anemia and had to take B-12 injections for it. I don’t want to get it too. – B.B.

ANSWER: Vitamin B-12 is not found in any plants, so fruits, vegetables and grains have none. Meat, poultry, eggs and shellfish are loaded with it. Many foods are vitamin-B12-fortified; cereals are a good example. Even though cereal grains have none, fortification makes them a good source. You have to check the nutrition label to see if B-12 has been added.

Most of the world eats a vegetarian diet, and those who do are the healthier for it. Through the centuries, these people have learned how to include B-12 in their diets. Vegetarians coming from cultures not used to vegetarianism can develop a B-12 deficiency if they don’t pay close attention to alternate sources of the vitamin. Some will have to take a B-12 supplement.

Your mother’s pernicious anemia most likely didn’t come from too little B-12 in her diet. It probably came from a lack of intrinsic factor, a stomach substance that facilitates B-12 transport into the circulation. Relatives of a patient with a lack of intrinsic factor have an increased risk of coming down with it.

DEAR DR. DONOHUE: What do you think of doctors over 70 operating? A friend needs a cataract operation. She and her husband have gone to an eye doctor for years and like him very much. He is over 70. She hasn’t heard anything adverse against him, but she has some fears that age might have made him less competent in the operating room. What can she do to quiet her fears? – Anon.

ANSWER: It’s not a matter of age. It’s a matter of what age has done to a doctor. If the doctor has steady hands, a clear brain and is physically fit, I wouldn’t hesitate to have that doctor operate on my eyes. Something can be said for experience.

Hospitals keep a close watch on their doctors, including eye doctors. If one isn’t capable of performing up to par, that person is notified that privileges to practice in the hospital are being terminated.

This is the age of malpractice, and hospitals don’t want suits any more than doctors want them.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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