DEAR DR. DONOHUE: I have eczema quite bad. It itches all the time, and I scratch all the time. I have tried a number of salves and ointments, but none has been much help. My dermatologist says I should be using a cortisone ointment. I am afraid of cortisone. My mother had to take it, and she developed a bleeding ulcer that caused her death. Isn’t there another kind of medicine I could take? – P.R.

ANSWER:
You have an unfounded fear. Your dermatologist wants you to use cortisone applied to the skin. The doctor doesn’t want you to take cortisone by mouth. When a cortisone drug – and there are many of them – has to be used orally, it can have serious side effects if it is taken in high doses for long periods. It can upset blood sugar control. It can thin bones. It can irritate the stomach and possibly lead to ulcers. These are side effects that have to be faced when only oral cortisone can control a desperate illness. And there are ways to minimize those side effects. However, cortisone applied to the skin is minimally absorbed and has few side effects on the body. Equating what happened to your mother, tragic as it was, with what could happen to you by using a cortisone ointment is blowing things way out of proportion. You should try the medicine that the doctor suggests.

Now back to eczema. Have you tried some general ways of controlling it in addition to skin ointments and creams? Don’t wear woolen clothes or use woolen blankets. Don’t wash your clothes with harsh soaps. Run the clothes through two rinse cycles. For your skin, use a mild soap like Dove or Neutrogena. After washing, pat the skin with a towel, but don’t dry it completely. While it’s still a little damp, apply a moisturizer such as Eucerin, Aquaphor, Lubriderm or petroleum jelly.

You might experiment with your diet. Eliminate, one at a time, eggs, milk, nuts, wheat, soy and fish to see if any of these items aggravates your eczema. If one does, then stay away from it from here on in.

Two other medicines, Elidel and Protopic, are used for eczema. They aren’t cortisone drugs. The FDA requires the manufacturer put a warning on these drugs that says they might cause cancer. Such a relationship hasn’t been proven, but it does make people leery about using them.

DEAR DR. DONOHUE: My wife and I have eight children. We don’t want and can’t afford any more. My wife cannot use birth control medicine because she had clots in the past. She tried an IUD, but that didn’t work for us. Our choices seem to be limited to my having a vasectomy or her having a tubal ligation. I am afraid of a vasectomy. I hear it causes impotence. Does it? – R.W.

ANSWER:
Vasectomies do not cause impotence. Neither do they cause cancer, which was once a rampant rumor. Nor do they cause heart disease, another false rumor.

DEAR DR. DONOHUE: My mother is going to drive my father to his grave. She has many peculiar habits and beliefs, and her behavior is getting worse.

She smokes nonstop. She won’t leave the house out of fear. Fear of what, I don’t know. She doesn’t allow my father to have any friends visit. She says they are all hostile to her. That isn’t true. At times, she makes absolutely no sense.

We know she’s in need of professional help, but we don’t know how to go about getting it. She refuses to see any doctor.

I told my father to have her committed. How is that done? – B.F.

ANSWER:
That’s a legal question, for which you’ll have to consult a lawyer. Commitment procedures vary from state to state. In general, the court considers whether people are dangerous to themselves or to others, and whether they are so incapacitated that they cannot take care of basic needs.

Your mother is suffering from serious mental illnesses. She needs help. The family doctor can put you in touch with a mental health professional who can give you guidance on how to coax her into treatment.

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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