DEAR DR. DONOHUE: I have worked in construction since my early 20s. I am Scotch, and when I had hair, it was strawberry blond. Now I have actinic keratoses. I know they come from sun exposure and that they can turn into cancer. What I would like to hear from you is the best treatment for them. I have seven children, all of whom have my complexion and all of whom are outdoor people. How can they protect themselves from actinic keratoses? – P.G.

ANSWER: Sun exposure can lead to actinic keratoses in anyone, regardless of ethnicity, but fair-skinned people who spend much time outdoors are the ones most susceptible to having them. They appear on places exposed to the ultraviolet rays of the sun – the ears, scalp, forearms, backs of the hands and any other skin bathed with sunlight. They have the potential to become skin cancer, so they have to be treated. In the U.S., upward of 2 million yearly visits to dermatologists are prompted by these skin lesions. Most often they appear in late middle age.

They come in many shapes and sizes, so a single description is all but impossible. However, many start out as a red patch of skin with a scale on its surface. They progress to a raised, thickened patch, usually one-tenth to two-fifths of an inch in diameter. The surface feels rough to the touch.

There is no one best treatment. The size of the keratoses and their number dictate the most reasonable treatment. Liquid nitrogen freezes them off. Doctors can scrape them off with a special instrument. Fluorouracil (Efudex) cream or lotion, or Aldara cream can be applied directly to them. All of these treatments work well, as do others. Your children shouldn’t go outside without applying sunblock to their skin. They have a good chance of following in your footsteps if they don’t.

DEAR DR. DONOHUE: I had one attack of diverticulitis. Since then I have taken a commercial fiber product. I haven’t had another diverticulitis attack and I don’t want one, but I am having four quite-soft bowel movements every day. Should I continue with the fiber supplement? – M.N.

ANSWER: You should call your doctor and tell him or her what’s happening. I’m sure that the doctor will tell you either to stop the fiber or to greatly decrease the dose of it.

Diverticula are small, bubblelike protrusions from the colon. Actually, the protrusion is the colon lining that has poked its way through the colon’s muscular wall.

In countries where grains are refined – and that includes Canada and the United States – people do not get much fiber (roughage) in their diet because the outer coat of grains is discarded during refinement. Fiber keeps undigested food soft and moist in its passage through the digestive tract. The colon has to exert great force to push hard, dried-out food residue through the tract. That force is responsible for the formation of diverticula.

You’ll soon know whether you need to keep on with some additional fiber by the kind of stools you pass. If they become hard, then you’ll have to restart your fiber supplement in a lower dose or start eating more high-fiber foods, like whole grains.

The diverticulosis booklet explains diverticulosis and diverticulitis in depth. Readers can obtain a copy by writing: Dr. Donohue – No. 502, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

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