DEAR DR. ROACH: I had my ears pierced when I was about 10, developed pea-size keloids, which I had removed from behind both lobes, and discontinued wearing earrings. I’m 60 now, and have been thinking about trying ear-piercing again. Might it have been the piercing, the 10-karat-gold earrings or a combination of both that caused the keloids? Should I leave well enough alone? — K.J.W.

ANSWER: Keloids are benign growths that occur at a site of injury as a result of disordered healing. Keloids can be relatively small, like the pea-size ones you had after ear-piercing, or they can be large, disfiguring and painful. People who form keloids once are likely to do so again, so you would be at risk if you choose to re-pierce your ears.

If you do take the risk, keeping the piercing site clean and covered with ointment such as Vaseline may help prevent keloids. If keloids start to form, the earlier they are treated, the better. Injection of corticosteroids is helpful for most. Pressure earrings, available at www.delasco.com, also seem to help.

Personally, I would recommend leaving well enough alone, but I wanted you to have enough information to make your own decision.

DEAR DR. ROACH: I have a son who is gay. He is a joy to all of us. He is kind and generous. What I would like to know is if he was born this way, or is it a mixup in the genes. Is it his fault he is gay? I love him and support him in whatever he does. Is there any way you can help me? — D.H.G.

ANSWER: It is wonderful that you love your son and support him. But I think your question implies that there is a problem when there isn’t one. From my standpoint, there is nothing wrong with being gay, and there is no fault in his genes or his upbringing, and no blame to assign.

You could just as well ask a heterosexual person if he or she were born that way. Decades ago, physicians did think that homosexuality was a psychiatric condition, but those days are (fortunately) long since past.

DEAR DR. ROACH: My daughter was diagnosed with PCOS nine years ago, when she was unable to become pregnant. She had only one symptom: insulin resistance. She was put on metformin and had successful IVF twice. She remains on metformin but does not restrict her carb/sugar intake. As an old nurse, this does not make sense to me. I’d appreciate any information you can provide. — A.

ANSWER: I learned early in my career to listen to nurses, especially experienced ones, and in this case it’s true again.

Insulin resistance is a major component of polycystic ovarian syndrome. Just as we would in people with type II diabetes, we use metformin to reduce the total amount of sugar the body has to deal with by reducing the liver’s ability to make more sugar. However, adding more sugar through diet gets rid of much of the benefit of metformin! All people with insulin resistance — whether they have PCOS, prediabetes or diabetes — need to carefully monitor their sugar intake.

Sugar is found in so many places. It’s very hard to get away from it, unless you buy your own raw ingredients and cook for yourself. Even then, you have to look at labels carefully. But doing so can dramatically reduce weight gain and diabetes risk.

TO READERS: Questions about the common problem of uterine fibroids are answered in the booklet of that name. To obtain a copy, write: Dr. Roach — No. 1106, 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. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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