DR. ROACH WRITES: Every year around this time I write a column on the different flu vaccines that are available. Before doing so this year, I want to implore readers to get their flu vaccine. If you have never gotten one, now is the time. If you had a bad reaction 20 years ago, give the vaccine another chance this year. If you have never had the flu and don’t see the reason for the vaccine, this is the year to start.

The reason I say this is that as I write, COVID-19 cases continue to increase in many parts of North America. Hospitals will be stressed. More people getting the flu shot means fewer people who need to be hospitalized for flu. I recall years where every bed in the intensive care unit was filled with a person with severe lung disease from influenza, and ICU beds may be in very short supply.

The flu and COVID-19 share many symptoms, so a case of the flu may often mean getting tested for COVID-19, which may not be easy to obtain. Protect yourself, your family, friends, neighbors, community and the health care system by getting a flu shot this year. Physical distancing, mask wearing and handwashing will all help, but the flu vaccine is the most important.

This year’s flu vaccine will include two A strains: an H1N1, an H3N2, and one or two B strains, depending on whether it’s the trivalent or quadrivalent. Since it is the A strains that are more likely to cause hospitalization, either vaccine type will protect against the most dangerous type of flu.

This year, finally, there are approved quadrivalent high-dose and quadrivalent adjuvant vaccines available for people over 65. These provide a higher degree of protection over standard dose, but if one isn’t immediately available, I would recommend getting any available flu vaccine starting now. September and October are probably the best months to get the vaccine, but vaccination is likely to be of benefit as long as flu strains are circulating, which usually is well into January or later.

As in previous years, people with an egg allergy may get any flu vaccine, and do not need the vaccine made without egg (Flucelvax quadrivalent). A live, attenuated nasal vaccine is available for adults up to age 50, but should not be used by people with a weakened immune system (through disease or medication) or their caregivers. Pregnant women should get the flu shot, not the nasal vaccine.

DEAR DR ROACH: Is it safe to use hemorrhoid cream under your eyes, as three actresses on TV said they do? — C.P.

ANSWER: Hemorrhoid creams are made with petrolatum, mineral oil and a vasoconstrictor, such as phenylephrine. Some contain hydrocortisone. The manufacturer of Preparation H doesn’t recommend using its products under the eyes, and I don’t either. Vasoconstrictors may temporarily make the skin feel tighter, as the blood vessels constrict, but this is doing nothing to help you in the long term. Hydrocortisone should not be applied to the face for prolonged periods, as it can permanently thin the skin on your face. Petrolatum and mineral oil can block pores and predispose to acne. I recommend using only products designed for the face, on the face.

* * *

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 send mail to 628 Virginia Dr., Orlando, FL 32803.