DEAR DR. DONOHUE: I fractured my wrist in 2003, and I still have pain to this day. The problem is said to be reflex sympathetic dystrophy. I have never heard of it, and I am told there is nothing to be done for it. Now my fingers do not bend. Can something be done for this? – B.H.

ANSWER: Reflex sympathetic dystrophy is now called complex regional pain syndrome. It happens after an injury, sometimes one as insignificant as a minor sprain.

The sequence of events goes something like this. Even though the injury heals, the injured site becomes swollen and develops burning, throbbing or aching pain weeks to three months after the injury originally occurred. The skin is warm and tender to the touch.

In another three months, the skin cools, but pain remains.

After three more months pass, the skin and tissues in the injured area shrink, and the adjacent joints can become stiff.

The situation is not without treatment. Pain medicines can generally control that aspect of this condition. Capsaicin cream or a lidocaine skin patch applied to the involved site can ease discomfort. Nerve blocks are another approach to pain control. In resistant cases, a device called a spinal-cord stimulator delivers a mild electric current to the spinal cord and blocks the transmission of painful signals to the brain.

Most important is physical therapy. You need a supervised program to improve the flexibility of your wrist, hand and fingers. A physical therapist can devise such a program for you, and you should see about one quickly.

You might also want to visit the Reflex Sympathetic Dystrophy Syndrome Association’s Web site, at www.rsds.org. It has a good deal of useful information.

DEAR DR. DONOHUE: I have awful dandruff. I also have flakes and red blotches on my face.

I was told that you ran a column saying that Listerine was a good treatment for it. Will you please tell me how to use it? – H.C.

ANSWER: I didn’t advise using Listerine for dandruff.

You have seborrheic (SEB-oh-REE-ik) dermatitis. It sometimes shows itself as ordinary dandruff – dry, white flakes that fall from the scalp – and produces minor itchiness. Another manifestation is yellowish, crusted patches on red skin that shed larger, greasy flakes. Involved sites include the scalp, the eyebrows, the chin, the breastbone, behind the ears and the lines that arc from the bottom sides of the nose to the lips.

Seborrheic dermatitis arises from the overproduction of skin oil and from the interaction of a skin yeast called pityrosporum.

The scalp usually responds to a shampoo like Nizoral A-D, Selsun Blue or Head and Shoulders. None requires a prescription. If they don’t get the job done, then prescription items are necessary.

For the face, Nizoral or Loprox cream is helpful. Both need a doctor’s prescription.

I have mentioned only a few treatments. There are many more. And there are medicines that are taken by mouth. All of these require a doctor’s approval.

DEAR DR. DONOHUE: In August 2001, I had unprotected sex, which resulted from a drunken golf party. I sought medical assistance, and the doctor declared I had no evidence of HIV infection. Blood tests were negative. I wasn’t satisfied and saw two other doctors. They found no infection. I was still not satisfied and saw a urologist, who supported the other doctors’ findings. I have seen several doctors since and have taken many blood tests. In a recent column you mentioned purple spots as a sign of AIDS, and that has caused me great concern. I have had purple spots come and go on a few occasions. I am enclosing copies of my lab tests and would appreciate your recommendations. – Anon.

ANSWER: My recommendation is to stop obsessing about this encounter and the fear of a sexually transmitted disease. Your tests and examinations indicate good health. The purple spots I spoke of were Kaposi’s sarcoma, a cancer that does not come and go. You do not have it.

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.