How concerned should I be about my crusty brown skin patches? Dr Ellie reveals whether you should be worried about cancer
I am 77 and have crusty patches on my breasts, back and stomach. Could they be cancerous?
Dr Ellie Cannon replies: It is unlikely. These sound like seborrhoeic keratoses – harmless skin growths that affect around three-quarters of people over 70 and often appear as rough, crusty patches in shades of tan, brown or black that can grow several centimetres wide.
Although sometimes called seborrhoeic warts, they’re not caused by a virus as actual warts are. They’re clusters of skin cells and, while the cause is not fully understood, they don’t turn cancerous – although patients may be bothered by how they look. But if one suddenly changes its size, shape or colour – particularly if it’s very dark – it’s worth getting checked by your GP or a dermatologist to be safe.
The most common treatment is freezing – also known as cryotherapy – which involves applying liquid nitrogen to the lesion to destroy the build-up of skin cells. This typically causes the area to blister, scab and fall away within a week or two.
Because these patches are benign and don’t become cancerous, removal is usually considered cosmetic and not funded by the NHS
Or it can be removed by curettage, where the mark is scraped away using a small tool called a curette. This is done under local anaesthetic and may be combined with cauterisation – a technique using heat to seal the area and minimise regrowth risk.
Another common treatment is electrosurgery, where a targeted electrical current burns away the lesion, often followed by scraping to remove any remaining tissue.
Laser therapy – vaporising the keratosis with a focused beam of light – is another possible approach, but tends to be more expensive and less available.
Because these patches are benign and don’t become cancerous, removal is usually considered cosmetic and not funded by the NHS. And even if removed privately, they may regrow or return elsewhere.
For the past two years I’ve had pins and needles and numbness in both legs. Specialists can’t tell me why – what should I do?
Dr Ellie Cannon replies: Pins and needles and numbness in the legs are a common but distressing problem, and usually a sign of a nerve-related issue, especially if in both legs.
Nerves carry electrical signals that help us sense touch, pressure and pain. When they aren’t working properly – usually due to damage or underlying conditions – these signals can misfire, causing sensations such as tingling or numbness.
The root issue is often in the spine, where the nerves for the legs begin. A slipped disc or spinal arthritis can compress them, leading to the sensations.
Another possible cause is peripheral neuropathy – damage to the nerves at the ends of the limbs, typically the feet.
It becomes more common with age and can be linked to diabetes, a vitamin B12 deficiency or major treatments such as chemotherapy.
A medication designed to treat nerve-related pain and tingling called pregabalin may help. But your GP can arrange more tests to find the problem. An X-ray of the lower spine may reveal nerve compression, and nerve conduction studies can help identify where the issue lies.
Vascular trouble – problems with the veins or arteries – can cause leg pain, but they don’t typically lead to pins and needles or numbness.
My ten-year-old grandson has been having bouts of sickness and gagging in the morning – sometimes he can’t even eat his breakfast. It often happens before football matches or on school days, then fades after ten to 15 minutes. What could be causing this?
Dr Ellie Cannon replies: Nausea in children can be due to a range of things, but the reassuring detail in this case is that symptoms settle quickly.
If there was a physical cause behind it, then it would usually occur at different times of the day and might also be triggered by eating or lying down.
The fact that it only happens in the morning suggests emotional upset or mild stress. Morning nausea and issues swallowing are often linked to anxiety – in both adults and children – often triggered by anticipation of the day ahead.
It’s important to rule out any physical cause, so a visit to the GP is a sensible next step.
If your grandson is growing well, eating normally the rest of the time, sleeping soundly and staying active, those are all positive signs – but the GP may want to run some basic tests.
Occasionally a lingering stomach infection, such as Helicobacter pylori, can cause nausea and stomach discomfort, especially before eating, but
it can be checked with a simple stool test. Constipation is another common, and often overlooked, cause of nausea in children.
Since breakfast is important before school or physical activity, it may help to shift the morning routine – waking up earlier to allow more time before eating. It can also be useful to talk with your grandson about how physical symptoms (‘butterflies’ or a tight stomach) can happen when we feel anxious. This may spark a conversation and give him the language to express what’s going on.
