I have a big problem—my skin on my face and scalp has itched awfully for a long time non-stop. What causes such itching? Could it be playing football in the sun years ago? How can I get rid of this nuisance?

Itching of the skin in any part of the body can have a very large number of causes, some of which I shall list below:

• overcleaning of the skin with soaps and shampoos that remove too much of the natural oil from the skin.

• drying of the skin from long exposure to the sun, which may be helped by oily creams (eg. sorbolene).

• dermatitis of many different causes may result in a minimal rash but a maximal itch. Mild steroid creams may assist.

• psoriasis, a skin disease that is more common in older people, and causes red, scaly, itchy patches, particularly on the scalp, elbows and knees.

• scabies, caused by a tiny insect burrowing under the skin. Small red dots or lines may be seen, but the whole area may be very itchy.

• liver failure can cause a generalised itch of the skin in many parts of the body.

• allergies may occur in any part of the body in response to a wide range of substances in the environment, and result in intensely itchy skin.

• a nerve rash may flare at times of stress and anxiety to cause an itch.

If I continued the list, I would probably fill several pages, but the above suggestions may be helpful. Obviously the best solution is to take youritchy skin to a doctor so that s/he can examine it carefully, make a diagnosis and prescribe appropriate treatment.

How are allergies treated? Is there any permanent cure? I have to live on antihistamines for my rash that keeps flaring up for no apparent reason.

The treatment of an acute allergic reaction will depend on where it occurs, its severity, and its duration. Antihistamine drugs are the mainstay of treatment and may be given by tablet, mixture, injection or cream. They are best used early in the course of an allergic reaction or if an exposure to an allergy-provoking situation is expected. Unfortunately, in past years only sedating antihistamines were available, which caused drowsiness as an unacceptable side effect, but now a wide range of safe and effective non-sedating antihistamines are available.

Once the reaction is established, a severe attack may require steroid tablets or injections, adrenaline injections, or, in very severe cases, emergency resuscitation. Other drugs may be used in specific allergy situations (eg. lung-opening drugs in acute asthma).

There are a number of substances that can be used on a regular basis to prevent certain allergic reactions. These include sodium cromoglycate (Intal and Opticrom) and nedocromil sodium (Tilade—asthma spray only) which may prevent hay fever, asthma and allergic conjunctivitis if used several times a day throughout the allergy season (often spring). They are available as inhalers, nasal sprays and eye drops.

A small number of patients are so allergic to certain substances (eg. bee stings or ant bites) that they must carry an emergency supply of an injectable drug (usually adrenaline) with them at all times, and must inject themselves it they suspect that they have been exposed to the allergic substance.

Once the substances that cause an allergy in an individual have been identified, further episodes of allergic reaction may be prevented by desensitisation. This involves giving extremely small doses of the allergy-causing substance to the patient, and then slowly increasing the dose over many weeks or months until the patient can tolerate the substance at the maximum likely exposure level. The desensitisation is normally given by weekly injections.

If you can find out what is causing your allergy reaction, it may be possible to have a course of desensitisation, and be cured.