Is there any connection between eczema and asthma? Half of my family seems to have one disease, while the other half have the other.

It seems strange that a skin and lung disease can be connected, but this is the case. In fact, there is a third disease—hay fever—that is also connected to eczema and asthma. All three are ‘ atopic’ diseases—that is there is a specific type of reaction by the tissue in the lung, skin and nose, often to outside substances such as temperature changes, dust or pollen, but sometimes to internal triggers such as stress or hormone changes.

Patients with these conditions will know that the disease flares and settles without treatment, and usually for no apparent cause. Others will recognise that before a menstrual period, at times of anxiety, in certain seasons or with a particular type of weather, their condition will worsen.

People with one of these three diseases, also have an above average risk of developing one of the others.

It is possible for allergists to desensitise you to any allergies that may be the cause, but this procedure will not work against the other factors. Fortunately there are creams, sprays and medications that can control these diseases, but there is no cure.

Different doctors and naturopaths have told me different ways to deal with my asthma. What is the best treatment for asthma?

The best treatment is that which completely prevents the disease. It is far better to prevent asthma than to deal with acute attacks. If the asthma only occurs every month or two, intermittent treatment may be appropriate. Most patients are being under-medicated, rather than taking too much. This applies particularly to patients who obtain their medication over the counter from chemists rather than seeing a doctor. This habit could prove expensive to your health!

Prevention involves two classes of drugs:

— Intal or Tilade

— Steroids (eg. Becotide, Becloforte, Flixotide, Pulmicort, Aldecin etc.).

Both groups are designed to be used regularly on a long term basis to prevent asthma attacks.

If an attack does occur, treatment is usually by one of a number of sprays (eg. Ventolin, Respolin, Bricanyl, Serevent). These can also be given by a nebuliser (when they are even more effective) or in a tablet or mixture (when they are less effective than a spray).

Combination inhalers are now available (eg. Seretidc) that have both preventive and treatment medication in the one dose.

Tablets or mixtures of a group of drugs called theophyllines can also be given to treat an attack of asthma. These include medications such as Ausryn and Theo-Dur.

If these medications do not work adequately, there are a number of add-on sprays and tablets that can be used including Atrovent and Prednisone.

I must emphasise how important it is to be under the continued care of a doctor when using any of these medications. Asthma can be well controlled with the cooperation of the patient.