Browned off at pale patches spoiling good tan.

Byline: doctor gareth

QI was in Spain and got quite a good tan but I have loads of paler, round patches on my shoulders and back which didn't seem to tan as well as the others. What can cause this?

A The most common cause for what you describe is a condition called pityriasis. This is a fungal infection in the top layer of the skin that causes mild discolouration which is more noticeable when you get a tan. It is easily cleared up with an anti-fungal athlete's foot cream from the chemist. A rarer cause of pale patches is vitiligo, which can cause complete depigmentation of the skin. If the anti-fungal doesn't work I would let your GP have a look at it.

QI got glasses for the first time a few months back. When I take my specs off, I now feel that my eyes are much worse than they were before. Can this happen?

A My optician friend tells me glasses do not weaken the eye but that you probably were making do with worsening vision without really noticing how bad it was getting. When you get glasses, your vision improves so when you take them off you notice a big difference.

Q My baby has a very swollen testicle. The doctor says he has a hydrocele. Will he need an operation?

AA hydrocele is a collection of fluid that builds up on one or both of the testicles. It is entirely harmless but can become quite large. It may resolve on its own but if he needs the fluid removed it is a relatively simple operation.

QI have a real problem with swallowing tablets. How do I get over this as I have to take pills for my blood pressure?

A See if your GP can prescribe your medicine in liquid or syrup form. If not, place the pills on the very back of your tongue and then take a mouthful of water swallowing it all at once. Or try wrapping the tablet in a piece of bread and swallowing that.

Q My dad had a chest x-ray and he tells me that the doctor told him he had "bulls" in his lungs. What are these?

AI can only think the doctor said that he had developed bullae. These are swellings at the end of the breathing tubes that can develop after an infection or as a result of chronic obstructive disease. He will likely need more investigations such as a CT scan or bronchoscopy which involves passing a small camera into the lungs in order to find out what caused the bullae to form.

QI have had really bad indigestion for months. The pharmacist says it may be caused by an infection in my stomach. Could this be the case?

A You should never take antacids for months without being examined by your GP. The infection the pharmacist was talking about is Helicobacter pylori - a bacteria in the stomach which cause ulcers to form. The GP can run a simple test for it so you should make an appointment.