Health Q&A: Keratosis pilaris management, Shingrix access, and lifestyle guidance

Keratosis pilaris, a condition characterized by small red bumps on the upper arms, affects more than four in ten adults. It results from a buildup of keratin, a protein in the skin, which can block hair follicles and lead to bumps that resemble gooseflesh. The condition can appear on the arms, legs, buttocks and back. It is usually harmless and not infectious, but the bumps can be itchy or feel rough, and many people find it unsightly, especially in dry winter weather.

Doctors often start with simple skin care. The first step is using an emollient—a medical moisturizer bought in pharmacies. Products containing salicylic acid, such as CeraVe SA, can soften and flatten bumps, while moisturizers with urea can be similarly helpful. If over-the-counter moisturizers are not enough, prescription creams that soften the skin, including steroids and retinoids, may be recommended. Regular gentle exfoliating scrubs can also help with dry skin.

Practical tips include avoiding hot showers; taking short lukewarm showers; using a humidifier in dry bedrooms. If symptoms persist or diagnosis is unclear, a GP can confirm keratosis pilaris, sometimes via a virtual consultation by sending photos of the rash.

In a separate health update, readers asked about the NHS shingles vaccine. The new Shingrix vaccine is highly effective, but eligibility remains constrained. The NHS currently offers Shingrix to most people aged 70–80 and those turning 65, with a maximum eligible age of 80. People who had Zostavax in the past decade generally cannot switch to Shingrix. There are exceptions this month: adults 18 and over who are severely immunosuppressed can now receive Shingrix regardless of age. Those who had Zostavax before 2013 and later become eligible under NHS criteria, or who have become severely immunosuppressed since their jab, may also receive Shingrix. For those who cannot access it on the NHS, the vaccine is available for about £460 for two doses, and anyone over 50 can pay for it, even if they have previously had Zostavax.

For stroke survivors, hormone replacement therapy is unlikely to help stroke-related incontinence. Estrogen can help bladder issues when incontinence is menopause-related, but not when caused by brain injury from a stroke. NHS local bladder services can provide pelvic floor exercises and other strategies to improve continence.

For osteoarthritis, natural strategies include weight loss, physiotherapy and regular exercise to relieve pain and reduce surgery risk. Only about one in ten OA patients go on to knee replacement surgery. Some patients use supplements such as glucosamine and chondroitin, though medical research evidence is variable.

Separately, a growing public health discussion centers on grey area drinking. The NHS advises no more than 14 units of alcohol per week; many people exceed this without recognizing the health risks. Tactics to cut down can include keeping a weekly alcohol diary and setting drink-free days. Readers who think they may be grey area drinkers are encouraged to share experiences and strategies.

Readers with questions for Dr Ellie Cannon can email DrEllie@mailonsunday.co.uk. Dr Cannon cannot enter into personal correspondence, and responses should be taken in a general context.