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testing is usually recommended to find out whether you have primary or secondary Raynaud’s. Secondary Raynaud’s may require more treatment and, in some cases, referral to a specialist. Secondary Raynaud’s may be suspected if: your symptoms only started when you were over 30 years of age – most cases of primary Raynaud’s begin between the ages of 20 to 30 you’re experiencing severe pain during an attack of Raynaud’s only one side of your body is affected Your GP may also check the tiny blood vessels, known as capillaries, found where your nail meets the finger. These capillaries are often larger in people with secondary Raynaud’s, and look like red pen marks. Blood tests Your GP may also refer you for blood tests to check for other health conditions that could be causing your symptoms. These tests may include: a full blood count – to check for infection or, much less commonly, a cancer of the blood, such as leukaemia an antinuclear antibodies (ANA) test – to check for an overactive


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for infection or, much less commonly, a cancer of the blood, such as leukaemia an antinuclear antibodies (ANA) test – to check for an overactive immune system, which is common in people with autoimmune conditions such as scleroderma and lupus erythrocyte sedimentation rate – to check for an autoimmune disorder Scleroderma & Raynaud’s UK (SRUK) If you’ve been diagnosed with Raynaud’s, Scleroderma & Raynaud’s UK (SRUK) may be helpful. It is the UK’s leading charity for people affected by the condition. Treating Raynaud’s phenomenon You can usually treat Raynaud’s phenomenon yourself, although medication is sometimes necessary. If you’ve been diagnosed with secondary Raynaud’s, you may be referred to a specialist in the treatment of the underlying condition. If your secondary Raynaud’s may be a side effect of a medication, you may be asked to stop taking it, to see if your symptoms improve. Self-help The following advice is recommended for both primary and secondary Raynaud’s. Keep your


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to stop taking it, to see if your symptoms improve. Self-help The following advice is recommended for both primary and secondary Raynaud’s. Keep your whole body warm, especially your hands and feet. Wear gloves and warm footwear in cold weather. If you smoke, stop. Quitting smoking will improve your circulation, which should help to improve symptoms. Exercise regularly, as this helps to improve your circulation and reduce stress levels (see below). For most people, 150 minutes of vigorous exercise a week is recommended. Read more about exercise. Try to minimise your stress levels. Regular exercise, eating a healthy diet, and relaxation techniques, such as deep breathing or activities such as yoga, can help. You may find it useful to avoid stimulants such as coffee, tea and cola. If you find it difficult to control feelings of stress, you may require additional treatment, such as counselling. Medication Nifedipine If your symptoms fail to improve, you may be prescribed nifedipine. This


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may require additional treatment, such as counselling. Medication Nifedipine If your symptoms fail to improve, you may be prescribed nifedipine. This is the only medicine licensed to treat Raynaud’s phenomenon in the UK. It doesn’t cure Raynaud’s, but can help to relieve the symptoms. Nifedipine is a calcium channel blocker – a type of medication that encourages the blood vessels to widen. Depending on the pattern of your symptoms and how well you respond to treatment, you may be asked to take your medication every day. Alternatively, you may only need to take it as prevention; for example, during a sudden snap of cold weather. Side effects are common and include: oedema – swelling of certain parts of the body, such as your hands and feet, due to a build-up of fluid headaches heart palpitations dizziness constipation Don’t drink grapefruit juice when taking nifedipine, as this could make side effects worse. The side effects should improve as your body gets used to the medicine, but


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juice when taking nifedipine, as this could make side effects worse. The side effects should improve as your body gets used to the medicine, but tell your GP if you find them particularly troublesome. There are alternative calcium channel blockers that may suit you better. Other medications Other medications have been used to treat Raynaud’s, but their use is controversial, as there is limited evidence to show they’re effective in most people. However, some people have claimed to benefit from treatment. These medications include: fluoxetine – which was widely used in the treatment of depression sildenafil – which is used to treat erectile dysfunction (inability to get or maintain an erection) These medicines are not licensed for the treatment of Raynaud’s in the UK, but you may be prescribed them if it’s thought the potential benefit outweighs the possible risks. Surgery Surgery for Raynaud’s is rare. It’s usually only recommended if your symptoms are so severe that there’s a risk the


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the possible risks. Surgery Surgery for Raynaud’s is rare. It’s usually only recommended if your symptoms are so severe that there’s a risk the affected body part, such as your fingers, could lose their blood supply and begin to die. Read more about the complications of Raynaud’s phenomenon. A type of surgery called sympathectomy is sometimes used. It involves cutting the nerves causing the affected blood vessels to spasm. The results of a sympathectomy are often only temporary and further treatment and possibly more surgery may be required after a few years. Complications of Raynaud’s phenomenon People with Raynaud’s phenomenon have an increased risk of developing other problems, such as scleroderma. Scleroderma Around 1 in 16 women and 1 in 50 men with Raynaud’s develop a condition called scleroderma, usually between the ages of 25 and 55. Scleroderma is when the body produces excessively high levels of collagen. Scleroderma is a Greek word meaning hard skin, but it can affect other


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55. Scleroderma is when the body produces excessively high levels of collagen. Scleroderma is a Greek word meaning hard skin, but it can affect other areas of the body, such as the kidneys, heart and lungs. Symptoms of scleroderma include: puffy and itchy skin tight and uncomfortable joints small calcium spots and red spots under the skin trouble swallowing, known as dysphagia diarrhoea, bloating or constipation There’s no cure for scleroderma, but there are ways of overcoming problems it may cause. For example, medicines can reverse or slow down the processes that cause damage around the body. For more information, visit Scleroderma & Raynaud’s UK (SRUK), a UK charity dedicated to improving the lives of people affected by Scleroderma and Raynaud’s. Ulcers and gangrene In severe cases of Raynaud’s, the blood supply to an affected body part can become severely diminished. Without a constant supply of blood, the tissue in the body part will begin to die. This problem is rare and


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body part can become severely diminished. Without a constant supply of blood, the tissue in the body part will begin to die. This problem is rare and normally only occurs in secondary Raynaud’s. The initial sign is an open sore, known as an ulcer, which develops on the surface of the body part. If you suspect a skin ulcer, contact your GP for advice. Left untreated, the tissue can die, which is known as gangrene (specifically, dry gangrene). The symptoms of dry gangrene normally begin with a red line on the skin that marks the edges of the affected tissue. The tissue becomes cold and numb, and can be painful as the tissue dies. However, many people, particularly the elderly, experience no sensations. The affected area changes colour from red, to brown, to black. The dead tissue will then shrivel up, separate from the healthy tissue and fall off. These complications normally require admission to hospital, where you’ll be given medication designed to thin your blood, which should help


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fall off. These complications normally require admission to hospital, where you’ll be given medication designed to thin your blood, which should help to restore blood flow. If you fail to respond to treatment, you may need surgery to unblock or repair damaged blood vessels. Source:Chest Heart & Stroke Scotland - Opens in new browser window Last updated: 02 July 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/reactive-arthritis/


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Ready Steady Baby! 0 Home Ready Steady Baby! Ready Steady Baby! Your guide to pregnancy, labour and birth and early parenthood up to 8 weeks Pregnancy Health problems in pregnancy Including common ailments and conditions that occur before and during pregnancy Looking after yourself and your baby Including how to eat well, keep active and prevent illness in pregnancy Preparing for parenthood Including benefits, housing support and your rights at work during and after pregnancy Relationships and wellbeing in pregnancy Including looking after your mental wellbeing and bonding with baby during pregnancy Your antenatal care Including tests, scans and checks and who'll be looking after you and your baby Your baby’s development Including the first signs of pregnancy and how your baby develops week to week Labour and birth After the birth Including newborn tests and examination and help for babies born sick or premature Assisted birth Including assisted birth by forceps or ventouse delivery,


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newborn tests and examination and help for babies born sick or premature Assisted birth Including assisted birth by forceps or ventouse delivery, or caesarean section Getting ready for the birth Including making a birth plan and deciding where to give birth Giving birth Including what happens during the birth at full term and if your labour's premature Labour Including signs that labour has started and options for pain relief during labour and birth Meeting your new baby Including having skin-to-skin contact with your baby and the first feeds Early parenthood Caring for your new baby Including how to bathe your baby, change their nappies and soothe them when they cry Getting to know your baby Including how to bond with your baby and talk, sing and read to them Going home Including keeping your baby safe at home and how to help them sleep safely If your baby's ill When to see your GP or pharmacist, or phone 999 if your baby's unwell Your baby’s development from 2 to 12 months Your baby


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safely If your baby's ill When to see your GP or pharmacist, or phone 999 if your baby's unwell Your baby’s development from 2 to 12 months Your baby will develop many new skills in its first year Your growing family Including how and when to introduce your baby to friends and family Your wellbeing after the birth Including looking after your mental health and helping your body recover after the birth Other languages and formats Easy Read Ready Steady Baby information in Easy Read Other languages Ready Steady Baby information in other languages NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/pregnancy-and-childbirth/losing-a-baby/recurrent-miscarriage/


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https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/respiratory-syncytial-virus-rsv/


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Respiratory syncytial virus (RSV) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Infections and poisoning Respiratory syncytial virus (RSV) Respiratory syncytial virus (RSV) Respiratory syncytial virus (RSV) is a virus that can affect the lungs and airways. In most people, RSV causes mild cold-like symptoms. Occasionally, RSV can cause severe lung infections. These can include: bronchiolitis (an infection of the small airways in the lungs) pneumonia RSV infections peak during late autumn and winter, but can happen all year round. Read more about the RSV vaccine for older adults Read more about the RSV vaccine during pregnancy Symptoms of RSV RSV infection often looks like a cold. You may experience: a runny nose a decreased appetite tiredness a cough shortness of breath wheezing fever croup a middle ear infection (otitis media) You can treat a


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a runny nose a decreased appetite tiredness a cough shortness of breath wheezing fever croup a middle ear infection (otitis media) You can treat a mild cases of RSV at home, without contacting a healthcare professional. When to get medical advice Phone 999 if: you have severe difficulty breathing – for example, you struggle to speak without pausing, gasping or choking you have severe chest pain in the middle of your chest that isn’t going away – it may feel like pressure, tightness or squeezing you have pain that spreads to your arms, back, neck and jaw you feel more drowsy than usual or find it more difficult to wake up your lips or skin are turning very pale, blue or grey – on brown or black skin this is easier to see on the palms of your hands Your child: has lips or skin that are turning pale, blue or grey – on brown or black skin this is easier to see on the palms of their hands has severe difficulty breathing – they may make grunting noises or suck their stomach in under their


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is easier to see on the palms of their hands has severe difficulty breathing – they may make grunting noises or suck their stomach in under their ribcage is breathing fast or stops or pauses is pulling in at their throat area (tracheal tug) or their windpipe is more prominent is limp, floppy or not responding like they normally do – they may find it difficult to focus on you or are more difficult to wake up than usual is less than 3 months old and has a temperature of 38°C (101°F) or above and has not had a vaccination in the past 2 days is less than 3 months old and has a temperature of 36°C (97°F) or less and has not had a vaccination in the past 2 days Phone your GP immediately if you: are more short of breath than usual have pain when breathing in or coughing are feeling confused, dizzy, or lightheaded feel sick or are being sick – for example, you can’t keep food or fluids down are coughing up blood (haemoptysis) have heart palpitations – this may feel like your heart is racing,


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example, you can’t keep food or fluids down are coughing up blood (haemoptysis) have heart palpitations – this may feel like your heart is racing, going too slowly or skipping a beat or like a fluttering feeling in your chest are peeing less than usual – this can be a sign of dehydration have a very high or low temperature – for example, you feel either hot or cold to touch or you’re shivering Your child: is more short of breath than usual has pain when breathing in or coughing is feeling confused, dizzy or lightheaded feels sick or is being sick – for example, they can’t keep food or fluids down is coughing up blood (haemoptysis) has had a dry nappy for 12 hours or more, or is showing other signs of dehydration has a very high or low temperature – for example, they feel either hot or cold to touch or are shivering If your GP is closed, phone 111. Treatment for RSV There’s no specific treatment for RSV. A mild case of RSV will normally get better on it’s own, and can be treated at


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phone 111. Treatment for RSV There’s no specific treatment for RSV. A mild case of RSV will normally get better on it’s own, and can be treated at home. You can ease symptoms in the same way you would for a cold. This could include: drinking plenty of fluids taking over-the-counter pain relief like paracetamol or ibuprofen Read more about treating a common cold What causes RSV RSV is spread by droplets from coughs and sneezes. It can live on surfaces or objects for several hours. Someone with RSV will normally be contagious for 1 to 2 days before RSV symptoms start. Most people are contagious for 3 to 8 days. Some infants and people with weakened immune systems may be contagious for up to 4 weeks. Who is most at risk of RSV RSV infection can happen to anyone, but for most it will be a mild infection that is like a cold. Some groups are more at risk of severe infection. They are: babies who were born prematurely children under 2 years of age people with chronic lung disease or


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are more at risk of severe infection. They are: babies who were born prematurely children under 2 years of age people with chronic lung disease or congenital heart disease people with weakened immune systems adults over 65 years of age How to prevent RSV There are things you can do to help prevent RSV infection. Do wash your hands often, especially before touching your mouth or handling food sneeze and cough into tissues throw used tissues away immediately and then wash your hands clean surfaces regularly use your own cup, plates, cutlery and kitchen utensils Don’t do not share towels with someone who has cold-like symptoms do not let your child share toys with someone who has cold-like symptoms RSV vaccination The RSV vaccination programme helps protect babies and older adults from the RSV virus. The vaccine will be offered: to older adults aged 75 to 79 during pregnancy (from 28 weeks onwards) Read more about the RSV vaccine for older adults Read more about the RSV vaccine during


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adults aged 75 to 79 during pregnancy (from 28 weeks onwards) Read more about the RSV vaccine for older adults Read more about the RSV vaccine during pregnancy Last updated: 01 May 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform RSV vaccine for older adults RSV vaccine during pregnancy NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/restless-legs-syndrome/


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-children/retinoblastoma-children/


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Retinoblastoma in children | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in children Retinoblastoma: Children Retinoblastoma: Children Retinoblastoma is an uncommon eye cancer that usually affects children under 5, although it can affect children of any age. Treatment is very effective and nearly all children with retinoblastoma are cured. More children than ever are surviving childhood cancer. There are new and better drugs and treatments, and we can now also work to reduce the after-effects of having had cancer in the past. It’s devastating to hear that your child has cancer, and at times it can feel overwhelming. There are many healthcare professionals and support organisations to help you through this difficult time. Understanding more about the cancer your child has and the treatments that may be used can often help


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to help you through this difficult time. Understanding more about the cancer your child has and the treatments that may be used can often help parents to cope. Your child’s specialist will give you more detailed information and if you have any questions it’s important to ask the specialist doctor or nurse who knows your child’s individual situation. Retinoblastoma develops in the light-sensitive lining of the eye (called the retina). There are 2 forms of retinoblastoma: a heritable form – this is genetic or inherited; there are often tumours in both eyes (bilateral) or sometimes only in 1 eye a non-heritable form – this is not passed on in the family; there’s 1 tumour in only 1 eye (unilateral) Causes The heritable form of retinoblastoma, which accounts for about 2 in every 5 cases, is caused by a genetic abnormality. This means that an abnormal gene allows the tumour to develop. This abnormal gene may either be inherited from a parent or happen for the first time at an early stage of


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gene allows the tumour to develop. This abnormal gene may either be inherited from a parent or happen for the first time at an early stage of development in the womb. Genetic counselling and support is available for families in which a member has retinoblastoma. Not all children of a parent with retinoblastoma will inherit this gene, but children born into families with a history of retinoblastoma are offered blood testing. They are also usually checked (screened) soon after birth for signs of retinoblastoma. This means that treatment can be started early if a tumour does develop. Screening usually starts shortly after birth and is repeated every few months for 5 years. An eye specialist examines the eye, while shining a light into it with an ophthalmoscope. In younger children, this may need to be done under a general anaesthetic. The genetic abnormality in the heritable form of retinoblastoma is now well-understood. But we don’t know what causes non-heritable retinoblastoma. Signs


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genetic abnormality in the heritable form of retinoblastoma is now well-understood. But we don’t know what causes non-heritable retinoblastoma. Signs and symptoms Some children with a family history of retinoblastoma are picked up by screening before they have any symptoms. If there’s no family history of retinoblastoma, the first sign of the condition is often a white pupil that does not reflect light (leukocoria). This may be picked up when a picture of your child is taken using flash photography. The pupil of the affected eye may look white in the photograph. Some children may have a squint or, if the tumour is large, they may have a painful red eye. How retinoblastoma is diagnosed Tests are likely to involve an examination under anaesthetic (EUA) where an eye specialist (ophthalmologist) examines your child’s eye while they’re asleep. Unlike nearly all other types of cancer, retinoblastomas can be diagnosed just by their appearance. So it’s not usually necessary to take a sample


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Unlike nearly all other types of cancer, retinoblastomas can be diagnosed just by their appearance. So it’s not usually necessary to take a sample of tissue (a biopsy). Your child will have several more EUAs to check how treatment is progressing. When retinoblastoma is diagnosed, your child may have some other tests to check the exact position and size of the tumour, and whether it has begun to spread into surrounding structures. This is known as staging. They may have some of the following tests: an ultrasound scan – this is a painless scan that uses sound waves to examine the eye and the surrounding area an MRI (magnetic resonance imaging) scan – this uses magnetism to build up a detailed picture of the eye and the head a lumbar puncture – the doctor inserts a fine needle between the bones in the lower spine to remove a sample of the fluid from around the brain and spinal cord (cerebrospinal fluid) then the fluid is examined under a microscope to check whether there are any cancer


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fluid from around the brain and spinal cord (cerebrospinal fluid) then the fluid is examined under a microscope to check whether there are any cancer cells present a bone marrow sample – this may be taken to check whether there are any cancer cells in the bone marrow (where our blood cells are made); the doctor inserts a needle into the hip bone and draws some of the bone marrow out with a syringe so that it can be checked for any cancer cells a bone scan – this involves taking a series of X-rays to check for signs of any spread to the bones a blood test – this may be taken for genetic testing for the Rb gene; the results of this test can take some months The doctor or a specialist nurse will explain more about the tests that your child needs. Staging The stage of a cancer is a term used to describe its size and whether it has spread from where it first started. Knowing the stage of your child’s retinoblastoma helps the doctors to decide on the most appropriate treatment. The


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from where it first started. Knowing the stage of your child’s retinoblastoma helps the doctors to decide on the most appropriate treatment. The following staging system is commonly used for retinoblastoma. Intraocular retinoblastoma There is cancer in 1 or both eyes, but it has not spread to other parts of the eye or the tissues surrounding the eye. This stage may be sub-divided into 5 grades (A–E), depending on the size and position of the cancer and on whether there’s any damage to the eye. Extraocular retinoblastoma The cancer has spread outside the eye into surrounding tissue, or to other parts of the body. Treatment Treatment depends on the number, position and size of the tumours in the eye. The aim of treatment is to first get rid of the cancer, and secondly to try to keep the sight in the eye. Some treatments may cause changes to the vision in the affected eye. Your child’s specialist will talk to you about the possible risks as well as the advantages of the treatment.


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to the vision in the affected eye. Your child’s specialist will talk to you about the possible risks as well as the advantages of the treatment. Smaller tumours For smaller tumours, treatment is given to the eye itself (called local therapy), while your child is asleep and under anaesthetic. Cryotherapy This is used to freeze the tumours. More than 1 session may be necessary, in which case they are usually done at monthly intervals. Laser therapy A laser is used to heat the tumour. Your child may need a number of sessions at intervals of 3 to 4 weeks. Plaque A small radioactive disc is stitched over the tumour on the outside of the eye. The disc needs to stay in place for up to 4 days while the radiation destroys the cancer cells. This is done for slightly larger tumours, or tumours that have not been successfully treated with other methods. Thermotherapy This process uses heat to destroy the cancer cells and may be combined with chemotherapy or radiotherapy, as heat can improve the


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Thermotherapy This process uses heat to destroy the cancer cells and may be combined with chemotherapy or radiotherapy, as heat can improve the effectiveness of these treatments. The heat is produced by a laser, which is directed at the tumour. Larger tumours Chemotherapy This is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It may be given before the local treatments mentioned above, to help shrink the tumour and make treatment more successful. Chemotherapy can also be used if the cancer has spread to other parts of the body, or if there’s a risk that it may spread. The chemotherapy drugs most commonly used to treat retinoblastoma are carboplatin, etoposide, and vincristine. Newer techniques include giving chemotherapy directly into the artery (the blood vessel) that supplies the eye (intra-arterial chemotherapy) or injecting chemotherapy into the central gelatinous part of the eye (intra-vitreal chemotherapy). Surgery If the tumour is very large and the vision in


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chemotherapy into the central gelatinous part of the eye (intra-vitreal chemotherapy). Surgery If the tumour is very large and the vision in the eye is lost, your child is likely to need an operation to remove the eye. The specialist will only do this if it is absolutely necessary. An artificial eye is then fitted. Radiotherapy Radiotherapy treats cancer by using high energy rays from a machine to destroy the cancer cells, while doing as little harm as possible to normal cells. It can be given to the whole eye but does have some effect on the surrounding tissue. Radiotherapy for retinoblastoma is normally only used when other treatments have not worked well. Side effects of treatment The side effects will depend on the treatment your child is having. The immediate side effects will usually improve when treatment finishes. But unfortunately, some treatments may cause side effects that develop many years later. The specialist will explain all of this to you before treatment starts. Your


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some treatments may cause side effects that develop many years later. The specialist will explain all of this to you before treatment starts. Your child’s follow-up will include checking for any long-term effects of treatment. Clinical trials Many children have their treatment as part of a clinical research trial. Trials aim to improve our understanding of the best way to treat an illness, usually by comparing the standard treatment with a new or modified version. Specialist doctors carry out trials for children’s cancers. If appropriate, your child’s medical team will talk to you about taking part in a clinical trial, and will answer any questions you have. Written information is provided to help explain things. Taking part in a research trial is completely voluntary, and you’ll be given plenty of time to decide whether it’s right for your child. Treatment guidelines Sometimes, clinical trials are not available for your child’s tumour. This may be because a recent trial has just


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your child. Treatment guidelines Sometimes, clinical trials are not available for your child’s tumour. This may be because a recent trial has just finished, or because the tumour is very rare. In these cases, you can expect your doctors and nurses to offer treatment which is agreed to be the most appropriate, using guidelines which have been prepared by experts across the country. The Children’s Cancer and Leukaemia Group (CCLG) is an important organisation which helps to produce these guidelines. Follow-up care At least 9 out of every 10 children with retinoblastoma are cured. Following treatment, the eye specialist will frequently examine your child’s eye under anaesthetic to check that the retina is healthy, the cancer has not come back, and no new tumours have developed. Follow-up is usually in a clinic for childhood cancers, called a paediatric oncology clinic. Children with heritable retinoblastoma will be given genetic counselling when they are old enough to understand it.


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a paediatric oncology clinic. Children with heritable retinoblastoma will be given genetic counselling when they are old enough to understand it. Having the heritable form of retinoblastoma means an increased risk of developing other types of cancer later in life. Your child will be followed up closely into adulthood. They will be encouraged to get any new symptoms, such as a lump, checked early, and to have a healthy lifestyle to help to reduce cancer risk. Your feelings As a parent, the fact that your child has cancer is one of the worst situations you can be faced with. You may have many emotions, such as fear, guilt, sadness, anger and uncertainty. These are all normal reactions and are part of the process that many parents go through at such a difficult time. Your child may have a variety of powerful emotions throughout their experience with cancer. Further information and advice if your child has cancer Source: Children's Cancer and Leukaemia Group - Opens in new browser window


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with cancer. Further information and advice if your child has cancer Source: Children's Cancer and Leukaemia Group - Opens in new browser window Last updated: 09 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Scottish Cancer Network: Patient information Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-children/rhabdomyosarcoma/


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/rheumatoid-arthritis/


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Rheumatoid arthritis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Conditions that can affect multiple parts of the body Rheumatoid arthritis Rheumatoid arthritis Rheumatoid arthritis is a long-term condition. It can cause: pain swelling stiffness in the joints It can also cause deformity of the joints. It normally affects the hands, wrists and feet. But, other joints and parts of the body are sometimes also affected. Causes of rheumatoid arthritis Rheumatoid arthritis is an autoimmune condition. This means it’s caused by the body’s immune system attacking itself. The immune system helps to defend our body from infections. But, in rheumatoid arthritis the immune system sends antibodies to the lining of the joints by mistake. The antibodies then attack the tissues surrounding the joint. This causes the thin layer of cells


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antibodies to the lining of the joints by mistake. The antibodies then attack the tissues surrounding the joint. This causes the thin layer of cells (synovium) covering the joints to become sore and inflamed. Inflammation also causes chemicals to be released. These chemicals thicken the synovium and damage the: bones cartilage – the stretchy connective tissue between bones tendons – the tissue that connects bone to muscle ligaments – the tissue that connects bone and cartilage The chemicals can also change the shape of the joint over time. What is rheumatoid arthritis? Symptoms of rheumatoid arthritis The symptoms of rheumatoid arthritis vary from person to person. They can come and go, and may change over time. Symptoms of rheumatoid arthritis that affect the joints include: pain swelling stiffness and difficulty moving affected joints redness heat around the joints In some people, firm swellings called rheumatoid nodules also develop under the skin around affected joints. Some


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redness heat around the joints In some people, firm swellings called rheumatoid nodules also develop under the skin around affected joints. Some people with rheumatoid arthritis can experience other symptoms. This includes: tiredness and lack of energy a high temperature (fever) sweating a poor appetite weight loss Diagnosing rheumatoid arthritis Rheumatoid arthritis can be difficult to diagnose. This is because many conditions cause joint stiffness and inflammation. You should speak to your GP if you think you have symptoms of rheumatoid arthritis. They will ask about your symptoms and carry out a physical examination to: check your joints for any swelling look at how easily your joints move You GP may also arrange blood tests. If your GP thinks that you have rheumatoid arthritis, they will refer you to a specialist (Rheumatologist). The Rheumatologist will arrange to meet you to go over your history and examine your joints. They may need to arrange extra tests, like more blood tests


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Rheumatologist will arrange to meet you to go over your history and examine your joints. They may need to arrange extra tests, like more blood tests or scans, before they can make a diagnosis and decide if treatment is needed. These will: check for joint inflammation and damage show what kind of arthritis you have Treating rheumatoid arthritis There’s no cure for rheumatoid arthritis but with treatment the joint pain, swelling and stiffness will improve and the risk of joint damage can be reduced. Medication Different types of medications can be used to treat rheumatoid arthritis to relieve joint pain, stiffness and swelling. This will also reduce the chance of developing joint damage. The two main types of medication are: disease-modifying anti-rheumatic drugs (DMARDs) biologic treatments They usually need to be taken for a long-time. They are most effective when started early after the first symptoms. You may also need other medication to relieve the joint pain and stiffness.. For


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They are most effective when started early after the first symptoms. You may also need other medication to relieve the joint pain and stiffness.. For example: painkillers non-steroidal anti-inflammatory drugs (NSAIDs) corticosteroids Supportive treatments You may be offered other treatments to help your rheumatoid arthritis symptoms. This includes: physiotherapy – helps improve muscle strength, flexibility and fitness occupational therapy – provides training and advice if you need help with everyday tasks or are having difficulty at work podiatry – helps if you have problems with your feet Surgery If you have rheumatoid arthritis, surgery is sometimes needed to: improve movement in your joint reduce pain correct damage to the shape of the joint Surgery for rheumatoid arthritis includes: finger, hand and wrist surgery – there are different types to correct problems in this area arthroscopy – a procedure to remove inflamed joint tissue joint replacement surgery – surgery to replace part


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types to correct problems in this area arthroscopy – a procedure to remove inflamed joint tissue joint replacement surgery – surgery to replace part or all of a joint Complementary and alternative therapies Some people with rheumatoid arthritis try complementary therapies like: massage acupuncture osteopathy chiropractic Living with rheumatoid arthritis Rheumatoid arthritis can be hard to deal with because the symptoms are unpredictable. Some days the pain and stiffness will be worse than others and there’s no way of knowing when a flare-up will occur. This may mean that some people develop stress, anxiety or depression. It can also cause fear, frustration and anger. You should speak to a healthcare professional if you’re struggling to deal with your condition. The National Rheumatoid Arthritis Society (NRAS) website has information about living with rheumatoid arthritits. You can also phone the National Rheumatoid Arthritis Society (NRAS) helpline on 0800 298 7650. It’s Monday to


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living with rheumatoid arthritits. You can also phone the National Rheumatoid Arthritis Society (NRAS) helpline on 0800 298 7650. It’s Monday to Friday, 9.30am to 4.30pm. The helpline offers information and emotional support for people with rheumatoid arthritis. Starting a family If you’re taking medication for rheumatoid arthritis, tell your healthcare team if you: want to start a family are worried about becoming pregnant while on medication They will make sure your arthritis is controlled whilst you’re trying to get pregnant. Raising a family Babies and young children are physically and mentally demanding for any parent. But, rheumatoid arthritis can increase the challenges. If you’re struggling to cope, you should speak to your health visitor. Sex and relationships Pain, discomfort and changes in the way you feel can affect your sex life. Your self-esteem or thoughts about how you look may also affect your confidence. Talk to your partner or GP about how rheumatoid arthritis is


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life. Your self-esteem or thoughts about how you look may also affect your confidence. Talk to your partner or GP about how rheumatoid arthritis is affecting your sexuality and sexual relationships. Money and benefits If you have to stop work or work part time because of rheumatoid arthritis, you may find it hard to cope financially. You may be entitled to financial support like: Statutory Sick Pay Employment and Support Allowance Personal Independence Payment Attendance Allowance Carer’s Allowance Adult Disability Payment You may also be eligible for other benefits if you have children living at home or if you have a low household income. Telecare Self-Check online tool Visit the Telecare Self-Check online tool to find the right support for you in your area. This will help you find information on telecare services that could help you live independently at home for longer. Complications of rheumatoid arthritis Having rheumatoid arthritis can sometimes lead to other conditions. This


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live independently at home for longer. Complications of rheumatoid arthritis Having rheumatoid arthritis can sometimes lead to other conditions. This includes: carpal tunnel syndrome – tingling and numbness in your hand and fingers inflammation in other parts of the body for example in the lungs or around the heart joint damage and deformity If you have rheumatoid arthritis, you’re also at a higher risk of: cardiovascular disease (CVD) – which can cause heart attacks or strokes cervical myelopathy The risk of complications developing is lower if rheumatoid arthritis is controlled well. Risk factors for rheumatoid arthritis It’s not clear what triggers rheumatoid arthritis. But, there are some things that could increase the risk of developing it. This includes: genetics – it may run in families hormones – it’s more common in women which may be due to the effects of a hormone called oestrogen smoking Source: Scottish Society for Rheumatology - Opens in new browser window Last updated:


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may be due to the effects of a hormone called oestrogen smoking Source: Scottish Society for Rheumatology - Opens in new browser window Last updated: 07 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Arthritis Other health sites The Pain Toolkit Pain Concern Versus Arthritis: rheumatoid arthritis National Rheumatoid Arthritis Society (NRAS) NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/ringworm-and-other-fungal-infections/


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Rosacea | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Skin, hair and nails Rosacea Rosacea About rosacea Symptoms of rosacea Causes of rosacea Treating rosacea Preventing rosacea About rosacea Rosacea is a common but poorly understood long-term skin condition that mainly affects the face. It can be controlled to some degree with long-term treatment, but sometimes the changes in physical appearance can have a significant psychological impact. Symptoms of rosacea Symptoms often begin with episodes of flushing, where the skin turns red for a short period, but other symptoms can develop as the condition progresses, such as: burning and stinging sensations permanent redness spots (papules and pustules) small blood vessels in the skin becoming visible Rosacea is a relapsing condition, which means there are periods when symptoms are particularly bad,


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small blood vessels in the skin becoming visible Rosacea is a relapsing condition, which means there are periods when symptoms are particularly bad, but less severe at others. Read about the symptoms of rosacea Rosacea symptoms include redness and flushing, as well as stinging and spots.Source: https://dermnetnz.org/ When to see your GP See your GP if you have persistent symptoms that could be caused by rosacea. Early diagnosis and treatment can help stop the condition getting worse. There’s no specific test for rosacea, but your GP will often be able to diagnose the condition by: examining your skin asking about your symptoms asking about possible triggers you may have In some circumstances your GP may arrange further tests to rule out other conditions with similar symptoms, such as lupus or the menopause. For example, these could be a blood test or skin biopsy, where a small scraping of skin is removed and examined. Causes of rosacea The exact cause of rosacea is unknown, although a


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test or skin biopsy, where a small scraping of skin is removed and examined. Causes of rosacea The exact cause of rosacea is unknown, although a number of possible factors have been suggested, including abnormalities in the blood vessels of the face and a reaction to microscopic mites commonly found on the face. Although they’re not thought to be direct causes of the condition, several triggers have been identified that may make rosacea worse. These include: exposure to sunlight stress strenuous exercise hot or cold weather hot drinks alcohol and caffeine certain foods, such as spicy foods Read about causes of rosacea Treating rosacea There’s currently no cure for rosacea, but treatment can help control the symptoms. Long-term treatment is usually necessary, although there may be periods when your symptoms improve and you can stop treatment temporarily. For most people, treatment involves a combination of self-help measures and medication, such as: avoiding known triggers – for


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treatment temporarily. For most people, treatment involves a combination of self-help measures and medication, such as: avoiding known triggers – for example, avoiding drinks containing alcohol or caffeine creams and gels – medications applied directly to the skin to reduce spots and redness oral medications – tablets or capsules that can help clear up more severe spots, such as oral antibiotics In some cases procedures such as laser and intense pulsed light (IPL) treatment may be helpful. These involve beams of light being aimed at the visible blood vessels in the skin to shrink them and make them less visible. Read about more about treating rosacea and self-help measures for rosacea Living with rosacea Any long-term (chronic) condition can have an adverse psychological effect, but rosacea can be particularly troublesome as it affects your appearance. This can change how you feel about yourself and how you interact with others. Many people with rosacea have reported feelings of low


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your appearance. This can change how you feel about yourself and how you interact with others. Many people with rosacea have reported feelings of low self-esteem, embarrassment and frustration. It’s important to try to come to terms with the fact you have a chronic condition that, although incurable, is controllable. Persevering with your treatment plan and avoiding your individual triggers are the best ways of controlling your symptoms. As your physical symptoms improve, you may start to feel better psychologically and emotionally. If you have rosacea, take comfort in knowing you’re not alone. There are millions of people living with the condition in the UK and across the world. You can find support and information from organisations like: Changing Faces – a charity for people with a visible difference or facial disfigurement, who can be contacted on 0300 012 0275 for counselling and advice Speak to your GP if you’re feeling depressed as a result of your condition. They may recommend


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contacted on 0300 012 0275 for counselling and advice Speak to your GP if you’re feeling depressed as a result of your condition. They may recommend further treatment if necessary. Ocular rosacea Rosacea that affects your eyes (ocular rosacea) can lead to a number of eye problems, some of which can be serious. Symptoms of ocular rosacea can include: feeling like there is something in your eyes dry eyes irritated and bloodshot eyes inflammation of the eyelids (blepharitis) Rosacea can sometimes cause the cornea, the transparent layer at the front of the eyeball, to become inflamed and damaged. This is known as keratitis. This damage can make the cornea vulnerable to ulceration and infection, which could potentially threaten your sight. Symptoms of serious problems with your corneas include: eye pain sensitivity to light (photophobia) deterioration in your vision Contact your GP immediately if you think you may have a problem with your corneas. If this isn’t possible, visit your nearest


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in your vision Contact your GP immediately if you think you may have a problem with your corneas. If this isn’t possible, visit your nearest accident and emergency (A&E) department. If keratitis isn’t treated promptly by an ophthalmologist, a doctor who specialises in treating eye conditions, there’s a risk of permanent vision loss. Symptoms of rosacea Rosacea causes a range of symptoms, although not everyone will experience them all. Most people with rosacea have periods when their symptoms are particularly troublesome, followed by periods when their symptoms are less so. The main symptoms of rosacea include: flushing persistent facial redness visible blood vessels papules and pustules thickened skin These are discussed in more detail below. Other symptoms associated with rosacea include: sensitive skin – burning, itching, stinging and pain dry, rough skin raised red patches (plaques) on your skin facial swelling (lymphoedema) Rosacea can cause different symptoms, including facial


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pain dry, rough skin raised red patches (plaques) on your skin facial swelling (lymphoedema) Rosacea can cause different symptoms, including facial redness and flushing.Source: https://dermnetnz.org/ Permanent damage to the face (scarring) almost never occurs in rosacea. Flushing Flushing is when your skin turns red for a short period – usually a few minutes. It tends to mainly affect the face, although it can spread to your neck and chest. In some cases the redness may be accompanied by an unpleasant feeling of heat. In rosacea flushing is often caused by a certain trigger, such as sun exposure, hot drinks or exercise. See causes of rosacea for more information about possible triggers. Persistent facial redness Persistent facial redness (erythema) is like a blush or a patch of sunburn that doesn’t go away, or the sort of blotchy skin often associated with drinking too much alcohol. This can be upsetting for those with rosacea as people can mistakenly assume they are heavy drinkers.


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associated with drinking too much alcohol. This can be upsetting for those with rosacea as people can mistakenly assume they are heavy drinkers. The redness usually affects the cheeks, nose and chin, but may spread to other areas, such as the forehead, neck and chest. Visible blood vessels Over time the blood vessels in the skin may become permanently widened (dilated) and visible. The medical name for visible blood vessels is telangiectasia. Papules and pustules If you have rosacea, you may develop round red bumps that rise from your skin (papules) and pus-filled swellings (pustules). These spots appear on your face and are similar to acne. Rosacea used to be called acne rosacea, but the 2 conditions are quite different. In rosacea there are no blackheads and the skin is not greasy, but dry and peeling. Rosacea spots also don’t cause scarring. Thickened skin In the most serious cases of rosacea the skin can thicken and form excess tissue, usually around the nose. This causes the nose


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Thickened skin In the most serious cases of rosacea the skin can thicken and form excess tissue, usually around the nose. This causes the nose to take on a large, bulbous appearance (rhinophyma). Rhinophyma is an uncommon, severe symptom of rosacea and takes several years to develop. It almost exclusively affects men. Causes of rosacea The exact cause of rosacea is unknown, although a number of potential factors have been suggested. It’s possible a combination of these factors may be responsible for the condition, although there isn’t enough evidence to say this for certain. Some of the main factors that have been suggested are outlined below. Blood vessel abnormalities Some experts believe abnormalities in the blood vessels of the face may be a major contributing factor for rosacea. This may explain symptoms of flushing, persistent redness and visible blood vessels. It’s not known what causes these abnormalities. But sun damage may be responsible for degeneration of the elastic


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redness and visible blood vessels. It’s not known what causes these abnormalities. But sun damage may be responsible for degeneration of the elastic tissue of the skin and the dilation of blood vessels. Skin peptides Recent research has shown external triggers such as ultraviolet (UV) light, spicy food, alcohol (particularly red wine), exercise, stress, heat and cold can lead to the activation of certain molecules within the skin called peptides. Increased levels of these peptides may in turn affect the immune system or nerves and blood vessels (neurovascular system) of the skin. Activation of these systems can cause dilation of blood vessels, redness and inflammation. Microscopic mites Microscopic mites called demodex folliculorum usually live harmlessly on human skin, but people with rosacea have particularly large numbers, which may play a role in the condition. It is currently uncertain whether the mite is a cause or an effect of rosacea, although some researchers have suggested


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play a role in the condition. It is currently uncertain whether the mite is a cause or an effect of rosacea, although some researchers have suggested the symptoms may be caused by the skin reacting to bacteria in the mites’ faeces. Helicobacter pylori bacteria Helicobacter pylori bacteria are bacteria found in the digestive system. It’s been suggested these bacteria may be a possible cause of rosacea, although a link hasn’t been proven. One theory is the bacteria may stimulate the production of a protein called bradykinin, which is known to cause blood vessels to expand. Genetics Rosacea seems to be more common in families, although it’s not clear which genes – if any – are involved or how they’re passed on. Triggers of rosacea Although they’re not thought to be direct causes of the condition, many people with rosacea find certain triggers make their symptoms worse. Different people can have different triggers, but triggers that have been commonly reported include: exposure to


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triggers make their symptoms worse. Different people can have different triggers, but triggers that have been commonly reported include: exposure to sunlight stress hot or cold weather strong winds strenuous exercise alcohol hot baths spicy foods hot drinks humidity caffeine – found in tea, coffee and cola the menopause dairy products other medical conditions certain medicines – such as amiodarone, corticosteroids and high doses of vitamins B6 and B12 Treating rosacea Although rosacea can’t be cured, treatment can help keep the symptoms under control. Long-term treatment is usually necessary, although there may be periods where your symptoms improve and you can stop treatment temporarily. Treatment choices depend on which type of symptom is most troublesome, but usually involves a combination of self-help measures and medication, and are outlined below. Self-help measures There are a number of things you can do yourself to help keep the symptoms of rosacea under control, including:


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outlined below. Self-help measures There are a number of things you can do yourself to help keep the symptoms of rosacea under control, including: avoiding things that trigger your symptoms – for example, by using sun cream and covering yourself up if direct sunlight makes your symptoms worse taking good care of your skin – for example, by using products suitable for sensitive skin using make-up – patches of persistent red skin can be disguised using specially designed camouflage make-up keeping your eyelids clean – if rosacea is causing your eyelids to become inflamed (blepharitis) Treating papules and pustules If you have round red bumps that rise from your skin (papules) and pus-filled swellings (pustules) caused by rosacea, there are a number of different medications that can be effective. These can be divided into topical treatments that are applied to the skin, or oral treatments, which are taken by mouth. Topical treatments Topical medications are usually prescribed first.


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that are applied to the skin, or oral treatments, which are taken by mouth. Topical treatments Topical medications are usually prescribed first. These include: metronidazole cream or gel azelaic acid cream or gel ivermectin cream Ivermectin is a relatively new medicine. There’s some evidence to suggest it may be more effective and perhaps less irritating to the skin than metronidazole, although it’s not currently available on the NHS everywhere and may only be recommended if the other treatments don’t work. You’ll usually need to apply these topical treatments once or twice a day, taking care not to get them in your eyes or mouth. It may be several weeks before you notice any significant improvement in your symptoms. Side effects of these treatments can include a burning or stinging sensation, itchiness and dry skin. Oral antibiotics If your symptoms are more severe, an oral antibiotic medication may be recommended as these can help reduce inflammation of the skin. Antibiotics often


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your symptoms are more severe, an oral antibiotic medication may be recommended as these can help reduce inflammation of the skin. Antibiotics often used to treat rosacea include tetracycline, oxytetracycline, doxycycline and erythromycin. These medications are usually taken for 4 to 6 weeks, but longer courses may be necessary if the spots are persistent. For example, a low-dose doxycycline capsule is available if oral antibiotics need to be taken long term. Common side effects of these medications include: feeling and being sick diarrhoea bloating and indigestion tummy (abdominal) pain loss of appetite Some of the medications used can also make your skin sensitive to sunlight and artificial sources of light, such as sun lamps and sunbeds. As with the topical treatments mentioned above, these medications usually need to be taken once or twice a day and you may not notice a significant improvement in your symptoms for several weeks. Oral isotretinoin Isotretinoin is a medicine often


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twice a day and you may not notice a significant improvement in your symptoms for several weeks. Oral isotretinoin Isotretinoin is a medicine often used to treat severe acne, but at lower doses it’s also occasionally used to treat rosacea. As isotretinoin is a strong medication that can cause a range of side effects, it can only be prescribed by a specialist in treating skin conditions (dermatologist) and not your GP. Common side effects of isotretinoin include: dryness and cracking of the skin, lips and nostrils inflammation of your eyelids (blepharitis) or eyes (conjunctivitis) headaches muscle or joint pain back pain blood in your urine (haematuria) mood changes Isotretinion can also cause birth defects if taken during pregnancy. Treating facial redness Treating facial redness and flushing caused by rosacea is generally more difficult than treating papules and pustules caused by the condition. But as well as the self-help measures mentioned above, there are some medications that


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than treating papules and pustules caused by the condition. But as well as the self-help measures mentioned above, there are some medications that can help. Brimonidine tartrate Brimonidine tartrate is a relatively new medication for facial redness caused by rosacea. It comes in the form of a gel that’s applied to the face once a day. The medication works by restricting the widening (dilation) of the blood vessels in your face. Research has shown it can start to have an effect about 30 minutes after it’s first used, and this can last for around 12 hours. Common side effects of brimonidine tartrate include itchiness and a burning sensation where the gel is applied. Less common side effects can include: a dry mouth headaches pins and needles dry skin A rebound effect, where flushing becomes worse, has also been reported with this medication. Oral treatments Alternatively, there are a number of oral medications that may help improve redness caused by rosacea. These include: clonidine – a


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Oral treatments Alternatively, there are a number of oral medications that may help improve redness caused by rosacea. These include: clonidine – a medication that relaxes the blood vessels beta-blockers – medications that decrease the activity of the heart anxiety medications – medications sometimes used to help calm the person and reduce blushing It’s not clear how effective these medications are at treating redness caused by rosacea, but they may sometimes be prescribed under the supervision of a dermatologist. Laser and intense pulsed light (IPL) treatment Redness and visible blood vessels (telangiectasia) can also sometimes be successfully improved with vascular laser or intense pulsed light (IPL) treatment. These treatments may also improve flushing. A referral to a dermatologist is usually required before having these treatments and they’re not usually available on the NHS, so you may need to pay for them privately. Around 2 to 4 treatments may be needed, so the overall cost


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and they’re not usually available on the NHS, so you may need to pay for them privately. Around 2 to 4 treatments may be needed, so the overall cost may be significant. Laser and IPL machines produce narrow beams of light that are aimed at the visible blood vessels in the skin. The heat from the lasers damages the dilated veins and causes them to shrink so they’re no longer visible, with minimal scarring or damage to the surrounding area. Laser treatment can cause pain, but most people don’t need an anaesthetic. Side effects of laser treatment are usually mild and can include: bruising crusting of the skin swelling and redness of the skin blisters (in rare cases) infection (in very rare cases) These side effects usually only last a few days and are rarely permanent. Treating thickened skin In some people with rosacea the skin of the nose can become thickened. This is known as rhinophyma. If you have severe rhinophyma, your GP may refer you to a dermatologist or plastic surgeon to


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nose can become thickened. This is known as rhinophyma. If you have severe rhinophyma, your GP may refer you to a dermatologist or plastic surgeon to discuss ways the appearance of your skin can be improved. A number of surgical treatments are available to remove any excess tissue and remodel the nose into a more pleasing shape. This may be done with a laser, a scalpel or specially designed abrasive instruments using a technique called dermabrasion. Treating eye problems If rosacea is affecting your eyes (ocular rosacea), you may require further treatment. For example, you may need to use lubricating eye drops or ointment if you have dry eyes, or oral antibiotics if you have blepharitis. If initial treatment isn’t effective or you develop any further problems with your eyes, you’ll need to be referred to an eye specialist called an ophthalmologist for further assessment and treatment. Preventing rosacea If you have rosacea, there are a number of things you can do to help keep the


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for further assessment and treatment. Preventing rosacea If you have rosacea, there are a number of things you can do to help keep the condition under control. Avoid triggers Many people with rosacea notice certain triggers make their symptoms worse. Although it’s not always practical or possible, taking steps to avoid these triggers can help reduce the severity and frequency of your symptoms. If you’re not sure whether your symptoms have a specific trigger, it may be useful to keep a diary to identify whether your symptoms get worse depending on things like the activities you do and foods or drinks you have. Advice about how to avoid some common triggers can be found below. Sunlight As sunlight is the most commonly reported trigger of rosacea, you should use sun cream whenever possible, even when it’s overcast. A sun cream with a sun protection factor (SPF) of at least 30 is recommended. A broad-spectrum sun cream that protects against UVA and UVB light should be used. Using sun


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protection factor (SPF) of at least 30 is recommended. A broad-spectrum sun cream that protects against UVA and UVB light should be used. Using sun creams specifically designed for children may help reduce skin irritation. Covering exposed skin with clothes or a sun hat may also help. Try to minimise your exposure to the sun during the summer months, particularly in the middle of the day when the sun is at its hottest. But remember, sun can also be strong in the morning and evening, so take adequate precautions at these times as well. Stress Stress is also a commonly reported trigger of rosacea. Successfully managing your stress levels can help control your symptoms. Ways you can reduce stress include: learning relaxation techniques, such as deep breathing exercises, meditation and yoga taking regular exercise As strenuous exercise can sometimes make rosacea symptoms worse, a low-intensity exercise programme, such as walking or swimming, may be better than high-intensity activities,


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sometimes make rosacea symptoms worse, a low-intensity exercise programme, such as walking or swimming, may be better than high-intensity activities, such as running or aerobics. Read about stress management. Food and drink Some of the most commonly reported food- and drink-related triggers are alcohol and spicy foods. You may want to try completely removing these from your diet to see if your rosacea improves. But there are many other dietary triggers that can also affect some people with rosacea. It’s a good idea to include information about how your diet affects your rosacea symptoms in your rosacea diary. Cold weather Covering your face and nose with a scarf can help protect your skin from cold temperatures and wind. If you need to spend considerable time outside during cold weather, protect your face with a balaclava. Skincare techniques The advice below about skincare techniques may also help control your rosacea symptoms. Clean your skin every morning and evening using a


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techniques The advice below about skincare techniques may also help control your rosacea symptoms. Clean your skin every morning and evening using a gentle, non-abrasive cleanser. Use soap-free cleansers with non-alkaline or neutral pH. Avoid scented soaps and alcohol-based skin cleansers Rinse your face with lukewarm water and allow skin to dry thoroughly before you apply medication or make-up Look for products suitable for sensitive skin. These are usually described as mild, hypoallergenic, fragrance-free and non-comedogenic (will not block pores) Use a moisturiser to soothe skin if it feels sore Avoid oil-based or waterproof cosmetics requiring solvents for removal. Use water-based make-up and skin products instead Avoid astringents, toners and other facial or hair products that contain ingredients that might irritate your skin, such as fragrances, alcohol, menthol, witch hazel, eucalyptus oil, camphor, clove oil, peppermint, sodium lauryl sulphate and lanolin You may want to avoid


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fragrances, alcohol, menthol, witch hazel, eucalyptus oil, camphor, clove oil, peppermint, sodium lauryl sulphate and lanolin You may want to avoid using anything on your skin that you aren’t sure of. You can then gradually reintroduce products once your symptoms have been treated and cleared to see if you can use them again without any problems Men may find that using an electric razor, rather than a blade, helps reduce skin irritation Some people find regular gentle facial massage reduces swelling (lymphoedema) Don’t use steroid cream unless you’re specifically instructed to by your GP, as it may make your symptoms worse Skin camouflage It may be possible to disguise patches of persistent red skin using specially designed camouflage make-up. The charity Changing Faces offers a skin camouflage service, available nationally and free of charge, to help with the use of these creams. Your GP or dermatologist can refer you to the skin camouflage service and prescribe skin camouflage


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of charge, to help with the use of these creams. Your GP or dermatologist can refer you to the skin camouflage service and prescribe skin camouflage make-up. Eyelid hygiene If your eyelids are inflamed as a result of rosacea (blepharitis), cleaning your eyelids every day with warm water and a small amount of cleaning solution can help ease your symptoms. Avoiding eye make-up can also help reduce your symptoms, but if you do choose to wear eye make-up, make sure it is a type that washes off easily so you can still clean your eyelids. Source: NHS 24 - Opens in new browser window Last updated: 17 January 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Changing Faces NHS inform About NHS inform Editorial policy


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Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Changing Faces NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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Scarlet fever | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Infections and poisoning Scarlet fever Scarlet fever Scarlet fever is a bacterial illness that mainly affects children. It causes a distinctive pink-red rash. The illness is caused by Streptococcus pyogenes bacteria, also known as Group A Streptococcus, which are found on the skin and in the throat. Scarlet fever symptoms Scarlet fever usually follows a sore throat or a skin infection, like impetigo, caused by particular strains of Streptococcus bacteria. The symptoms of scarlet fever usually develop 2 to 5 days after infection. However, the incubation period (the period between exposure to the infection and symptoms appearing) can be as short as one day or as long as 7 days. Speak to your GP if: You or your child: have symptoms of scarlet fever do not get better in a week (after seeing


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as one day or as long as 7 days. Speak to your GP if: You or your child: have symptoms of scarlet fever do not get better in a week (after seeing a GP) have scarlet fever and chickenpox at the same time are ill again weeks after scarlet fever got better – this can be a sign of a complication like rheumatic fever are feeling unwell and have been in contact with someone who has scarlet fever Rash The distinctive rough pink-red rash caused by scarlet fever.https://dermnetnz.org/ The distinctive rough texture rash caused by scarlet fever.https://dermnetnz.org/ The distinctive pink-red rash caused by scarlet fever develops 12 to 48 hours after symptoms like a sore throat or headache. Red blotches are the first sign of the rash. These turn into a fine pink-red rash that feels like sandpaper to touch and looks like sunburn. It may also be itchy. On darker skin the rash may be more difficult to see although its rough texture should be apparent. The rash usually starts on the chest and


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itchy. On darker skin the rash may be more difficult to see although its rough texture should be apparent. The rash usually starts on the chest and stomach, but soon spreads to other parts of the body, like the: ears neck elbows inner thighs groin The rash doesn’t usually spread to the face. However, the cheeks become flushed and the area just around the mouth stays quite pale. The rash will turn white if you press a glass on it. The rash usually fades after about a week, but the outer layers of skin, usually on the hands and feet, may peel for several weeks afterwards. In milder cases, sometimes called scarlatina, the rash may be the only symptom. Other symptoms of scarlet fever Other symptoms of scarlet fever may include: swollen neck glands loss of appetite nausea or vomiting red lines in the folds of the body, such as the armpit, which may last a couple of days after the rash has gone a white coating on the tongue, which peels a few days later leaving the tongue red and swollen


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may last a couple of days after the rash has gone a white coating on the tongue, which peels a few days later leaving the tongue red and swollen (this is known as strawberry tongue) a general feeling of being unwell When to seek medical advice If you think you or your child may have scarlet fever, see your GP for a proper diagnosis and appropriate treatment. It usually clears up after about a week Your GP should be able to diagnose scarlet fever by examining the distinctive rash and asking about other symptoms. They may also decide to take a sample of saliva from the back of the throat so it can be tested in a laboratory to confirm the diagnosis. There’s no evidence to suggest that catching scarlet fever when pregnant will put your baby at risk. However, if you’re heavily pregnant, tell the doctors and midwives in charge of your care if you’ve been in contact with someone who has scarlet fever. How scarlet fever spreads Scarlet fever is very infectious and can be caught by: breathing


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you’ve been in contact with someone who has scarlet fever. How scarlet fever spreads Scarlet fever is very infectious and can be caught by: breathing in bacteria in airborne droplets from an infected person’s coughs and sneezes touching the skin of a person with a Streptococcal skin infection, such as impetigo sharing contaminated towels, baths, clothes or bed linen It can also be caught from people who have the bacteria in their throat or on their skin but don’t have any symptoms. Who’s affected by scarlet fever Most cases of scarlet fever occur in children under 10 (usually between 2 and 8 years of age). However, people of any age can get the illness. As it’s easily spread, scarlet fever is likely to affect someone in close contact with a person with a sore throat or skin infection caused by Streptococcus bacteria. Outbreaks can occur in nurseries and schools where children are in close contact with one another. The symptoms of scarlet fever will only develop in people susceptible


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in nurseries and schools where children are in close contact with one another. The symptoms of scarlet fever will only develop in people susceptible to toxins produced by the Streptococcus bacteria. Most children over 10 years of age will have developed immunity to these toxins. It’s possible to have scarlet fever more than once, but this is rare. Treating scarlet fever Most cases of scarlet fever clear up after about a week without treatment. However, your GP may recommend treatment as it: reduces the length of time you’re infectious speeds up recovery lowers the risk of complications of scarlet fever With treatment, most people recover in about 4 to 5 days and can return to nursery, school or work 24 hours after starting antibiotic treatment. Without treatment, you’ll be infectious for 1 to 2 weeks after symptoms appear. Antibiotics Scarlet fever is usually treated with a 10-day course of antibiotics. This is often in the form of penicillin or amoxicillin tablets, although liquid


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Scarlet fever is usually treated with a 10-day course of antibiotics. This is often in the form of penicillin or amoxicillin tablets, although liquid may be used for young children. For people who are allergic to penicillin, alternative antibiotics like erythromycin can be used instead. The symptoms usually improve within 24 hours of starting antibiotics, with the other symptoms disappearing within a few days. However, it’s important that the whole course of treatment is completed to ensure the infection is fully cleared and reduce the potential for antibiotic resistance. Keep your child away from nursery or school for at least 24 hours after starting antibiotic treatment. Adults with scarlet fever should also stay off work for at least 24 hours after starting treatment. Self care Many of the symptoms of scarlet fever can be relieved using some simple self care measures. Do drink plenty of cool fluidseat soft foods (if your throat is painful)take paracetamol to bring down a high


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using some simple self care measures. Do drink plenty of cool fluidseat soft foods (if your throat is painful)take paracetamol to bring down a high temperatureuse calamine lotion or antihistamines to relieve itching Complications of scarlet fever Most cases of scarlet fever don’t cause complications, particularly if the condition is properly treated. However, there’s a small risk of the infection spreading to other parts of the body and causing more serious infections, like: an ear infection a throat abscess (painful collection of pus) sinusitis (inflammation of the sinuses) pneumonia (inflammation of the lungs) Very rare complications that can occur at a later stage include: bacteraemia (an infection of the bloodstream) septic arthritis meningitis necrotising fasciitis (a severe infection involving death of areas of soft tissue below the skin) Streptococcal toxic shock syndrome (rapidly progressive symptoms with low blood pressure and multi-organ failure) Speak to your GP immediately


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skin) Streptococcal toxic shock syndrome (rapidly progressive symptoms with low blood pressure and multi-organ failure) Speak to your GP immediately if: You or child develop any of these symptoms in the first few weeks after the main infection has cleared up: feeling very unwell severe pain severe headaches vomiting diarrhoea If your GP is closed, phone the 111 service. Preventing scarlet fever from spreading There’s currently no vaccine for scarlet fever. If your child has scarlet fever, keep them away from nursery or school for at least 24 hours after starting treatment with antibiotics. Adults with the illness should also stay off work for at least 24 hours after starting treatment. GPs, schools and nurseries should be aware of the current high levels of scarlet fever and inform local health protection teams if they become aware of cases, particularly if more than one child is affected. Do cover your mouth and nose with a tissue when coughing or sneezing wash your hands with soap


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particularly if more than one child is affected. Do cover your mouth and nose with a tissue when coughing or sneezing wash your hands with soap and water after using or disposing of tissues. Don’t do not share contaminated utensils, cups and glasses, clothes, baths, bed linen or towels Source: NHS 24 - Opens in new browser window Last updated: 23 June 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Self-help guide: Sore throat Self-help guide: Fever in adults Self-help guide: Fever in babies Fever in adults Fever in children Streptococcus A (strep A) Other health sites Group A strep in Scotland NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms


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sites Group A strep in Scotland NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/neck-and-back-problems-and-conditions/sciatica/


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Sciatica | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Neck and back problems and conditions Sciatica Sciatica This information may be useful for those who have been diagnosed with sciatica. People who are experiencing new or ongoing symptoms should visit their healthcare professional for assessment, diagnosis or treatment. Read more about managing a back problem What is Sciatica? Sciatica is a common condition and can also be known as nerve root or radicular pain. Sciatica is a term used to describe pain felt in the leg but which often comes from the lower back. The sciatic nerve starts in the lower back and goes all the way down the back of the leg into the foot. Symptoms can be experienced along any part of the nerve. They can have a sudden or slow onset and can vary from mild to severe. Symptoms of sciatica Sciatica


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can be experienced along any part of the nerve. They can have a sudden or slow onset and can vary from mild to severe. Symptoms of sciatica Sciatica can have a range of symptoms, these can include: lower back pain leg pain, often this feels worse than back pain a change in sensation in the leg or foot muscle spasms in the back a weakness in the leg or foot A change in feeling in the leg or foot can include: pins and needles numbness hot or cold burning sensations shooting sensations sensations that can be hard to describe What causes Sciatica? Sciatica can be caused by irritation of the nerves which travel from the spine down the legs. This can be from inflammation around the nerves and in some cases from pressure, usually from a disc related change. Most symptoms of sciatica will improve with time. Nerves are resilient and in most cases inflammation and any disc changes resolve allowing nerves to recover. Diagnosing sciatica In order for sciatica to be diagnosed you’ll need an


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cases inflammation and any disc changes resolve allowing nerves to recover. Diagnosing sciatica In order for sciatica to be diagnosed you’ll need an assessment from a healthcare professional. They’ll ask you questions about your back and leg issue and then carry out a physical examination. This may include checking your range of movement and strength. You may sometimes need to have a further examination to rule out other possible health conditions. Is a scan needed? A scan rarely changes how you manage the condition in the early stages. X-ray and MRI is generally not advised in people with sciatica. This is because structural changes of the spine are very common with age and often present in people who have no symptoms. A scan can be considered if your symptoms are unchanged for more than 12 weeks, continue to greatly impact your quality of life and you wish to consider surgery. Your healthcare professional can discuss this with you. How long does sciatica last? Sciatica usually


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of life and you wish to consider surgery. Your healthcare professional can discuss this with you. How long does sciatica last? Sciatica usually improves within 12 weeks but this can vary significantly between individuals. For some people symptoms take up to a year to settle but can come and go within this time. It’s important to remember, lots of things can influence symptoms such as poor sleep, stress and emotional wellbeing. When to get professional advice Rarely, sciatica can cause a condition called Cauda equina syndrome to develop. Cauda equina syndrome Cauda equina syndrome is a rare but serious back condition which can lead to permanent damage or disability. If you develop this condition you’ll need to be seen by an emergency specialist spinal team. Phone 111 as soon as possible if you have: loss of feeling/pins and needles between your inner thighs or genitals numbness in or around your back passage or buttocks altered feeling when using toilet paper to wipe yourself


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between your inner thighs or genitals numbness in or around your back passage or buttocks altered feeling when using toilet paper to wipe yourself increasing difficulty when you try to urinate increasing difficulty when you try to stop or control your flow of urine loss of sensation when you pass urine leaking urine or recent need to use pads not knowing when your bladder is either full or empty inability to stop a bowel movement or leaking loss of sensation when you pass a bowel motion change in ability to achieve an erection or ejaculate loss sensation in genitals during sexual intercourse If you have had a new significant trauma affecting your back in the last 7 days, for example a fall from height or a direct impact to the back area, you should also phone 111. Treatment of sciatica Most people will recover from sciatica with a combination of time, modifying activity, and pacing themselves to allow the nerves to adapt. Pain medication, staying active, and gentle exercise will also


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of time, modifying activity, and pacing themselves to allow the nerves to adapt. Pain medication, staying active, and gentle exercise will also help. The nerve can still be sensitive so it is recommended to build up your tolerance to activities slowly. The little and often approach to movement is recommended. Self help There are some things you can do to help manage this condition yourself. Visit our back problems page to find out how to help your sciatica symptoms Work A back problem can sometimes mean you need to take some time off work to help recovery. How long you’re off will depend on the nature of your condition and your role at work. You do not need to be symptom free before you consider returning to work. Continuing to go to work, or returning to work as soon as is possible for you, will help your recovery. Gradually getting back to your normal daily activities can help to build up your strength and stamina levels. Help and support Following this advice, you should see


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back to your normal daily activities can help to build up your strength and stamina levels. Help and support Following this advice, you should see gradual improvements over time. You should see the biggest change in your symptoms within the first couple of weeks. Most problems should have improved within 6 weeks. If your sciatica hasn’t improved within 6 weeks of following this advice, or if your symptoms get worse at any time, talk to a healthcare professional about your symptoms. Find out about access to MSK services in your area When dealing with any health condition it’s important to also look after your mental wellbeing as this can impact your recovery. Source: NHS 24 MSK Clinical Advisory Group - Opens in new browser window Last updated: 06 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com


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has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Back problems Exercises for back pain How to access MSK services Mental wellbeing Other health sites Pain Association Scotland NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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Self-harm | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Mental health Self-harm Self-harm Introduction Signs Causes Treatment Introduction Self-harm is when somebody intentionally damages or injures their body. It is a way of expressing deep emotional feelings such as low self-esteem, or a way of coping with traumatic events, such as the death of a loved one. If you are self-harming, you should see your GP for help. You can also contact Breathing Space or call the Samaritans on 116 123 for support. Read more about where to get help if you self-harm Self-harm is an expression of personal distress, rather than an illness, although it can be linked to other mental health conditions such as depression. Read more about the causes of self-harm Research has suggested that self-harm is most common among 15-19 year olds, and those suffering from anxiety


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Read more about the causes of self-harm Research has suggested that self-harm is most common among 15-19 year olds, and those suffering from anxiety and depression. Signs of self-harm Types of self-harm may include: cutting the skin burning the skin punching your own body poisoning yourself with tablets misusing alcohol or drugs eating disorders, such as deliberately starving yourself (anorexia nervosa), binge eating or bulimia People often try to keep self-harm a secret because of shame or fear of discovery. For example, they may cover up their skin and avoid discussing the problem. It may, therefore, be up to close family and friends to notice when somebody is self-harming, and to approach the subject with care and understanding. The signs may include unexplained injuries and signs of depression or low-self esteem. Read more about the signs of self-harm Someone who is self-harming can seriously hurt themselves, so it is important that they speak to a GP about the underlying issue


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signs of self-harm Someone who is self-harming can seriously hurt themselves, so it is important that they speak to a GP about the underlying issue and about any treatment or therapy that might help them. Signs There are many different forms of self-harm and they are not always easy to notice. People who self-harm usually try to keep it a secret from their friends and family and often injure themselves in places that can be hidden easily by clothing. If you suspect that a friend or relative is self-harming, look out for any of the following signs: unexplained cuts, bruises or cigarette burns, usually on their wrists, arms, thighs and chest keeping themselves fully covered at all times, even in hot weather signs of depression, such as low mood, tearfulness or a lack of motivation or interest in anything changes in eating habits or being secretive about eating, and any unusual weight loss or weight gain signs of low self-esteem, such as blaming themselves for any problems or thinking


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secretive about eating, and any unusual weight loss or weight gain signs of low self-esteem, such as blaming themselves for any problems or thinking they are not good enough for something signs they have been pulling out their hair signs of alcohol or drug misuse The person who is self-harming may feel deep shame and guilt, or may feel confused and worried by their own behaviour. It’s important to approach them with care and understanding. They may not wish to discuss their self-harm with you, but you could suggest that they speak to an anonymous helpline or see their GP. Causes There are many reasons why people self-harm, but the causes usually stem from unhappy emotions. Self-harming has been described as a “physical expression of emotional distress”. If somebody is feeling overwhelmed with unhappy emotions, they may find that the physical act of hurting themselves makes them feel better. If you are feeling like this, you can speak to your GP, contact Breathing Space or call the


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act of hurting themselves makes them feel better. If you are feeling like this, you can speak to your GP, contact Breathing Space or call the Samaritans on 116 123 for support. Social factors and trauma Research has shown that social factors commonly cause emotional distress in people who self-harm. These include: difficult relationships with friends or partners difficulties at school, such as not doing well academically difficulties at work being bullied, either at home, school or work worries about money alcohol or drug misuse coming to terms with your sexuality if you think you might be gay or bisexual coping with cultural expectations, for example, an arranged marriage Self-harm could also sometimes be a way of coping with a traumatic experience. For example: sexual, physical or emotional abuse, including domestic abuse and rape the death of a close family member or friend having a miscarriage Emotional distress The distress from a traumatic experience or an unhappy situation can


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death of a close family member or friend having a miscarriage Emotional distress The distress from a traumatic experience or an unhappy situation can lead to feelings of low self-esteem or self-hatred. You could also have feelings of: anger guilt anxiety loneliness grief numbness or emptiness feeling unconnected to the world being unclean, unworthy, trapped or silenced if you have been abused The emotions can gradually build up inside you, and you may not know who to turn to for help. Self-harm may be a way of releasing these pent-up feelings and finding a way to cope with your problems. It is not usually an attempt to seek attention, but a sign of emotional distress. Some research has suggested that people who self-harm may have difficulty managing or “regulating” their emotions. They use self-harm as a way of managing tension and anger. Research has also shown that people who self-harm are poorer at problem solving. Self-harm is linked to anxiety and depression. These mental health


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Research has also shown that people who self-harm are poorer at problem solving. Self-harm is linked to anxiety and depression. These mental health conditions can affect people of any age. Self-harm can also occur alongside antisocial behaviour, such as misbehaving at school or getting into trouble with the police. Psychological causes In some cases there may be a psychological reason for the self-harming (where the cause is related to an issue with your mind). For example: you may hear voices telling you to self-harm you may have repeated thoughts about self-harming and feel like you have to do it you may disassociate (lose touch with yourself and your surroundings) and self-harm without realising you are doing it it can be a symptom of borderline personality disorder (a condition that causes instability in how a person thinks, feels and behaves) Treatment It is important for anyone who self-harms to see their GP, who will aim to treat the underlying emotional cause as well as any


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and behaves) Treatment It is important for anyone who self-harms to see their GP, who will aim to treat the underlying emotional cause as well as any physical injury. Your GP is likely to ask you about your feelings in some detail. They will want to establish why you self-harm, what triggers it and how you feel afterwards. Your GP may ask you some questions to see if you have an underlying condition such as depression, anxiety or borderline personality disorder. If the way you self-harm follows a particular pattern of behaviour, such as an eating disorder, you may be asked additional questions about this. Your height, weight and blood pressure may also be checked, and you may be asked about any drinking or drug-taking habits. It is important that you are honest with your GP about your symptoms and your feelings. If you don’t know why you self-harm, tell your GP this. Specialist referral Recent research indicates that most teenagers who self-harm are able to give up this behaviour as


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self-harm, tell your GP this. Specialist referral Recent research indicates that most teenagers who self-harm are able to give up this behaviour as they learn to manage feelings in healthier ways, for example, by talking to others. However, some young people who self-harm continue to do so into adulthood and if you fall into this category, your GP may refer you to a mental health professional. This could be: a counsellor – somebody who is trained in talking therapies a psychiatrist – a qualified medical doctor with further training in treating mental health conditions a psychologist – a health professional who specialises in the assessment and treatment of mental health conditions For example, if you have lost a close relative, you may be referred to a specialist grief counsellor for help coping with bereavement. If you are self-harming after an incident of rape, or physical or mental abuse, you may be referred to someone who is trained in dealing with victims of sexual assault or


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after an incident of rape, or physical or mental abuse, you may be referred to someone who is trained in dealing with victims of sexual assault or domestic abuse. If you have another condition that is linked to your self-harming, such as anorexia nervosa or bulimia, you may be referred to a specialist in eating disorders and a dietitian or nutritionist (somebody who specialises in nutrition). It might also be recommended that you attend a self-help group, for example, Alcoholics Anonymous if you are misusing alcohol, or Narcotics Anonymous if you are misusing drugs. These groups can offer support as you try to stop your self-harming behaviour. Assessment You may be offered a psychosocial assessment, which aims to investigate all the factors that contribute to your self-harming, including: social factors – for example, your relationships with others psychological factors – your feelings and emotions motivational factors – what made you want to do it You will be asked about your current


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others psychological factors – your feelings and emotions motivational factors – what made you want to do it You will be asked about your current feelings, particularly if you are feeling hopeless or considering suicide. If you have any other symptoms, either physical or emotional, you will also be asked about these. After the assessment you will be allowed to read through what has been written to make sure that you agree with it. Any further treatment will, if possible, be decided jointly between you and your mental health professional. It will be a specific programme for you according to your needs and what is likely to be effective. You will be asked for your consent before any treatment begins. Seeking immediate help for an injury or overdose Some physical injuries may need treating in an accident and emergency (A&E) department. For example, you may need to call 999 for an ambulance if: you or somebody else have taken an overdose of drugs, alcohol or prescription medication


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For example, you may need to call 999 for an ambulance if: you or somebody else have taken an overdose of drugs, alcohol or prescription medication somebody is unconscious you or somebody else are in a lot of pain you or somebody else are having difficulty breathing you or somebody else are losing a lot of blood from a cut or wound you or somebody else are in shock after a serious cut or burn If you would like to talk to somebody immediately about the way you are feeling, contact Breathing Space or call the Samaritans on 116 123. Source: NHS 24 - Opens in new browser window Last updated: 03 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Depression self-help guide Other health sites Breathing Space Self-harm


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500 characters Send feedback Add this page to Info For Me Also on NHS inform Depression self-help guide Other health sites Breathing Space Self-harm Network Scotland NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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Septic shock | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Blood and lymph Septic shock Septic shock Septic shock is a life-threatening condition that happens when your blood pressure drops to a dangerously low level after an infection. Any type of bacteria can cause the infection. Fungi such as candida and viruses can also be a cause, although this is rare. At first the infection can lead to a reaction called sepsis. This begins with: weakness chills a rapid heart and breathing rate Left untreated, toxins produced by bacteria can damage the small blood vessels, causing them to leak fluid into the surrounding tissues. This can affect your heart’s ability to pump blood to your organs, which lowers your blood pressure and means blood doesn’t reach vital organs, such as the brain and liver. Phone 999 immediately if: You think that you or someone in


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blood pressure and means blood doesn’t reach vital organs, such as the brain and liver. Phone 999 immediately if: You think that you or someone in your care has symptoms of septic shock like: low blood pressure (hypotension) that makes you feel dizzy when you stand up a change in your mental state, like confusion or disorientation diarrhoea nausea and vomiting cold, clammy and pale skin Who is more at risk of developing septic shock? People with a weakened immune system have an increased risk of developing septic shock. This includes: newborn babies elderly people pregnant women people with long-term health conditions, such as diabetes, cirrhosis or kidney failure people with lowered immune systems, such as those with HIV or AIDS or those receiving chemotherapy Treating septic shock You’ll usually be admitted to an intensive care unit (ICU) so your body’s functions and organs can be supported while the infection is treated. In some cases treatment may start in the emergency


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unit (ICU) so your body’s functions and organs can be supported while the infection is treated. In some cases treatment may start in the emergency department. Treatment may include: oxygen therapy fluids given directly through a vein (intravenously) medication to increase your blood flow antibiotics surgery (in some cases) Oxygen therapy To help you breathe more easily, you’ll be given oxygen through a face mask, a tube inserted into your nose, or an endotracheal tube inserted into your mouth. If you have severe shortness of breath, a mechanical ventilator may be used. Increasing blood flow You’ll probably be given fluids directly into a vein. This will help raise your blood pressure by increasing the amount of fluid in your blood. To increase the blood flow to your vital organs, such as your brain, liver, kidneys and heart, you may be prescribed inotropic medicines or vasopressors. Inotropic medicines Inotropic medicines (inotropes), such as dobutamine, stimulate your heart. They


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prescribed inotropic medicines or vasopressors. Inotropic medicines Inotropic medicines (inotropes), such as dobutamine, stimulate your heart. They increase the strength of your heartbeat, which helps get oxygen-rich blood to your tissues and organs, where it’s needed. Vasopressors Vasopressors include: dopamine adrenaline noradrenaline These medicines will cause your blood vessels to narrow, increasing your blood pressure and the flow of blood around your body. This will allow your vital organs to start functioning properly. Antibiotics Antibiotics are often used to treat the associated bacterial infection. The type of antibiotic used depends on the type of bacterial infection and where in the body the infection started. You may be started on antibiotics immediately to increase your chances of survival. Initially, two or three types of antibiotics may be used. The most effective type of antibiotic can be used once the bacterium responsible for the infection is identified. Surgery In


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antibiotics may be used. The most effective type of antibiotic can be used once the bacterium responsible for the infection is identified. Surgery In severe cases of sepsis or septic shock, the large decrease in blood pressure and blood flow can kill organ tissue. If this happens, surgery may be required to remove the dead tissue. Complications of septic shock The chances of surviving septic shock will depend on: the cause of infection the number of organs that have failed how soon treatment is started Complications of septic shock can include: inability of the lungs to take in enough oxygen (respiratory failure) the heart not being able to pump enough blood around the body (heart failure) kidney failure or injury abnormal blood clotting These are serious health conditions that will need to be treated urgently. Septic shock can be fatal because of complications like these. Source: NHS 24 - Opens in new browser window Last updated: 09 January 2025 How can we improve this page? Help us


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because of complications like these. Source: NHS 24 - Opens in new browser window Last updated: 09 January 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Sepsis Heart failure Other health sites Surviving Sepsis Campaign UK Sepsis Trust British Heart Foundation: Heart failure Chest Heart & Stroke Scotland: Heart failure Intensive Care Society NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/severe-head-injury/


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Shingles | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Infections and poisoning Shingles Shingles Shingles, also known as herpes zoster, is an infection of a nerve and the skin around it. It’s caused by the varicella-zoster virus, which also causes chickenpox. Symptoms of shingles The main symptom of shingles is pain, followed by a rash that develops into itchy blisters. These look like chickenpox. Sometimes shingles causes symptoms that develop a few days before the painful rash. This includes symptoms like: a headache burning, tingling, numbness or itchiness of the skin in the affected area a feeling of being generally unwell a high temperature (fever) Shingles rash The shingles rash usually appears on one side of your body. It develops on the area of skin related to the affected nerve. New blisters can appear for up to a week. A few days after


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on one side of your body. It develops on the area of skin related to the affected nerve. New blisters can appear for up to a week. A few days after appearing they become yellowish in colour, flatten and dry out. Scabs then form where the blisters were, which may leave some slight scarring. Examples of the shingles rash Shingles on the back Shingles on the chest Shingles on the face Shingles on back of neck Shingles pain Most people with shingles experience a localised band of pain in the affected area. The pain may be a constant, dull or burning sensation and its intensity can vary from mild to severe. You may have sharp stabbing pains from time to time, and the affected area of skin will usually be tender. Getting advice from a GP or pharmacist Contact your GP practice if: You haven’t had chickenpox before, you’ve been exposed to someone who has chickenpox or shingles and you: are pregnant have a weakened immune system (the body’s natural defence system) are under 18 years old If


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who has chickenpox or shingles and you: are pregnant have a weakened immune system (the body’s natural defence system) are under 18 years old If your GP is closed, phone 111. Speak to a pharmacist if: you’re 18 years or over and have symptoms of shingles If the pharmacist cannot treat you they may recommend you see your GP. Find your nearest pharmacy Causes of shingles When you catch chickenpox the virus stays in your body. It can become active again later on if your immune system is lowered and cause shingles. Your immune system can be lowered by things like: stress other illnesses or conditions treatments like chemotherapy It’s possible to have shingles more than once, but it’s very rare to get it more than twice. Treating shingles There’s no cure for shingles. But, there are ways to ease your symptoms until the condition improves. Shingles symptoms usually get better in 2 to 4 weeks. Speak to your GP or pharmacist as soon as you get symptoms of shingles. Early treatment may help to


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symptoms usually get better in 2 to 4 weeks. Speak to your GP or pharmacist as soon as you get symptoms of shingles. Early treatment may help to reduce the severity of the condition and complications. Treating symptoms at home Do keep the rash as clean and dry as possible wear loose-fitting clothing use a cool damp cloth to soothe the skin and keep blisters clean try calamine lotion to help relieve itching Don’t do not let dressings or plasters stick to the rash do not use antibiotic cream – this slows healing Other treatments for shingles Your GP or pharmacist may recommend painkillers to ease discomfort caused by shingles. This includes: paracetamol non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen opioids – used for more severe pain antidepressants – used for severe pain anticonvulsants – used for severe pain Some people with shingles may also be prescribed antiviral tablets. Preventing the spread of shingles You can’t give shingles to other people. But, other people


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with shingles may also be prescribed antiviral tablets. Preventing the spread of shingles You can’t give shingles to other people. But, other people can catch chickenpox from you if they haven’t had it before. If you have shingles, you’re contagious until the last blister has dried and scabbed over. To help prevent the virus being passed on: Don’t do not share towels or flannels do not go swimming do not play contact sports do not go work or school if your rash is weeping (oozing fluid) and can’t be covered Chickenpox Chickenpox can be particularly dangerous for certain groups of people. If you have shingles, avoid: pregnant women who haven’t had chickenpox before people with a weak immune system, for example someone with HIV or AIDS babies less than 1 month old (unless it’s your own baby) Complications of shingles Complications can sometimes occur as a result of shingles. They are more likely if your immune system is low, (the body’s natural defence system), or are elderly. Shingles


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occur as a result of shingles. They are more likely if your immune system is low, (the body’s natural defence system), or are elderly. Shingles is rarely life threatening. Complications, though, can mean that around 1 in every 1,000 cases in adults over the age of 70 is fatal. Complications can include: postherpetic neuralgia eye problems Ramsay Hunt syndrome the rash becoming infected with bacteria white patches (a loss of pigment) or scarring in the area of the rash inflammation of the lungs (pneumonia), liver (hepatitis), brain (encephalitis), spinal cord (transverse myelitis), or protective membranes that surround the brain and spinal cord (meningitis) – these complications are rare. The shingles vaccine Read about the shingles vaccine and find out if you’re eligible Source: NHS 24 - Opens in new browser window Last updated: 23 June 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name,


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2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Shingles vaccine Other health sites The Pain Toolkit Pain Concern British Pain Society: FAQs Age UK Find your nearest pharmacy Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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Sickle cell disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Blood and lymph Sickle cell disease Sickle cell disease About sickle cell disease ​Symptoms and diagnosis ​Treating sickle cell disease ​Living with sickle cell disease ​Causes of sickle cell disease ​Sickle cell disease carriers and screening About sickle cell disease Sickle cell disease is the name for a group of blood disorders. The most severe is sickle cell anaemia. These disorders are inherited, meaning they are passed on through your genes. You can have a blood test at any time to find out if you carry the gene for sickle cell disease, or if you have sickle cell disease. Sickle cell disease affects how your body produces red blood cells. Normal red blood cells are round – red blood cells affected by sickle cell disease harden and become sickle-shaped, like a crescent moon.


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cells. Normal red blood cells are round – red blood cells affected by sickle cell disease harden and become sickle-shaped, like a crescent moon. This causes them to die too quickly and block blood vessels, leading to symptoms that are often painful. People from particular ethnic backgrounds are more likely to have sickle cell disease or carry the gene. You are more likely to have sickle cell disease if you are from one of these ethnic backgrounds: African Asian Caribbean Eastern Mediterranean Middle Eastern There are treatments to manage sickle cell disease, but no cure yet – it’s a lifelong condition. Find out about symptoms and diagnosis Find out about treating sickle cell disease Find out about living with sickle cell disease Find out about screening to see if you’re a sickle cell carrier ​Symptoms and diagnosis The main symptoms of sickle cell disease are sickle cell crises (very painful episodes affecting different parts of the body), infections, and anaemia. Getting immediate


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sickle cell disease are sickle cell crises (very painful episodes affecting different parts of the body), infections, and anaemia. Getting immediate medical advice There are a number of serious problems that can appear suddenly as a result of sickle cell disease. If you experience any of the following symptoms, you should get medical advice immediately: high temperature (a fever) going to 38C (100.4F) or higher difficulty breathing drowsiness, confusion, or slurred speech a severe headache, stiff neck, or dizziness skin or lips that are very pale fits (seizures) serious pain that isn’t responding to treatments at home sudden swelling in the tummy priapism – a painful erection lasting two hours or more weakness on one or both sides of your body sudden vision loss, or changes in your vision If you develop any of the symptoms listed above, phone your GP or care team immediately. If you can’t contact your GP or care team, go to your closest Accident and Emergency (A&E) department. Dial


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phone your GP or care team immediately. If you can’t contact your GP or care team, go to your closest Accident and Emergency (A&E) department. Dial 999 for an ambulance if you aren’t able to travel yourself. It’s important to make sure that the medical team looking after you know that you have sickle cell disease. Sickle cell crises Episodes of pain known as sickle cell crises happen when the blood vessels that go to one part of your body become blocked. The pain can be severe. Sickle cell crises are one of the most common symptoms of sickle cell disease and, on average, occur once a year and last up to seven days. Some people have sickle cell crises every few weeks – others experience them less than once a year. A sickle cell crisis typically affects one part of the body at a time. The most common parts affected are: hands or feet (this is especially common in young children) ribs and breastbone spine pelvis tummy legs and arms Sickle cell crises have different causes. They can be


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is especially common in young children) ribs and breastbone spine pelvis tummy legs and arms Sickle cell crises have different causes. They can be triggered by cold, rainy or windy weather, stress, dehydration, or exercise that leaves you severely out of breath. Infection Sickle cell disease leaves people – especially children – extra vulnerable to infection because their bodies aren’t as effective at dealing with bacteria and viruses. This leaves them more vulnerable to viruses like the common cold, as well as severe and potentially life-threatening conditions like meningitis. As well as keeping up to date with their vaccinations, many people with sickle cell disease take daily doses of antibiotics in order to prevent infections. Anaemia Almost everyone with sickle cell disease has anaemia. Haemoglobin is found in red blood cells – it’s the substance that transports oxygen around the body. People with anaemia have low levels of haemoglobin in their blood. Most of the time anaemia


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the substance that transports oxygen around the body. People with anaemia have low levels of haemoglobin in their blood. Most of the time anaemia doesn’t cause symptoms, but if you’re infected with parvovirus, the virus that causes slapped cheek syndrome, the anaemia can get worse. When that happens, it causes: headaches a fast heartbeat fainting dizziness If these symptoms occur, the anaemia is usually treated with a blood transfusion. Sudden anaemia can happen in young children if they experience swelling of the spleen. This is also treated with a blood transfusion. Other sickle cell disease symptoms There’s a wide range of other issues that can be caused by sickle cell disease. These include: a serious lung condition called acute chest syndrome that can cause chest pain, a cough, breathing difficulties and fever pain in bones and joints delayed puberty delayed growth in childhood kidney or urinary problems, including bedwetting and blood in the urine gallstones – these are stones


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delayed puberty delayed growth in childhood kidney or urinary problems, including bedwetting and blood in the urine gallstones – these are stones in the gallbladder that can cause jaundice (yellow eyes and skin) and abdominal (tummy) pain ulcers on the lower legs (open sores that can be very painful) priapism – a painful, persistent erection that can last for several hours high blood pressure (pulmonary hypertension) transient ischaemic attacks (TIAs) or strokes – these happen when blood flow to the brain is interrupted or blocked enlarged spleen – this can cause a fast heartbeat, worsening of anaemia, a swollen tummy, shortness of breath and abdominal pain vision problems like floaters, worsened night vision, blurred vision, patchy vision and, occasionally, sudden vision loss These symptoms can be treated – see Treating sickle cell disease for more information. Diagnosing sickle cell disease You can have a blood test any time to find out if you have sickle cell disease, or find out


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for more information. Diagnosing sickle cell disease You can have a blood test any time to find out if you have sickle cell disease, or find out if you’re a carrier who could have a child with the condition. Sickle cell disease is usually diagnosed during pregnancy – free screening to find out if a baby is at risk of having the condition is offered to every pregnant woman in Scotland. Even if your family background doesn’t make it likely your child will have sickle cell disease, you can still request a test. If possible, screening should be done before the tenth week of pregnancy, so that there’s time to think about further tests that can find out if your baby will be born with sickle cell disease. Newborn babies are screened for sickle cell disease as part of the newborn blood spot test – the heel prick test. There are a few reasons for this: if a baby’s parents weren’t screened during pregnancy, this test identifies if the child has sickle cell disease if screening during pregnancy


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this: if a baby’s parents weren’t screened during pregnancy, this test identifies if the child has sickle cell disease if screening during pregnancy showed that the baby had a high risk of having sickle cell disease, but no more testing was done, the heel prick test will determine if the child has the condition or not this test shows if the baby is a carrier of sickle cell, and could one day have children of their own who have the condition (find out more about sickle cell carriers here) the heel prick test identifies other inherited conditions, like cystic fibrosis Another blood test will be used to confirm the diagnosis if the heel prick test suggests that the baby could have sickle cell disease. Learn about being tested to see if you carry the sickle cell gene ​Treating sickle cell disease People of all ages with sickle cell disease are supported by a team of medical professionals in a specialist sickle cell centre. A specialised care plan will be developed with you that helps you


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supported by a team of medical professionals in a specialist sickle cell centre. A specialised care plan will be developed with you that helps you to fully understand the condition and find the best way of managing it. Treating and preventing sickle cell crises Sickle cell crises can usually be managed at home. The following steps are recommended for adults or children experiencing a sickle cell crisis: over the counter painkillers like paracetamol and ibuprofen can help – although aspirin should not be given to anyone under 16 – and if needed, your GP may prescribe stronger painkillers heating pads or warm towels can be placed on the area and massaged to ease the pain – pharmacies usually sell heating pads you can use for this drink plenty – staying hydrated will help relaxing distractions like reading, videos, and computer games are a good way to distract your mind, or your child’s mind, from the pain If none of the above measures help, or the pain is very severe, phone your GP. You


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way to distract your mind, or your child’s mind, from the pain If none of the above measures help, or the pain is very severe, phone your GP. You or your child should go to the local accident and emergency (A&E) if it’s not possible to contact your GP. It may be necessary for you or your child to spend a few days in hospital being treated with stronger pain relief. The best way to prevent a sickle cell crisis is by being aware of potential triggers and avoiding them. Prevent dehydration by drinking plenty of fluids –especially water. Avoid alcohol – alcohol causes dehydration. Stay warm with enough layers of clothing to avoid getting cold, and avoid extreme temperatures. Don’t expose yourself to sudden changes in temperature – for example, avoid swimming in cold water. The lack of oxygen at high altitudes can trigger a sickle cell crisis, so be careful if you’re at high altitude for any reason. However, plane travel shouldn’t be an issue because planes maintain a consistent oxygen


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so be careful if you’re at high altitude for any reason. However, plane travel shouldn’t be an issue because planes maintain a consistent oxygen level due to being pressurised. Make sure to stay active, but avoid activities that leave you severely out of breath. Don’t smoke – smoking can trigger acute chest syndrome. Stay relaxed as much as you can – sickle cell crises can be triggered by stress, so consider learning relaxation techniques like breathing exercises. Your care team may recommend a medication called hydroxycarbamide (hydroxyurea) if you keep experiencing sickle cell crises. This is a capsule that is taken once a day. It works by reducing how many other types of blood cell, like white blood cells and platelets (clotting cells) there are in the body. This means that you’ll need regular blood tests to make sure you’re healthy. Treating and preventing infections Children who have sickle cell disease should be kept up to date on all of their routine vaccinations, and may also


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Treating and preventing infections Children who have sickle cell disease should be kept up to date on all of their routine vaccinations, and may also need additional vaccinations like the hepatitis B vaccine and the annual flu vaccine. If you have sickle cell disease, you’ll most likely need to take a dose of antibiotics every day, usually penicillin. This will not pose serious health risks. Reduce risk in day-to-day life by being careful about activities that can make you vulnerable to infection. Always follow good food hygiene measures, for example. If you’re planning to go abroad, talk to your GP as far in advance as you can. You might need extra vaccinations or medication, such as anti-malarials if you’re going to a place where malaria is a risk. It may also be a good idea to take extra precautions when it comes to food and water. Treating anaemia Most of the time, anaemia doesn’t have any symptoms and you won’t require any treatment for it. However, children with sickle cell


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Treating anaemia Most of the time, anaemia doesn’t have any symptoms and you won’t require any treatment for it. However, children with sickle cell anaemia who are also on a restricted diet (such as a vegan or vegetarian diet) may need folic acid supplements. Folic acid helps your body to create more red blood cells, so it can help to improve anaemia. It’s important to be aware that this type of anaemia isn’t the same as the anaemia caused by iron deficiency, so don’t take iron supplements without talking to your care team first. Taking iron supplements with the anaemia caused by sickle cell disease can be dangerous. Blood transfusions or hydroxycarbamide may be necessary for serious or persistent anaemia. Treating other sickle cell disease-related issues There are a range of treatments for other problems that can be caused by sickle cell disease, depending on the type of symptom and how severe it is: people with acute chest syndrome need emergency treatment – this involves oxygen,


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disease, depending on the type of symptom and how severe it is: people with acute chest syndrome need emergency treatment – this involves oxygen, blood transfusions, antibiotics, and fluids given through a vein, as well as possibly hydroxycarbamide to prevent it happening again painkillers can treat joint and bone pain a short course of hormones can be given to children in order to trigger delayed puberty gallbladder removal surgery is used to treat gallstones for persistent priapism, medication can stimulate blood flow, or a needle can be used to drain blood from the penis regular blood transfusions or hydroxycarbamide are given to people who have had a stroke or who are at greater risk of having one In addition to the treatments above, chelation therapy involves taking medication to make the level of iron in your blood lower, bringing it to safe levels. This treatment is given to people who need a lot of blood transfusions. Learn more about living with sickle cell disease here


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it to safe levels. This treatment is given to people who need a lot of blood transfusions. Learn more about living with sickle cell disease here ​Living with sickle cell disease Sickle cell disease is a lifelong illness, which can be managed well with treatment and self-help. In addition to preventing symptoms and crises as much as possible, there are a few things you can do that will make it easier to live with the condition and stay in the best possible health. Getting surgery when you have sickle cell disease If you’re due to have surgery, or you’re brought in for surgery in an emergency, it’s very important you take some precautions. You should tell your care team about any surgeries you have planned that involve a general anaesthetic. Tell your surgeon on the day that you have sickle cell disease. General anaesthetic can cause a number of problems, including increasing the risk of a sickle cell crisis. It’s important that you’re monitored closely during the surgery, and are given


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of problems, including increasing the risk of a sickle cell crisis. It’s important that you’re monitored closely during the surgery, and are given plenty of fluids as well as being kept warm. It might be necessary to have a blood transfusion before the surgery to reduce the chances of complications. Pregnancy and birth with sickle cell disease You can have a healthy pregnancy if you have sickle cell disease, but it’s a good idea to talk to your care team before planning a pregnancy, for a number of reasons: there’s a bigger chance of complications such as miscarriage, pre-eclampsia, anaemia and sickle cell pain while you’re pregnant you may have to stop taking some of the medications for sickle cell disease, like hydroxycarbamide, before getting pregnant, as these can harm a foetus it may be a good idea to find out if your partner is a sickle cell carrier and talk with a counsellor about what this could mean extra monitoring during pregnancy, as well as extra treatment, might be


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a sickle cell carrier and talk with a counsellor about what this could mean extra monitoring during pregnancy, as well as extra treatment, might be necessary It’s important to use a reliable form of contraception if you aren’t planning a pregnancy. Learn about pregnancy and newborn screening for sickle cell disease The outlook for people with sickle cell disease Most children with sickle cell disease lead normal, happy lives. However, sickle cell disease can be very different from person to person, and it’s still a serious condition. Sickle cell disease can have a big impact on someone’s life. It can lead to serious infections, strokes and transcient ischaemic attacks (TIAs), and lung problems, which can be fatal. The overall live expectancy for people with sickle cell disease is shorter than normal, but this changes depending on the type of sickle cell disease, what problems they experience, and how the condition is treated. Milder types of sickle cell disease may not impact life


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type of sickle cell disease, what problems they experience, and how the condition is treated. Milder types of sickle cell disease may not impact life expectancy. People with sickle cell anaemia have a typical life expectancy of between 40 and 60 years of age. As newer treatments are developed, it’s hoped that the outlook will get better. ​Causes of sickle cell disease Sickle cell disease is caused by a gene problem that is inherited from your parents. It isn’t something you can catch, and it’s not caused by anything the parents did during or before pregnancy. Inheriting sickle cell disease You inherit one set of genes from your mother, and one from your father. Genes always come in pairs. Children born with sickle cell disease inherit a copy of the sickle cell gene from both of their parents, so each one of the pair of genes is faulty. This happens when both parents are “carriers” – they carry the faulty gene for sickle cell. This is also known as having the sickle cell trait.


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This happens when both parents are “carriers” – they carry the faulty gene for sickle cell. This is also known as having the sickle cell trait. Carriers don’t have sickle cell disease, but if their partner is a carrier too they may have a child with the condition. When both of a child’s parents are sickle cell carriers: there’s a 25% (one in four) chance that each of their children won’t inherit any faulty genes – they won’t have sickle cell disease, and they won’t be able to pass it on to their children there’s a 50% (one in two) chance that each child will inherit a copy of the faulty gene from just one parent, and be a sickle cell carrier there’s a 25% (one in four) chance that each child will inherit copies of the sickle cell gene from both of their parents, and have sickle cell disease when they’re born You can find more information about how sickle cell disease is inherited from the Sickle Cell Society. Learn more about sickle cell carriers and screening ​Sickle cell disease


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about how sickle cell disease is inherited from the Sickle Cell Society. Learn more about sickle cell carriers and screening ​Sickle cell disease carriers and screening Sickle cell disease carriers are people who carry the faulty gene that causes sickle cell disease, but do not have the disease. This is also called having the sickle cell trait. If you have the sickle cell trait, you won’t develop sickle cell disease. However, there’s a risk that you’ll have a child with the condition, or who is also a sickle cell disease carrier. Sickle cell disease carriers The sickle cell gene can be carried by anyone, but people from certain ethnic backgrounds are much more likely to be carriers. You are more likely to be a carrier if you have family from one of these areas : Africa Asia The Caribbean The Eastern Mediterranean The Middle East Most sickle cell carriers in the UK have an African or Caribbean family background – it’s estimated around one in ten people with this background may be a


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sickle cell carriers in the UK have an African or Caribbean family background – it’s estimated around one in ten people with this background may be a sickle cell carrier. Finding out if you are a sickle cell carrier You can request a blood test from your GP at any time to find out if you’re a sickle cell carrier. This is a particularly good idea if your family background makes it more likely that you have the gene. Both men and women are able to get the test. Every pregnant woman in Scotland is offered screening to check if their baby is at risk of being born with sickle cell disease. You can ask for a test even if your family background doesn’t suggest your child will have sickle cell disease. It’s a good idea to have your partner screened for the gene too. If possible, screening should be done before the tenth week of pregnancy, so that there’s time to think about further tests that can find out if your baby will be born with sickle cell disease. Read more about diagnosis and


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so that there’s time to think about further tests that can find out if your baby will be born with sickle cell disease. Read more about diagnosis and screening for the sickle cell disease gene here Other health risks for sickle cell carriers You’re not at risk of developing sickle cell disease if you carry sickle cell. The only time you may be at risk of health problems is in rare cases where you might not get enough oxygen, such as: having surgery under general anaesthetic – make sure your medical team know you carry sickle cell before your operation so they can ensure you get enough oxygen during extreme sports such as deep sea diving and climbing at high altitudes – if you do sports like these, ensure you’re never short of oxygen during regular, intensive physical activity – make sure you drink plenty of fluids during training and avoid extreme exhaustion There’s also a very small risk of developing kidney problems associated with carrying sickle cell. Apart from these uncommon


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avoid extreme exhaustion There’s also a very small risk of developing kidney problems associated with carrying sickle cell. Apart from these uncommon situations, you can lead a completely normal and healthy life if you’re a sickle cell carrier. Other blood disorders Sickle cell carriers are also at risk of having a child with a blood disorder if their partner is a carrier of a different type of blood disorder. You can find more detailed information about some of the other types of carrier in the following pages: Your baby carries a gene for Sickle Cell Your baby carries a gene for unusual haemoglobin Source: NHS 24 - Opens in new browser window Last updated: 09 January 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me NHS inform


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health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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Sjögren's syndrome | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Immune system Sjogren’s syndrome Sjogren’s syndrome About Sjogren’s syndrome Symptoms of Sjogren’s syndrome Causes of Sjogren’s syndrome Diagnosing Sjogren’s syndrome Treating Sjogren’s syndrome Complications of Sjogren’s syndrome About Sjogren’s syndrome Sjögren’s (pronounced Show-grin’s) syndrome is an autoimmune disorder. The body’s immune system attacks glands that secrete fluid, such as the tear and saliva glands. The effects of Sjögren’s syndrome can be widespread. Certain glands become inflamed, which reduces the production of tears and saliva, causing the main symptoms of Sjögren’s syndrome, which are dry eyes and dry mouth. In women (who are most commonly affected), the glands that keep the vagina moist can also be affected, leading to vaginal dryness. Read more about the


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women (who are most commonly affected), the glands that keep the vagina moist can also be affected, leading to vaginal dryness. Read more about the symptoms of Sjögren’s syndrome What causes Sjögren’s syndrome? Sjögren’s syndrome is an autoimmune condition, which means that instead of protecting the body from infection or illness, the immune system reacts abnormally and starts attacking healthy cells and tissue. In Sjögren’s syndrome, the immune system attacks the tear and saliva glands, and other secretory glands throughout the body. The reasons for this remains unknown, but research suggests that it’s triggered by a combination of genetic, environmental and, possibly, hormonal factors. Some people are thought to be more vulnerable to the syndrome when they’re born and that certain events, such an infection, can trigger the problems with the immune system. Read more about the causes of Sjögren’s syndrome Healthcare professionals classify Sjögren’s syndrome as being either: primary –


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the immune system. Read more about the causes of Sjögren’s syndrome Healthcare professionals classify Sjögren’s syndrome as being either: primary – when the syndrome develops by itself and not as the result of another condition secondary – when the syndrome develops in combination with another autoimmune disorder, such as lupus or rheumatoid arthritis Diagnosing Sjögren’s syndrome Sjögren’s syndrome can be difficult to diagnose, because it has similar symptoms to other conditions and there is no single test for it. Your doctor will ask about your symptoms and carry out a test to see how dry your mouth and eyes are. Read more about diagnosing Sjögren’s syndrome Treating Sjögren’s syndrome There is no cure for Sjögren’s syndrome, but treatments can help control symptoms. Dry eyes and mouth can usually be helped with artificial tears and saliva. It’s important to maintain good eye and mouth hygiene, because your risk of developing an infection is greater. Taking care of your eyes and


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saliva. It’s important to maintain good eye and mouth hygiene, because your risk of developing an infection is greater. Taking care of your eyes and mouth can help prevent problems such as corneal ulcers and tooth decay. In severe cases, medication or surgery may be recommended. Read more about treating Sjögren’s syndrome Complications of Sjögren’s syndrome Sjögren’s syndrome can sometimes lead to complications. For example, your eyesight could be permanently damaged if the reduced tear production isn’t treated. Sjögren’s syndrome also increases your risk of developing non-Hodgkin lymphoma, which is a cancer of the lymph glands. However, the chances are still low, at around 5%. Women with Sjögren’s syndrome have an increased risk of having children with a temporary “lupus” rash or heart abnormalities. Any pregnancy will be closely monitored for potential problems. Read more about the complications of Sjögren’s syndrome Who’s affected by Sjögren’s syndrome? Sjögren’s syndrome most


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for potential problems. Read more about the complications of Sjögren’s syndrome Who’s affected by Sjögren’s syndrome? Sjögren’s syndrome most commonly affects people aged 40-60, with women accounting for about 90% of cases. It’s difficult to know exactly how many people are affected by the syndrome because many don’t see their GP about their symptoms. Further information on Sjögren’s syndrome Information about you If you have Sjögren’s syndrome, your clinical team will pass information about you on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS). This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time. Find out more about the register Symptoms of Sjogren’s syndrome The most commonly reported symptoms of Sjögren’s syndrome are a dry mouth and eyes, which can lead to other associated symptoms. However, these symptoms can be common in old age, and most people with dry eyes or a dry


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mouth and eyes, which can lead to other associated symptoms. However, these symptoms can be common in old age, and most people with dry eyes or a dry mouth do not have Sjögren’s syndrome. Many women also experience vaginal dryness, which can make sex painful. Associated symptoms of dry mouth A dry mouth can lead to: tooth decay and gum disease dry cough difficulty swallowing and chewing hoarse voice difficulty speaking swollen salivary glands (located between your jaw and ears) repeated fungal infections in the mouth (oral thrush) – symptoms of which can include a coated or white tongue Associated symptoms of dry eyes Dry eyes can lead to: burning or stinging eyes itchy eyes a feeling that there’s grit in your eyes irritated and swollen eyelids sensitivity to light (photophobia) tired eyes mucus discharge from your eyes These symptoms can get worse when you’re: in a windy or smoky environment in an air-conditioned building travelling on aeroplane Other symptoms of Sjögren’s syndrome


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get worse when you’re: in a windy or smoky environment in an air-conditioned building travelling on aeroplane Other symptoms of Sjögren’s syndrome In more serious cases of Sjögren’s syndrome, the immune system can attack other parts of the body, causing symptoms and conditions such as: dry skin tiredness and fatigue – which are common and can lead to total exhaustion muscle pain joint pain, stiffness and swelling vasculitis (inflammation of blood vessels) difficulty concentrating, remembering and reasoning Causes of Sjogren’s syndrome It’s not known exactly what causes Sjögren’s syndrome, but it’s thought to be linked to a problem with the immune system. The immune system Your immune system usually helps protect the body from infection and illness by making antibodies. Antibodies attack bacteria and viruses, which help stop you from becoming ill. An autoimmune condition causes your immune system to react abnormally. Instead of attacking foreign cells, such as bacteria, the antibodies


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ill. An autoimmune condition causes your immune system to react abnormally. Instead of attacking foreign cells, such as bacteria, the antibodies start attacking your body’s healthy cells and tissue. In Sjögren’s syndrome, the parts of the body usually affected are the tear, saliva and vaginal glands, which are collectively known as the exocrine glands. The antibodies damage the exocrine glands so they can no longer function normally. There’s some evidence that the immune system also damages the nerves that control these glands, which further reduces their effectiveness. The immune system can go on to damage other parts of the body, such as muscles, joints, blood vessels, nerves and, less commonly, organs. Possible triggers for Sjögren’s syndrome Primary Sjögren’s syndrome Most researchers believe that primary Sjögren’s syndrome is triggered by a combination of genetic and environmental factors. Certain people are born with specific genes that make them more vulnerable to a faulty


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by a combination of genetic and environmental factors. Certain people are born with specific genes that make them more vulnerable to a faulty immune system. Then, many years later, an environmental factor, possibly a common virus, triggers the immune system to stop working properly. The female hormone oestrogen also seems to play a role. Sjögren’s syndrome mostly occurs in women, and symptoms usually start around the time of the menopause, when oestrogen levels begin to fall. Falling oestrogen levels can contribute to dryness, and this dryness could make the condition more noticeable. Secondary Sjögren’s syndrome Sjögren’s syndrome can be associated with other autoimmune conditions, such as rheumatoid arthritis or lupus. This is known as secondary Sjögren’s syndrome. The exocrine glands Your saliva and tear glands play a vital role in protecting your mouth and eyes, which is why the symptoms of Sjögren’s syndrome can be widespread and troublesome. The importance of tears We usually


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protecting your mouth and eyes, which is why the symptoms of Sjögren’s syndrome can be widespread and troublesome. The importance of tears We usually only notice our tears when we cry, but our eyes are always covered by a thin layer of tears, known as a tear film. Tears are made up of a mix of water, proteins, fats, mucus and infection-fighting cells. Tears serve several important functions. They: lubricate the eye keep the eye clean and free of dust protect the eye against infection help stabilise your vision The importance of saliva Saliva also serves several important functions, including: keeping the mouth and throat naturally lubricated aiding digestion by moistening food and containing enzymes that can break down certain starches acting as a natural disinfectant (saliva contains antibodies, enzymes and proteins that protect against some common bacterial and fungal infections) Diagnosing Sjogren’s syndrome Sjögren’s syndrome can be difficult to diagnose because the symptoms are


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some common bacterial and fungal infections) Diagnosing Sjogren’s syndrome Sjögren’s syndrome can be difficult to diagnose because the symptoms are similar to those of other health conditions. You may see different health professionals for your different symptoms, such as a dentist for a dry mouth, an optician for dry eyes and a gynaecologist for a dry vagina, which can sometimes make it difficult to reach a firm diagnosis. See your GP if you experience any symptoms of dryness, particularly of your eyes and mouth. Screening questions Experts in the field have come up with a series of screening questions, which may be useful if you’re worried you may have Sjögren’s syndrome. If you answer “yes” to most of the questions below, you may have Sjögren’s syndrome and will probably be advised to have further tests. Have you had daily, persistent, troublesome dry eyes for more than three months? Do you keep having a sensation of grit in your eye? Do you need to use eye drops containing tear


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troublesome dry eyes for more than three months? Do you keep having a sensation of grit in your eye? Do you need to use eye drops containing tear substitutes more than three times a day? Have you had a daily feeling of dry mouth for more than three months? Do you keep getting swollen salivary glands (located between your jaw and your ears)? Do you frequently drink liquids to help you swallow food? Further testing Tests used to diagnose Sjögren’s syndrome include: tear break-up time and Schirmer tests a lip biopsy blood tests salivary flow rate These are explained below. Tear break-up time and Schirmer tests Tear break-up time and Schirmer tests are usually carried out by an ophthalmologist (a doctor who specialises in treating eye conditions). The tear break-up time test measures how effective your tear glands are. A non-toxic dye is dropped onto the surface of your eye and the colour of the dye allows the ophthalmologist to see how well your tear film is functioning and how long it


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onto the surface of your eye and the colour of the dye allows the ophthalmologist to see how well your tear film is functioning and how long it takes for your tears to evaporate. This test is also carried out using a slit lamp. A slit lamp is a low-power microscope with a high-intensity light source that can be focused to shine in a narrow beam. The specialist will use the slit lamp to examine your tear glands more closely. In the Schirmer test, small strips of blotting paper are placed into your lower eyelid. After five minutes, the strips are removed to see how much of the paper is soaked with tears. Lip biopsy During a lip biopsy, a small tissue sample is removed from your inner lip and examined under a microscope. A local anaesthetic is injected into the inner surface of your lower lip to numb the area, before a small cut is made to remove a few of your minor salivary glands. Clusters of lymphocytes (a type of white blood cell) in the tissue can indicate Sjögren’s syndrome. Blood


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remove a few of your minor salivary glands. Clusters of lymphocytes (a type of white blood cell) in the tissue can indicate Sjögren’s syndrome. Blood tests Blood tests are carried out to look for antibodies known as anti-Ro and anti-La (or SS-A and SS-B), which are produced when the immune system has been affected by Sjögren’s syndrome. These antibodies are only present in about 60% of people with Sjögren’s syndrome, so it’s possible to have a negative blood test result and still have the condition. Salivary flow rate A salivary flow rate test measures how much saliva your glands produce. You’ll usually be asked to spit as much saliva as you can into a cup over a five-minute period. The amount of saliva is then weighed or measured. An unusually low flow rate can indicate Sjögren’s syndrome. Treating Sjogren’s syndrome There’s no cure for Sjögren’s syndrome, but treatments help relieve symptoms such as eye and mouth dryness. Sjögren’s syndrome affects everyone in different ways, so


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for Sjögren’s syndrome, but treatments help relieve symptoms such as eye and mouth dryness. Sjögren’s syndrome affects everyone in different ways, so your treatment plan will be tailored to suit you. Eye care Artificial tears Mild to moderate cases of dry eye can usually be successfully treated with eye drops containing “artificial tears” – a liquid that mimics tears. These eye drops are available from a pharmacist, without a prescription. There are many different types of eye drops, so you can try different brands to find the one that works best for you. If you’re using eye drops regularly (more than three times a day), you should use one that doesn’t contain preservatives. This is because there’s evidence that over-exposure to preservatives can damage the surface of the eye. A short-term dose of eye drops containing corticosteroids may be recommended if your eyes become irritated. However, long-term corticosteroid use isn’t recommended because they can cause serious side effects. To


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be recommended if your eyes become irritated. However, long-term corticosteroid use isn’t recommended because they can cause serious side effects. To minimise the chance of experiencing side effects from corticosteroids, you’ll be prescribed the lowest effective dose for the shortest possible time. Moisture chamber spectacles Wearing glasses reduces tear evaporation by up to 30%, and this effect can be maximised by wearing specially-made glasses called moisture chamber spectacles. These wrap around your eyes like goggles and help retain moisture and protect the eyes from irritants. Some people used to be embarrassed to wear them, but modern designs look like sports glasses. Punctal plugs Punctual occlusion is a widely-used technique that seals the tear ducts (into which the tears drain) with small plugs. This should help keep the eye better protected by tears. Temporary plugs made of silicone are usually used first to see if they help. If it does, more permanent plugs can be used.


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better protected by tears. Temporary plugs made of silicone are usually used first to see if they help. If it does, more permanent plugs can be used. Mouth care Looking after your mouth A number of techniques can be used to keep your mouth lubricated, including: maintaining good oral hygiene to prevent tooth decay and gum disease increasing your fluid intake using sugar-free chewing gum to stimulate saliva production sucking ice cubes to help lubricate your mouth and reduce dryness regularly using mouth rinses to soothe your mouth and protect it against infection If you smoke, you should try to quit. Smoking irritates the mouth and increases the rate at which saliva evaporates. Read more about how to stop smoking Saliva substitutes There are a number of saliva substitute products that can help lubricate your mouth. However, they don’t replicate the role of saliva in preventing infection, so you’ll still need to maintain excellent oral hygiene. Saliva substitutes are available as a


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replicate the role of saliva in preventing infection, so you’ll still need to maintain excellent oral hygiene. Saliva substitutes are available as a spray, lozenge (medicated sweet), gel, or gum. Your GP or pharmacist can tell you which product is most suitable for you. Medication for Sjögren’s syndrome Pilocarpine The medicine pilocarpine is often used to treat the symptoms of dry eyes and dry mouth. Pilocarpine stimulates the glands to produce more saliva and tears. Side effects of pilocarpine include: hyperhidrosis (excessive sweating) nausea diarrhoea heartburn abdominal (stomach) pain an increased need to go to the toilet For some people, the side effects of pilocarpine are mild. Others find that the side effects outweigh the benefits. Don’t take pilocarpine if you have asthma or chronic obstructive pulmonary disease (COPD), or if you’re pregnant or breastfeeding. Hydroxychloroquine Hydroxychloroquine has been shown to slow down the immune system’s attack on the tear and saliva


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you’re pregnant or breastfeeding. Hydroxychloroquine Hydroxychloroquine has been shown to slow down the immune system’s attack on the tear and saliva glands. It can also help reduce any associated symptoms of muscle pain, joint pain and stiffness. You’ll need to take hydroxychloroquine for several weeks before you notice any improvements, and it could be six months before you experience the full benefit of the treatment. Side effects are uncommon and usually mild. They include: nausea skin rash loss of appetite stomach cramps vomiting In very rare cases, hydroxychloroquine can damage the retina, affecting vision. You’ll probably be asked to attend an eye examination so that your retina can be checked before you start treatment. Regular eye examinations (usually at least once a year) are also recommended after you begin treatment. Hydroxychloroquine shouldn’t be used by breastfeeding women. Treating other symptoms of Sjögren’s syndrome Dry skin Several soaps and creams are specifically


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shouldn’t be used by breastfeeding women. Treating other symptoms of Sjögren’s syndrome Dry skin Several soaps and creams are specifically designed for people with dry skin. Your pharmacist or GP can advise you. Vaginal dryness Vaginal dryness can be treated using a lubricant. Some women also use oestrogen creams or hormone replacement therapy (HRT). Muscle and joint pains Muscle and joint pains can be treated with an over-the-counter non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen. If this doesn’t work, see your GP, as stronger NSAIDs are available on prescription. NSAIDs can increase your risk of developing stomach ulcers and internal bleeding, particularly if they’re taken on a long-term basis. If you find swallowing NSAIDs difficult because of your dry mouth, you can try an NSAID cream that’s rubbed into affected joints. NSAIDs aren’t recommended for pregnant or breastfeeding women, or for people with pre-existing risk factors for cardiovascular or kidney


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joints. NSAIDs aren’t recommended for pregnant or breastfeeding women, or for people with pre-existing risk factors for cardiovascular or kidney conditions. General advice These simple tips can help prevent many of the problems associated with Sjögren’s syndrome: have a dental check-up every six months practise good dental hygiene – brushing, flossing and using mouthwash regularly avoid eating too many sweet foods avoid strong and perfumed soaps – use special creams and soaps from your pharmacist avoid dry environments, such as air-conditioned offices, whenever possible avoid drinking too much alcohol Complications of Sjogren’s syndrome Sjögren’s syndrome isn’t usually life-threatening, but it is linked to more seriousproblems. Non-Hodgkin lymphoma It’s estimated that people with Sjögren’s syndrome are 44 times more likely to develop non-Hodgkin lymphoma than people without the condition. Non-Hodgkin lymphoma is a cancer of the lymphatic system. The lymphatic system is a series of


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non-Hodgkin lymphoma than people without the condition. Non-Hodgkin lymphoma is a cancer of the lymphatic system. The lymphatic system is a series of vessels and glands (lymph nodes) that are spread throughout your body, much like your blood vessels. While this increased risk may sound alarming, the chance of a person with Sjögren’s syndrome developing non-Hodgkin lymphoma is still small, as it only affects around 5% of people with the syndrome. However, if you have Sjögren’s syndrome, you should be aware of the main early symptom of non-Hodgkin lymphoma, which is a painless swelling in a lymph node (gland) – usually in the neck, armpit or groin. Report any swollen lymph nodes to your GP. Eye damage If dry eyes aren’t treated, they can become inflamed and you can develop ulcers on the surface of your eyes (corneal ulcers). If left untreated, corneal ulcers can lead to loss of vision and permanent sight damage. Pregnancy If you’re planning to become pregnant and have Sjögren’s


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untreated, corneal ulcers can lead to loss of vision and permanent sight damage. Pregnancy If you’re planning to become pregnant and have Sjögren’s syndrome, ask your GP to test for certain antibodies that may be present in Sjögren’s syndrome and are known to cause a temporary lupus rash in newborn babies. In very rare cases, the antibodies can also cause heart defects in babies. If these antibodies are found, there should be no reason why you can’t continue with the pregnancy, but your child may need additional specialist care during pregnancy and after the birth. Read more about antenatal appointments Other conditions A number of other conditions have been linked to Sjögren’s syndrome, including: peripheral neuropathy – a condition that often involves loss of sensation in the hands and feet Raynaud’s phenomenon – restricted blood flow to the hands, which can cause them to feel cold, numb and painful kidney problems – such as inflammation or kidney stones an underactive thyroid gland


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the hands, which can cause them to feel cold, numb and painful kidney problems – such as inflammation or kidney stones an underactive thyroid gland (hypothyroidism) – which can lead to tiredness and weight gain irritable bowel syndrome (IBS) – which can cause abdominal pain and irregular bowel movements teeth cavities Source: NHS 24 - Opens in new browser window Last updated: 21 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Lupus Rheumatoid arthritis NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 –


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/skin-cancer-melanoma/


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/skin-cancer-non-melanoma/


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https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/skin-light-sensitivity/skin-light-sensitivity-photosensitivity/


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Skin light sensitivity (photosensitivity) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Skin, hair and nails Skin light sensitivity Skin light sensitivity (photosensitivity) Skin light sensitivity (photosensitivity) Skin light sensitivity (photosensitivity) means you have an unusual reaction to light. This can cause symptoms like pain, redness, itching or a rash when the skin is exposed to light. These symptoms can range from very mild to very severe. There are different types of light sensitivity conditions. Some are very common and others are rarer. They can affect anyone, including people of different ages and skin types. Types of light sensitivity Light sensitivity conditions can be put into different groups depending on what causes them. Immunological Some light sensitivity conditions happen when the immune system reacts unusually to light.


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groups depending on what causes them. Immunological Some light sensitivity conditions happen when the immune system reacts unusually to light. This includes light sensitivity conditions like: polymorphic light eruption juvenile spring eruption chronic actinic dermatitis solar urticaria actinic prurigo actinic folliculitis hydroa vacciniforme Drugs or chemicals Light sensitivity symptoms can be a side effect of some drugs or chemicals, for example: doxycycline quinolone antibiotics like ciprofloxacin bendroflumethiazide and other thiazides quinine calcium channel blockers nonsteroidal anti-inflammatory drugs (NSAIDs) – although these rarely contribute to light sensitivity phenothiazines (including chlorpromazine and prochlorperazine) St John’s Wort These are just examples of drugs that may cause light sensitivity and this is not an exhaustive list. Speak to a healthcare professional if you’re worried about the side effects of medication. Do not stop taking any medication without


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exhaustive list. Speak to a healthcare professional if you’re worried about the side effects of medication. Do not stop taking any medication without speaking to your healthcare professional first. Genetic Some light sensitivity conditions are caused by a genetic alteration. This includes: Xeroderma Pigmentosum Cockayne Syndrome Bloom Syndrome Rothmund-Thomson Syndrome Photoaggravated skin diseases Photoaggravated skin diseases are light sensitivity conditions. These conditions are not caused by light but can be triggered or worsened by exposure to light. Some examples of photoaggravated light sensitivity conditions include: rosacea lupus erythematosus atopic dermatitis psoriasis Darier disease dermatomyositis pemphigus vulgaris or foliaceus Light sensitivity symptoms Skin light sensitivity means that you get symptoms when the skin is exposed to light. Some common symptoms include: skin rash skin pain itching a burning or heat sensation on the skin blistering or fragile skin sunburn


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to light. Some common symptoms include: skin rash skin pain itching a burning or heat sensation on the skin blistering or fragile skin sunburn that happens very easily These symptoms can range from mild to severe. Sometimes people may also feel generally unwell due to a light sensitivity disease. For example, you may get headaches or fatigue. Although it’s rarer, some people may have unusual freckling or scarring of the skin. Light sensitivity rash Some light sensitivity rashes may only occur on exposed sites during summer. But, a rash that’s caused by light sensitivity can also happen: all year round through light clothing through windows and indoor light There may be no rash on areas that have a natural shadow like: under the chin the upper eyelids behind the ears You may also notice that the rash stops where you have been covered by clothing or footwear. Diagnosing light sensitivity You should speak to your GP if you think that you have a light sensitivity condition. If necessary,


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or footwear. Diagnosing light sensitivity You should speak to your GP if you think that you have a light sensitivity condition. If necessary, your GP may refer you to a dermatologist. Most people will not need to be referred for light sensitivity testing. But, if you do, your dermatologist may refer you to a light testing centre. In Scotland, this is at NHS Tayside’s Photobiology Unit. Treatments for light sensitivity A light sensitivity rash may be prevented with sun protection and by avoiding the sun. Your doctor will tell you if you need any other treatments. This could include light-based treatments or immune suppressant treatments. Psychological support may be needed if light sensitivity affects your day-to-day life. You may also need to take a vitamin D supplement if you have a light sensitivity condition. Further information on managing light sensitivity Source: NHS Tayside - Opens in new browser window Last updated: 17 January 2025 How can we improve this page? Help us improve


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light sensitivity Source: NHS Tayside - Opens in new browser window Last updated: 17 January 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Managing skin light sensitivity (photosensitivity) Other health sites BAD: Patient information leaflets BAD: Polymorphic light eruption Dermnetnz: Photosensitivity NHS Tayside: Patient Information Leaflets NHS Tayside: Photobiology Unity BPG: Useful links NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/slapped-cheek-syndrome/


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Slapped cheek syndrome | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Infections and poisoning Slapped cheek syndrome Slapped cheek syndrome Slapped cheek syndrome (also called fifth disease or parvovirus B19) is a viral infection. It’s most common in children but it can affect people of any age. It usually causes a bright red rash on the cheeks. Slapped cheek syndrome is normally a mild infection that clears up by itself in 1 to 3 weeks. Once you’ve had the infection, you’re usually immune to it for life. However, slapped cheek syndrome can be more serious for some people. If you’re pregnant, have a blood disorder or a weakened immune system and have been exposed to the virus, you should get medical advice. Symptoms of slapped cheek syndrome Symptoms of slapped cheek syndrome usually develop 4 to 14 days after becoming infected. Sometimes,


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advice. Symptoms of slapped cheek syndrome Symptoms of slapped cheek syndrome usually develop 4 to 14 days after becoming infected. Sometimes, symptoms may not appear for up to 21 days. First symptoms Some people with slapped cheek syndrome won’t notice any early symptoms, but most people will have the following symptoms for a few days: a slightly high temperature (fever) of around 38°C (100.4°F) a runny nose a sore throat a headache an upset stomach feeling generally unwell The infection is most contagious during this initial period. Adults may also feel joint pain and stiffness. This may continue for several weeks or even months after the other symptoms have passed. Slapped cheek rash Image source: dermnetnz.org Image source: Indian Pediatrics Slapped cheek syndrome (PDF, 36KB) After a few days, a distinctive bright red rash on both cheeks (‘slapped cheeks’) normally appears. Adults may not get this. By the time this rash develops, the condition is no longer contagious. After


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cheeks (‘slapped cheeks’) normally appears. Adults may not get this. By the time this rash develops, the condition is no longer contagious. After another few days, a light pink rash may also appear on the chest, stomach, arms and thighs. This often has a raised, lace-like appearance and may be itchy. The rashes will normally fade within a week or two. Occasionally, the body rash may come and go for a few weeks after the infection has passed. This can be triggered by exercise, heat, anxiety or stress. When to get medical advice You don’t usually need to see your GP if you think you or your child has slapped cheek syndrome as it normally gets better on its own. Speak to your GP practice if: You’ve been exposed to anyone with slapped cheek syndrome or you have symptoms of the infection and: you’re pregnant – there’s a very small risk of miscarriage or other complications you have a blood disorder, such as sickle cell anaemia or thalassaemia you have a weakened immune system ask for an


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or other complications you have a blood disorder, such as sickle cell anaemia or thalassaemia you have a weakened immune system ask for an urgent appointment if you have symptoms of severe anaemia, such as very pale skin, shortness of breath, extreme tiredness or fainting If your GP is closed, phone 111. In these cases, a blood test may be carried out to see if you’re immune to the infection. If you’re not immune, you’ll be monitored carefully to check for any problems. If you develop severe anaemia, it’s likely that you’ll be sent to hospital for a blood transfusion. What to do if you or your child has slapped cheek syndrome Slapped cheek syndrome is usually mild and should clear up without specific treatment. If you or your child is feeling unwell, there are things you can do help ease the symptoms. Do rest drink plenty of fluids – babies should continue their normal feeds take paracetamol or ibuprofen for a high temperature, headaches or joint pain – children under 16 shouldn’t


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babies should continue their normal feeds take paracetamol or ibuprofen for a high temperature, headaches or joint pain – children under 16 shouldn’t take aspirin use an emollient (moisturising lotion) on itchy skin speak to a pharmacist about itchy skin – they can recommend the best antihistamine for children Unless you or your child is feeling unwell, you do not have to stay away from work or school once the rash has developed. The infection is no longer contagious by this point. Let your child’s school know if your child has slapped cheek syndrome. How do you get slapped cheek syndrome? Slapped cheek syndrome is caused by a virus called parvovirus B19. This is found in the droplets in the coughs and sneezes of someone with the infection. The virus is spread in a similar way to colds and flu. You can become infected by: inhaling droplets that are sneezed or coughed out by someone with the infection touching a contaminated surface or object and then touching your mouth or nose


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droplets that are sneezed or coughed out by someone with the infection touching a contaminated surface or object and then touching your mouth or nose Someone with slapped cheek syndrome is infectious during the period before the rash develops. Once the rash appears, the condition can no longer be passed on. Preventing slapped cheek syndrome It’s very difficult to prevent slapped cheek syndrome. This is because people who have the infection are most contagious before they develop any obvious symptoms. Make sure that everyone you live with washes their hands often to help stop the infection from spreading. There’s currently no vaccine available to protect you against the condition. Source: NHS 24 - Opens in new browser window Last updated: 29 July 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message


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been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Self-help guide: Rash Skin rashes in children NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/soft-tissue-sarcomas/


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Soft tissue sarcomas | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Soft tissue sarcomas Soft tissue sarcomas Soft tissue sarcomas are a group of rare cancers affecting the tissues that connect, support and surround other body structures and organs. Tissues that can be affected by soft tissue sarcomas include fat, muscle, blood vessels, deep skin tissues, tendons and ligaments. Soft tissue sarcomas can develop in almost any part of the body, including the legs, arms and the trunk (torso). There are many different types of soft tissue sarcoma, depending on where in the body they are located. For example: leiomyosarcomas – which develop in muscle tissue liposarcomas – which develop in fat tissue angiosarcomas – which develop in the cells of the blood or lymph vessels gastrointestinal stromal tumours (GISTs) – which can


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develop in fat tissue angiosarcomas – which develop in the cells of the blood or lymph vessels gastrointestinal stromal tumours (GISTs) – which can develop in the connective tissues that support the organs of the digestive system Soft tissue sarcomas account for around 1 in every 100 cancers diagnosed in the UK. What causes soft tissue sarcomas? Cancer develops when cells multiply uncontrollably, forming tumours. In the vast majority of soft tissue sarcomas it’s unclear what causes this to happen but there are a number of factors known to increase the risk, including: age – soft tissue sarcomas can occur at any age, including in children, but they are more common in middle-aged or elderly people and your risk increases as you get older certain genetic conditions – some genetic conditions, such as neurofibromatosis type 1 and retinoblastoma, are associated with an increased risk of soft tissue sarcomas previous radiotherapy – some people who have previously had radiotherapy for another


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are associated with an increased risk of soft tissue sarcomas previous radiotherapy – some people who have previously had radiotherapy for another type of cancer develop a soft tissue sarcoma, often many years after their previous treatment exposure to certain chemicals – exposure to some chemicals, including vinyl chloride, dioxins and phenoxyacetic herbicides, has been associated with increased rates of soft tissue sarcomas One particular type of soft tissue sarcoma called Kaposi’s sarcoma – which develops in skin cells – is caused by a virus known as the human herpesvirus type 8 (HHV-8) infecting someone with a weakened immune system (such as people with HIV). Signs and symptoms As soft tissue sarcomas can develop in most parts of the body, they can cause a wide range of symptoms. For example, a tumour near the stomach may cause abdominal (tummy) pain, a feeling of fullness and constipation, whereas a tumour near the lungs may cause a cough or breathlessness. There are often no


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(tummy) pain, a feeling of fullness and constipation, whereas a tumour near the lungs may cause a cough or breathlessness. There are often no obvious symptoms in the early stages of soft tissue sarcomas, although you may notice a soft, painless lump under your skin or deeper, that can’t easily be moved around and gets bigger over time. You should speak to your GP if you have a worrying lump or any other troublesome symptoms. A lump the size of a golf ball or larger should be regarded as suspicious and needs to be investigated urgently. Although it is much more likely you have a benign (non-cancerous) condition, it is important to get your symptoms checked out. Diagnosing soft tissue sarcomas If your GP feels there is a possibility you do have cancer, they will refer you for a number of hospital tests to confirm whether you have a soft tissue sarcoma. In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms


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sarcoma. In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of soft tissue sarcoma and refer people for the right tests faster. To find out if you should be referred for further tests for suspected soft tissue sarcoma, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral. A diagnosis of a soft tissue sarcoma will usually be made by a hospital specialist and will be based on your symptoms, a physical examination, and the results of: a biopsy – where a sample of suspected cancerous tissue is removed using a needle or during an operation so it can be tested and analysed in a laboratory imaging tests – a magnetic resonance imaging (MRI) scan is the main type of scan carried out to assess soft tissue sarcomas, although other scans may also be carried out If a diagnosis of a soft tissue sarcoma is confirmed, these tests will also help determine how far the cancer has spread (known as


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be carried out If a diagnosis of a soft tissue sarcoma is confirmed, these tests will also help determine how far the cancer has spread (known as the ‘stage’) and how aggressive the cancer is (known as the ‘grade’). Treating soft tissue sarcomas If you’re diagnosed with a soft tissue sarcoma your care team of specialist doctors and nurses will help you decide on the most appropriate treatment. Treatment depends on factors such as the stage and grade of the cancer, the location of any tumours, and your age and general health. The main treatments used are: surgery – to remove any tumours radiotherapy – where high-energy radiation is used to kill cancer cells chemotherapy – where medication is used to kill cancer cells Surgery Surgery is the main treatment for soft tissue sarcomas that are detected at an early stage. It involves removing the cancerous tumour along with a section of surrounding healthy tissue. This will help ensure no cancer cells are left behind. Every effort will be


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the cancerous tumour along with a section of surrounding healthy tissue. This will help ensure no cancer cells are left behind. Every effort will be made to reduce the impact of surgery on the appearance and functionality of the affected body part. But there is a possibility you’ll have some difficulty using the part of the body that is operated on after surgery and sometimes reconstructive plastic surgery may be needed to repair significant damage. In a small number of cases, there may be no option but to amputate the part of the body where the cancer is located, such as part of the leg. Radiotherapy Radiotherapy is often used after surgery to destroy any remaining cancer cells. This is carried out using an external machine that directs beams of radiation at a defined treatment area. Radiotherapy may also sometimes be used before surgery to make a tumour easier to remove, or as part of your treatment to reduce your symptoms if surgery is not possible. Common side effects of


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surgery to make a tumour easier to remove, or as part of your treatment to reduce your symptoms if surgery is not possible. Common side effects of radiotherapy include sore skin, tiredness and hair loss in the treatment area. These tend to get better within a few days or weeks of treatment finishing. Read more about the side effects of radiotherapy Chemotherapy Like radiotherapy, chemotherapy is sometimes used before surgery to shrink a tumour and make it easier to remove. This involves being given anti-cancer medication directly into a vein (intravenously). Chemotherapy may also be used alone or alongside radiotherapy for soft tissue sarcomas that cannot be surgically removed. Chemotherapy medications have a poisonous effect on the body’s cells, and can cause a number of temporary but unpleasant side effects, such as feeling tired and weak all the time, feeling and being sick, and hair loss from several parts of the body. Read more about the side effects of chemotherapy Outlook As


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weak all the time, feeling and being sick, and hair loss from several parts of the body. Read more about the side effects of chemotherapy Outlook As with most types of cancer, the outlook for a soft tissues sarcoma depends largely on how far the cancer has advanced when it is diagnosed. If the cancer is detected at an early stage and can be removed during surgery, there is a possibility it can be cured. But you’ll need regular check-ups following treatment to check for any signs the cancer has come back. You may also need long-term physiotherapy and occupational therapy to help you manage any physical difficulties resulting from surgery. A cure is not usually possible if a soft tissue sarcoma is only detected at a late stage when it has already spread to other parts of the body, although treatment can help slow the spread of the cancer and control your symptoms. Read further information soft tissue sarcomas Source: NHS 24 - Opens in new browser window Last updated: 09 October 2024 How


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control your symptoms. Read further information soft tissue sarcomas Source: NHS 24 - Opens in new browser window Last updated: 09 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Kaposi's sarcoma Radiotherapy Other health sites Cancer Research UK: Soft tissue sarcomas GIST Cancer UK Macmillan Cancer Support: Soft tissue sarcomas Scottish Cancer Network: Patient information Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-teenagers-and-young-adults/soft-tissue-sarcomas-teenagers-and-young-adults/


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Sore throat | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Ears, nose and throat Sore throat Sore throat Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers × You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Sore throats are very common and usually nothing to worry about. They normally get better within a week. Most are caused by minor illnesses such as cold or flu and can be treated at home. Treatments for a sore


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They normally get better within a week. Most are caused by minor illnesses such as cold or flu and can be treated at home. Treatments for a sore throat There are things you can do to help soothe a sore throat. Do take ibuprofen or paracetamol – paracetamol is better for children and for people who can’t take ibuprofen (children under 16 should never take aspirin) drink plenty of cool or warm fluids, and avoid very hot drinks eat cool, soft foods avoid smoking and smoky places suck lozenges, hard sweets, ice cubes or ice lollies – but don’t give young children anything small and hard to suck because of the risk of choking gargle with a homemade mouthwash of warm, salty water (children should not try this) How to gargle with salt water Dissolve half a teaspoon of salt in a glass of warm water (warm water helps salt dissolve). Gargle with the solution, then spit it out (do not swallow it). Repeat as often as you like. There are also products such as medicated lozenges and sprays sold in


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solution, then spit it out (do not swallow it). Repeat as often as you like. There are also products such as medicated lozenges and sprays sold in pharmacies that you may want to try. There isn’t much scientific evidence to suggest they help, although some people find them worth using. Antibiotics aren’t usually prescribed for a sore throat, even if it’s caused by a bacterial infection. They’re unlikely to make you feel better any quicker and they have unpleasant side effects. Sore throat self-help guide Complete our self-help guide to check your symptoms and find out what to do next. When to get professional advice Go to A&E or phone 999 if: You or your child have: symptoms that are severe or getting worse quickly difficulty breathing or swallowing severe pain started drooling a muffled voice a high-pitched sound as you breathe (stridor) If you have a sore throat, you can get advice and treatment directly from a pharmacy. Find your nearest pharmacy You don’t usually need to get


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If you have a sore throat, you can get advice and treatment directly from a pharmacy. Find your nearest pharmacy You don’t usually need to get medical advice if you have a sore throat. Your pharmacist may advise you to see your GP if: your symptoms are severe – for example with a high temperature or you feel shivery you have persistent symptoms that haven’t started to improve after a week you experience severe sore throats frequently you have a weak immune system – for example, you have HIV, are having chemotherapy, or are taking medication that suppresses your immune system If your GP practice is closed, phone 111. If you have a persistent sore throat (one that lasts 3 to 4 weeks), you should see your GP who may refer you for further tests. This is because your sore throat may be a symptom of a more serious condition. Causes of a sore throat The cause of a sore throat isn’t always obvious. But in most cases it’s a symptom of a viral or bacterial infection. Common causes A sore throat


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The cause of a sore throat isn’t always obvious. But in most cases it’s a symptom of a viral or bacterial infection. Common causes A sore throat is often a symptom of: colds or flu – you may also have a blocked or runny nose, a cough, a high temperature (fever), a headache and general aches laryngitis (inflammation of the voice box) – you may also have a hoarse voice, a dry cough and a constant need to clear your throat tonsillitis (inflammation of the tonsils) – you may also have red or spotty tonsils, discomfort when swallowing and a fever strep throat (a bacterial throat infection) – you may also have swollen glands in your neck, discomfort when swallowing and tonsillitis glandular fever – you may also feel very tired, have a fever and swollen glands in your neck It may also be caused by something irritating your throat. For example, smoke, gastro-oesophageal reflux disease (where acid leaks up from the stomach) and allergies. Less common causes Less often, a sore throat can be a


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smoke, gastro-oesophageal reflux disease (where acid leaks up from the stomach) and allergies. Less common causes Less often, a sore throat can be a sign of: a painful collection of pus at the back of the throat (quinsy) – the pain may be severe and you may also have difficulty opening your mouth or difficulty swallowing inflammation of the flap of tissue at the back of the throat (epiglottitis) – the pain may be severe and you may have difficulty breathing and difficulty swallowing These conditions are more serious and should be seen by a doctor as soon as possible. Source: NHS 24 - Opens in new browser window Last updated: 26 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Common cold Tonsillitis Glandular


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you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Common cold Tonsillitis Glandular fever Find your nearest pharmacy Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/neck-and-back-problems-and-conditions/spinal-stenosis/


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Spinal stenosis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Neck and back problems and conditions Spinal stenosis Spinal stenosis This information may be useful for people who have been diagnosed with spinal stenosis. This includes cervical stenosis and lumbar stenosis. People who are experiencing new or ongoing symptoms should contact their healthcare professional. Read about managing a back problem Read about managing a neck problem What is spinal stenosis? Spinal stenosis is narrowing of the tunnels in the spine which contain the nerves or spinal cord. It’s a common condition. Most narrowing is a normal part of the ageing process and often does not cause problems. In some cases spinal stenosis can lead to irritation or compression of the nerves. Spinal stenosis can affect any part of the spine but is most common in


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cases spinal stenosis can lead to irritation or compression of the nerves. Spinal stenosis can affect any part of the spine but is most common in the lower back (lumbar stenosis) and neck (cervical stenosis). This can lead to pain in the lower back and legs, or in the neck, arms and hands. Although stenosis can cause pain, the nerves can learn to adapt to the narrowed space. The majority of people with this condition can manage their symptoms well, with the right advice and information. In some cases further help is necessary, particularly if symptoms are impacting your arm or leg function, walking or quality of life. Symptoms of spinal stenosis Symptoms of spinal stenosis can vary. Many people experience no symptoms at all. Though uncommon, some people can experience both lumbar and cervical stenosis at the same time. Lumbar spine stenosis Lumbar spine stenosis symptoms affect the legs and may include: pain aching cramping heaviness and or weakness tingling pins and needles numbness


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Lumbar spine stenosis symptoms affect the legs and may include: pain aching cramping heaviness and or weakness tingling pins and needles numbness These symptoms are usually worse with walking or standing, and are relieved by sitting or leaning forward. Cervical spine stenosis Cervical spine stenosis symptoms affect the arms and may include: pain stiffness weakness tingling pins and needles numbness You may also experience headaches. Patients with spinal stenosis can also have back or neck pain. However in the absence of leg or arm symptoms, low back or neck pain are usually not thought to be caused by stenosis. Spinal stenosis is a long term condition, and symptoms can vary. Many patients find that managing their symptoms can help improve their quality of life. Any progression of symptoms is usually slow. This allows time for symptoms to be monitored and for treatments to be considered. Diagnosing spinal stenosis Spinal stenosis can be diagnosed following an assessment from a


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to be monitored and for treatments to be considered. Diagnosing spinal stenosis Spinal stenosis can be diagnosed following an assessment from a healthcare professional. They will ask questions about your symptoms and carry out a physical examination. In some cases, further examinations may be advised to rule out other serious health conditions. For people with severe and worsening symptoms, scans may be considered to help decide if spinal surgery may be helpful. What causes spinal stenosis? As we get older, ageing in the spine can cause tunnel narrowing and a reduction of space around the spinal cord or nerves. Other causes include: injury rheumatoid arthritis certain bone diseases being born with a narrow spinal canal Often people experience no symptoms, but in some cases it can cause irritation of these tissues. However, the nerves can learn to cope with this narrower tunnel. It’s important to note that pain does not always mean the nerves are being damaged. Pain can also be


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can learn to cope with this narrower tunnel. It’s important to note that pain does not always mean the nerves are being damaged. Pain can also be influenced by anything that impacts general health, such as poor sleep, stress and emotional wellbeing. When to get professional help Many people have a combination of pain, numbness and weakness affecting the low back and legs or neck and arms. These symptoms can be distressing, but don’t necessarily require urgent medical attention. Occasionally spinal stenosis can lead to serious conditions called cauda equina syndrome or cervical myelopathy. These are rare, but serious spinal conditions which can lead to permanent damage or disability. Early recognition and treatment can prevent further deterioration. If you develop these conditions, you may need to be seen by an emergency specialist team Speak to your GP urgently if: you have experienced a new onset or significant worsening of: changes to bladder and bowel function e.g. urgency,


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team Speak to your GP urgently if: you have experienced a new onset or significant worsening of: changes to bladder and bowel function e.g. urgency, frequency, difficulty passing urine, leaking, incontinence changes to sensation around the bottom and/or genitals or sexual dysfunction e.g. recent inability to achieve orgasm or erection reduced balance or difficulty walking pain, weakness, heaviness or changing sensation in the arms or legs clumsy hands e.g. dropping things, struggling with handwriting, buttons or zips if your neck pain is associated with a severe headache If your GP practice is closed phone 111 Contact your GP if: you also feel generally unwell you have neck pain that starts when you are ill with other problems – such as rheumatoid arthritis or cancer Treatment for spinal stenosis Many people can cope with their symptoms, as time can allow the nerves to adapt. Management options are based on a number of factors including individual’s symptoms, general health and


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as time can allow the nerves to adapt. Management options are based on a number of factors including individual’s symptoms, general health and patient preference. Treatment options include: exercise or physiotherapy exercise can reduce nerve irritation and make the nerve more resilient to movement. It will not change the spinal tunnel narrowing itself exercise may also help with general function, muscle strength and balance physiotherapy can also be beneficial, you may be referred to this or their may be an option to self-refer in your area. lifestyle management including: staying active modifying activities and pacing techniques maintaining a healthy weight stopping smoking managing stress and emotional wellbeing pain management strategies medication heat ice Read more about taking painkillers As well as these treatments your healthcare professional may advise you to monitor any change of your symptoms symptoms. Other treatment options If symptoms are not improving and other


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professional may advise you to monitor any change of your symptoms symptoms. Other treatment options If symptoms are not improving and other treatments have been tried, other options include: spinal injections spinal surgery specialist pain services Specific advice for treatment of lumbar stenosis If you’ve been diagnosed with lumbar stenosis, although walking can be uncomfortable, it’s safe to continue walking as long as symptoms remain manageable. Walking short distances regularly is encouraged to help manage your symptoms. If your leg symptoms are relieved by bending or leaning forward, it may be helpful to have regular breaks when walking. You can try taking a seat or leaning against a wall. If you are struggling with walking, it may be helpful to talk to a healthcare professional about a walking aid. Work Problems linked to spinal stenosis can sometimes mean you need to take some time off work. This may depend on the nature of your symptoms and your role at work. You do not need


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can sometimes mean you need to take some time off work. This may depend on the nature of your symptoms and your role at work. You do not need to be symptom-free before considering returning to work. Continuing to work or returning to work as soon as is possible will help your recovery. Gradually getting back to your normal daily activities can help to build up strength and stamina. Help and support Following this advice, you should see gradual improvements over time. If your symptoms have not improved, or get worse, talk to a healthcare professional about your symptoms. How to access MSK services in your area When dealing with any health condition it’s important to also look after your mental wellbeing as this can impact your recovery. Source: NHS 24 MSK Clinical Advisory Group - Opens in new browser window Last updated: 06 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name,


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2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Back problems Exercises for back pain Controlling pain How to access MSK services Keeping active Mental wellbeing Other health sites Chartered Society of Physiotherapy: back pain NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


key: source
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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/spleen-problems-and-spleen-removal/


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https://www.nhsinform.scot/illnesses-and-conditions/pregnancy-and-childbirth/during-a-pregnancy/stillbirth/


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Stillbirth | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Pregnancy and childbirth Losing a baby Stillbirth Stillbirth A stillbirth is when a baby dies after the 24th week of a pregnancy or during birth. It’s a devastating experience for parents and can affect you and your family in ways you don’t expect. How you might be feeling Your emotions will likely be in turmoil and you might feel angry, guilty, sad and lonely but also love and pride. There’s no right or wrong way to feel. If you already have children, think about how they might be feeling too and what support they’ll need. This is a very difficult time for you and everyone close to you so it’s important to support each other and ask for help if you need it. Causes of stillbirth The stillbirth or death of a newborn baby can happen for lots of reasons and doctors don’t yet know all the


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help if you need it. Causes of stillbirth The stillbirth or death of a newborn baby can happen for lots of reasons and doctors don’t yet know all the causes. Some are linked to problems with the placenta or mum’s health and others to the baby’s health or development but in some cases the reason can’t be explained. Although there are many reasons that a stillbirth can happen, you can decrease the risk by maintaining a health lifestyle before and during pregnancy. Read more about living a healthy lifestyle during pregnancy Death during pregnancy If your baby dies before birth, labour is usually induced. Going through labour and giving birth is the safest option for most women, even though it can be very distressing. It’s natural to want to know why this happened. It’s not always possible to know why your baby died and that can be hard to come to terms with. Your midwife and obstetrician will be there to support you through it. They will tell you what to expect and give you whatever help


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to terms with. Your midwife and obstetrician will be there to support you through it. They will tell you what to expect and give you whatever help you need. Should I hold my baby? Your midwife or doctor will ask if you’d like to see or hold your baby. You might want to involve other members of your family too. If you’re worried about what your baby looks like, your midwife or doctor can describe them to help you decide. Many parents find it comforting to see, touch and hold their baby and, if you want to, you can bath and dress them. Cuddle cot Your midwife can talk to you about a Cuddle Cot, a special cooling mattress inside a cot which can let you spend more time with your baby in the hospital or at home. This gives you more time to say goodbye, with the support of family and friends. If the hospital doesn’t have a Cuddle Cot then there are other organisations that can organise one for bereaved parents. Ask your midwife. After a stillbirth What you choose to do is very personal and


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are other organisations that can organise one for bereaved parents. Ask your midwife. After a stillbirth What you choose to do is very personal and individual, as is the way you grieve. Specialist help and support is available for parents and families who have lost a baby and your midwife, family nurse and health visitor can help you to find the right support locally. Registering a stillbirth Your baby’s stillbirth must be registered. Your midwife and the hospital staff can advise you how to do this. You can’t officially register a baby lost before 24 weeks of pregnancy, but some hospitals will give you a certificate in memory of your baby if you ask. More about registering the death of a baby Funeral arrangements You’ll need time to think what you’d like for your baby’s funeral. This could be a burial or cremation with a service in the style of your choice. Take as much time as you need to decide on the right way to say goodbye. All hospitals in Scotland will offer a funeral service


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style of your choice. Take as much time as you need to decide on the right way to say goodbye. All hospitals in Scotland will offer a funeral service for your baby free of charge or you may choose to make your own private arrangements, which can give you more choice and control. More about funeral arrangements Coping with the loss of a baby Everyone reacts differently to the loss of a baby. Your emotions might be overwhelming and you might feel physically drained too. Take time to rest and look after yourself. It’s important to know you are not alone and have done nothing wrong. More about coping with the loss of a baby Post-mortem If you lost your baby after 13 weeks, you’ll be offered a post-mortem (autopsy). This is a medical investigation to try to understand what happened and find out if there are issues that could affect a future pregnancy Whether or not to have a post-mortem can be a difficult decision and you’ll be given support and time to think it over. If you have questions


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Whether or not to have a post-mortem can be a difficult decision and you’ll be given support and time to think it over. If you have questions or worries, ask the person who discusses the post-mortem with you. Recovering from a stillbirth You will need care from your midwife and doctor to make sure your body is recovering. Your midwife will assist you through all the decisions you need to make and help you to find the right support. You don’t have to manage alone and it can sometimes help to talk with others who have been through baby loss. You, your baby’s father or your partner and your family are likely to need time to grieve. Remembering your baby Some parents find it helps to do something to remember their baby, like: creating a space in their garden saying a prayer writing a poem Others keep photographs, handprints or footprints, or locks of their baby’s hair in a memory box. No matter what stage of pregnancy your loss is, you can make a memory box – ask your midwife about this.


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locks of their baby’s hair in a memory box. No matter what stage of pregnancy your loss is, you can make a memory box – ask your midwife about this. Some hospitals give special boxes to parents just for this. Some parents don’t want to do any of these things, and that’s okay too. There’s no right or wrong way. To request a different language or format please email:nhs.healthscotland-alternativeformats@nhs.net Source: Public Health Scotland - Opens in new browser window Last updated: 05 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI)


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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/stomach-ache-and-abdominal-pain/


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Stomach cancer | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Stomach cancer Stomach cancer About stomach cancer Symptoms of stomach cancer Causes of stomach cancer Diagnosing stomach cancer Treating stomach cancer Living with stomach cancer About stomach cancer Stomach cancer, or gastric cancer, is a fairly uncommon type of cancer. The initial symptoms of stomach cancer are vague and easy to mistake for other less serious conditions. They include: persistent indigestion and heartburn trapped wind and frequent burping feeling very full or bloated after meals persistent stomach pain Symptoms of advanced stomach cancer can include: blood in your stools, or black stools loss of appetite weight loss As the early symptoms of stomach cancer are similar to those of many other conditions, the cancer is often advanced by the


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of appetite weight loss As the early symptoms of stomach cancer are similar to those of many other conditions, the cancer is often advanced by the time it’s diagnosed. It’s therefore important to get any possible symptoms of stomach cancer checked by your GP as soon as possible. Read more about diagnosing stomach cancer Who’s affected The exact cause of stomach cancer is still unclear, although you’re more likely to develop it if you: are male are 55 years of age or older smoke have a diet low in fibre and high in processed food or red meat have a diet that contains a lot of salted and pickled foods have a stomach infection caused by Helicobacter pylori (H. pylori) bacteria Read more about the causes of stomach cancer. Types of stomach cancer There are several different types of stomach cancer. More than 95% of stomach cancers develop in the cells of the stomach lining and are known as adenocarcinomas. Less common types of stomach cancer include lymphoma of the stomach, which develops


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the cells of the stomach lining and are known as adenocarcinomas. Less common types of stomach cancer include lymphoma of the stomach, which develops in the lymphatic tissue (tissue that drains away fluid and helps fight infection), and gastrointestinal stromal tumours (GISTs), which develop in the muscle or connective tissue of the stomach wall. How stomach cancer is treated Many cases of stomach cancer can’t be completely cured, but it’s still possible to relieve symptoms and improve quality of life using chemotherapy and in some cases radiotherapy and surgery. If operable, surgery can cure stomach cancer as long as all of the cancerous tissue can be removed. Surgery to remove some or all of the stomach is known as a gastrectomy. It will still be possible to eat normally after a gastrectomy, but you’ll probably have to adjust the size of your portions. Chemotherapy can also be used before surgery to help shrink the tumour and sometimes after surgery to help prevent the cancer


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size of your portions. Chemotherapy can also be used before surgery to help shrink the tumour and sometimes after surgery to help prevent the cancer returning. Read more about treating stomach cancer Living with stomach cancer Living with stomach cancer and the effects of surgery can be tough, but there are a range of services that can provide social, psychological and financial support. Read more about living with stomach cancer Symptoms of stomach cancer Many symptoms of stomach cancer are similar to less serious conditions, so it can be difficult to recognise in the early stages. Early stage symptoms include: persistent indigestion trapped wind and frequent burping heartburn feeling full very quickly when eating feeling bloated after eating feeling sick pain in your stomach or breastbone difficulty swallowing (dysphagia) vomiting (the vomit may be streaked with blood), although this is uncommon in the early stages Advanced stomach cancer Symptoms of more advanced stomach cancer


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vomit may be streaked with blood), although this is uncommon in the early stages Advanced stomach cancer Symptoms of more advanced stomach cancer include: blood in your stools, or black stools loss of appetite weight loss tiredness lumpiness and swelling in your stomach (caused by a build-up of fluid) anaemia (a reduced number of red blood cells that can cause you to feel tired and breathless) yellowing of the skin and whites of the eyes (jaundice) When to seek medical help Stomach cancer is usually easier to treat if it’s diagnosed early. It’s therefore important for your GP to refer you to a specialist as soon as possible if stomach cancer is suspected. Stomach cancer is much more common in older people, with 90 out of 100 cases occurring in people who are over 55 years of age. Indigestion is a very common symptom in the general population. However, it’s unlikely that someone with indigestion who’s under the age of 55 will have stomach cancer. However, see your GP if you have


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population. However, it’s unlikely that someone with indigestion who’s under the age of 55 will have stomach cancer. However, see your GP if you have indigestion and weight loss, anaemia or persistent vomiting. They should refer you to a specialist for further testing. Also see your GP if you have difficulty swallowing. This isn’t a common symptom among the general population and the cause should always be investigated. Read more about diagnosing stomach cancer Causes of stomach cancer Stomach cancer is caused by changes in the cells of the stomach, although it’s unclear exactly why these changes occur. Cancer begins with a change (mutation) in the structure of the DNA in cells, which can affect how they grow. This means cells grow and reproduce uncontrollably, producing a lump of tissue called a tumour. Left untreated, cancer can spread to other parts of the body, usually through the lymphatic system (a network of vessels and glands called lymph nodes located throughout the body).


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to other parts of the body, usually through the lymphatic system (a network of vessels and glands called lymph nodes located throughout the body). Once the cancer reaches your lymphatic system, it’s capable of spreading to other parts of your body, including your blood, bones and organs. It’s not known what triggers the changes in DNA that lead to stomach cancer and why only a small number of people develop the condition. Increased risk However, evidence suggests that a number of different factors can affect your chances of developing stomach cancer. Age and gender Your risk of developing stomach cancer increases with age. Most cases occur in people aged 55 or over. For reasons that are unclear, men are twice as likely as women to develop stomach cancer. Smoking People who smoke are about twice as likely to develop stomach cancer compared with non-smokers. This is because you swallow some cigarette smoke when you inhale and it ends up in your stomach. Cigarettes contain harmful


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with non-smokers. This is because you swallow some cigarette smoke when you inhale and it ends up in your stomach. Cigarettes contain harmful chemicals which can damage the cells in your stomach. The more you smoke and the longer you’ve been smoking, the bigger the risk. In the UK, around 1 in every 5 cases of stomach cancer (20%) is thought to be caused by smoking. H. pylori infection Helicobacter pylori (H. pylori) is a common type of bacteria. In most people, these bacteria are harmless, but in some people an H. pylori infection can cause problems such as stomach ulcers, recurring bouts of indigestion or long-term inflammation of the stomach lining (chronic atrophic gastritis). Research has found people with severe chronic atrophic gastritis have an increased risk of developing stomach cancer, although this risk is still small. Diet A diet rich in pickled vegetables, such as pickled onions or piccalilli, salted fish, salt in general and smoked meats, such as pastrami or smoked


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A diet rich in pickled vegetables, such as pickled onions or piccalilli, salted fish, salt in general and smoked meats, such as pastrami or smoked beef, increases your risk of stomach cancer. Countries where this type of diet is popular, such as Japan, tend to have much higher rates of stomach cancer than the UK. A high fibre diet with 5 portions of fruit and vegetables a day will help protect against stomach cancer, and a diet high in fats and processed food and red meat will increase your risk of getting stomach cancer. Family history You’re more likely to develop stomach cancer if you have a close relative with the condition, such as one of your parents or a sibling (brother or sister). In such cases, it may be appropriate for your doctor to arrange genetic counselling. It’s not fully understood why stomach cancer seems to run in families. It may be because of shared risk factors, such as having similar diets or having an H. pylori infection, or because of certain genes you inherit


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It may be because of shared risk factors, such as having similar diets or having an H. pylori infection, or because of certain genes you inherit from your parents. In around 1 in 50 cases of stomach cancer, testing has found that people share a mutation in a gene known as E-cadherin. You may be more at risk of getting the condition if you have the blood type A. Your blood type is passed on from your parents, so this could be another way in which family history may increase your risk of developing stomach cancer. There’s also a condition that runs in families called familial adenomatous polyposis (FAP), which may increase your risk of developing stomach cancer. FAP causes small growths, called polyps, to form in your digestive system, and is known to increase your risk of developing bowel cancer. Having another type of cancer Your risk of developing stomach cancer is increased if you’ve had another type of cancer, such as cancer of the oesophagus or non-Hodgkin lymphoma (cancer that


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of developing stomach cancer is increased if you’ve had another type of cancer, such as cancer of the oesophagus or non-Hodgkin lymphoma (cancer that develops in your white blood cells). For men, the risk of getting stomach cancer is increased after having prostate cancer, bladder cancer, breast cancer or testicular cancer. For women, the risk of developing stomach cancer increases after having ovarian cancer, breast cancer or cervical cancer. Certain medical conditions Having certain medical conditions can also increase your risk of developing stomach cancer, such as pernicious anaemia (a vitamin B12 deficiency, which occurs when your body can’t absorb it properly), and peptic stomach ulcers (an ulcer in your stomach lining, often caused by H. pylori infection). Stomach surgery If you’ve had stomach surgery, or surgery to a part of your body that affects your stomach, you may be more likely to develop stomach cancer. This can include surgery to remove part of your stomach (known as a


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body that affects your stomach, you may be more likely to develop stomach cancer. This can include surgery to remove part of your stomach (known as a partial gastrectomy), surgery to remove part of your vagus nerve (the nerve that carries information from your brain to organs such as your heart, lungs and digestive system), or surgery to repair a stomach ulcer. How stomach cancer spreads There are 3 ways stomach cancer can spread: directly – the cancer can spread from the stomach into nearby tissues and organs, such as the pancreas, colon, small intestine and peritoneum (the lining of the inside of the abdominal cavity) through the lymphatic system – the lymphatic system is a series of glands (nodes) located throughout your body, similar to the blood circulatory system; the glands produce specialised cells needed by your immune system to fight infection through the blood – which can cause the cancer to spread from the stomach to other parts of the body, most commonly the liver Stomach


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fight infection through the blood – which can cause the cancer to spread from the stomach to other parts of the body, most commonly the liver Stomach cancer that spreads to another part of the body is known as metastatic stomach cancer. Diagnosing stomach cancer Speak to your GP as soon as possible if you have stomach cancer symptoms such as indigestion, unexpected weight loss, anaemia and persistent vomiting. Your GP will ask about your symptoms and examine your stomach for any lumpiness or tenderness. If they think that stomach cancer may be a possibility they’ll refer you to a specialist for further investigation. In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of stomach cancer and refer people for the right tests faster. Find out who should be referred for further tests for suspected stomach cancer. Hospital tests If your GP thinks you may have stomach cancer, they’ll refer you to a specialist


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for further tests for suspected stomach cancer. Hospital tests If your GP thinks you may have stomach cancer, they’ll refer you to a specialist for tests. These may include a blood test and chest X-ray, which will assess your overall health. A sample of your stools may also be tested for blood. Because of the potentially serious nature of stomach cancer, you should be referred to the specialist within 2 weeks. Read more about waiting times. Endoscopy and endoscopic ultrasound An endoscopy is a procedure where the inside of your body is examined using a piece of equipment called an endoscope (a long, thin flexible tube with a light and a video camera at the end). If you need to have an endoscopy, you won’t be able to eat or drink for four to eight hours before the procedure. This is to ensure your stomach and duodenum (top of the small intestine) are empty. You’ll be awake during the endoscopy, but may be given a sedative by injection to make you feel drowsy and relaxed. A local


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intestine) are empty. You’ll be awake during the endoscopy, but may be given a sedative by injection to make you feel drowsy and relaxed. A local anaesthetic may also be sprayed onto the back of your throat, so the area is numbed. The endoscope will be passed down your gullet (food pipe) and into your stomach so the specialist can look for any stomach ulcers or signs of cancer. If tissue is found that may be cancerous, a sample will be taken for testing. This procedure is known as a biopsy. The sample will be examined under a microscope in a laboratory. The results will show whether the cells are cancerous (malignant) or non-cancerous (benign) and will usually take 7 to 10 days to come back. The endoscopy itself usually takes about 15 minutes, although you should allow about 2 hours in total for your visit. If your specialist thinks you may have cancer in the top part of your stomach, you may have an ultrasound scan at the same time as an endoscopy. This is known as an endoscopic


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you may have cancer in the top part of your stomach, you may have an ultrasound scan at the same time as an endoscopy. This is known as an endoscopic ultrasound and uses high-frequency sound waves to produce an image of your stomach (this method is commonly used to view an unborn baby in the womb). If you have an endoscopic ultrasound, an ultrasound probe will be attached to the end of the endoscope before it’s passed down your throat. The scan will help determine the stage of any cancer in the top part of your stomach. After an endoscopy, or an endoscopic ultrasound, you won’t be able to drive for several hours because of the sedative. You may also have a sore throat, although this should pass within a few days. Barium meal X-ray A barium meal X-ray or barium swallow involves drinking a chalky liquid containing a substance called barium, which makes your stomach show up on an X-ray. Nowadays, however, it’s less commonly used to diagnose stomach cancers. Organs such as your stomach


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which makes your stomach show up on an X-ray. Nowadays, however, it’s less commonly used to diagnose stomach cancers. Organs such as your stomach don’t usually show up on an X-ray because they’re made of soft tissue that isn’t dense enough to stop the X-rays passing through. However, when these organs are filled with barium, it blocks the X-rays and shows up white on an X-ray screen. You won’t able to eat or drink for at least 6 hours before the procedure because your stomach and duodenum need to be empty. You may be given an injection to relax the muscles in your digestive system. A barium swallow usually takes about 15 minutes. Afterwards, you’ll be able to eat and drink as normal, although you may need to drink more water to help flush the barium out of your system. You may feel slightly sick, and the barium may cause constipation. Your stools may be white for a few days afterwards as the barium passes through your system. Further testing If you’re diagnosed with stomach cancer,


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Your stools may be white for a few days afterwards as the barium passes through your system. Further testing If you’re diagnosed with stomach cancer, further tests may be needed to help determine how far it’s spread and how quickly it’s likely to spread (known as the stage and grade). Your cancer specialist (oncologist) will discuss this with you. However, it may not always be possible to identify the exact stage of your condition until your treatment starts. Laparoscopy Your specialist may need to examine your stomach in more detail to see if the cancer has spread, particularly to the lining of the abdominal cavity (peritoneum). If it has, you may need to have a small operation called a laparoscopy. This procedure is carried out under a general anaesthetic, so you’ll be unconscious during it. During the procedure, a thin viewing tube with a camera at the end (a laparoscope) will be inserted into your stomach through a small incision in the lower part of your tummy. In some cases,


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with a camera at the end (a laparoscope) will be inserted into your stomach through a small incision in the lower part of your tummy. In some cases, your specialist may need to examine more than one area of your stomach and make more than one incision. Computerised tomography or positron emission tomography scans During CT scans or PET scans, a series of X-ray images of your body are taken. A computer is then used to put the images together and create a detailed picture of the inside of your body. These scans will help your doctor assess how advanced your cancer is. It allows them to see whether the cancerous cells have formed tumours anywhere else in the body. The scans can also help your doctors work out which type of treatment will be most effective and appropriate for you. Liver ultrasound scan If your specialist thinks your stomach cancer may have spread to your liver, you may need to have a liver ultrasound. This type of scan uses high-frequency sound waves to produce an image


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cancer may have spread to your liver, you may need to have a liver ultrasound. This type of scan uses high-frequency sound waves to produce an image of your liver. Staging and grading After all of the tests have been completed and your test results are known, it should be possible to tell what stage and grade of stomach cancer you have. Staging is a measurement of how far cancer has spread. There are a number of different ways stomach cancer can be staged. One method uses a numbering system from 1 to 4. The higher the number, the further the cancer has spread. The majority of stomach cancers are at stage 3 or 4 when diagnosed, which means a cure isn’t usually possible. Grading describes how quickly the cancer is likely to spread in the future. There are 3 grades of stomach cancer: low-grade – the cancer tends to grow slowly medium-grade – the cancer grows a bit faster high-grade – the cancer is aggressive and likely to grow quickly Cancer Research UK has more information about the


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– the cancer grows a bit faster high-grade – the cancer is aggressive and likely to grow quickly Cancer Research UK has more information about the staging and grading of stomach cancer. Treating stomach cancer The treatments recommended for stomach cancer will depend on your general health and how far the cancer has spread. Most hospitals use multidisciplinary teams made up of a number of different specialists (see below) who work together to plan and carry out the best treatment, tailored to your circumstances. Feel free to discuss treatment with your care team at any time and ask questions. Your treatment plan The main treatments for stomach cancer are surgery, chemotherapy and radiotherapy. You may have 1 of these treatments or a combination. If surgery is recommended, you may have chemotherapy beforehand. If the tumour is in the upper part of your stomach, including the junction between the oesophagus and stomach, you may also have radiotherapy prior to surgery. Surgery is mainly


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part of your stomach, including the junction between the oesophagus and stomach, you may also have radiotherapy prior to surgery. Surgery is mainly used if stomach cancer is diagnosed at an early stage, whereas chemotherapy and radiotherapy tend to be used when the condition is diagnosed at a later stage. Where possible, the primary aim of treatment is to completely remove the tumour and any other cancerous cells in your body. It’s estimated that a cure is possible in 20 to 30% of stomach cancer cases. If it’s not possible to remove the tumour, your doctors will focus on trying to prevent it from getting any bigger and causing further harm to your body. This may be done using surgery or chemotherapy. In some cases, it’s not possible to eliminate the cancer or slow it down. In this case, your treatment will aim to relieve your symptoms and make you as comfortable as possible, usually with surgery or radiotherapy. A relatively new medication called trastuzumab (see below) can also be


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and make you as comfortable as possible, usually with surgery or radiotherapy. A relatively new medication called trastuzumab (see below) can also be used to treat some types of advanced stomach cancer. Your healthcare team will talk to you about which treatments are most suitable. Surgery If you’re diagnosed with stomach cancer at an early stage, it may be possible for the cancer to be completely removed during surgery. In some cases, it may be possible to pass a thin, flexible tube (endoscope) down your oesophagus (gullet), rather than making incisions in your tummy. This is known as endoscopic surgery, and can be used to remove a sample of the tumour for testing (biopsy). It can also be used to remove the tumour completely if stomach cancer is diagnosed at an early stage. However, if your cancer has spread beyond your stomach, it may not be possible to remove it completely. If this is the case, you may still have surgery to remove any cancer blocking your stomach, to ease your


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may not be possible to remove it completely. If this is the case, you may still have surgery to remove any cancer blocking your stomach, to ease your symptoms. This will depend on whether your symptoms can be controlled and the risks and side effects of undertaking major surgery. Any type of surgery for stomach cancer will involve a large operation and a long recovery time. If you have stomach cancer surgery, you’ll usually need to stay in hospital for around 2 weeks. You’ll also need several weeks at home to recover. Surgery to remove your stomach You may need to have part or all of your stomach removed. Surgery to remove part of your stomach is known as a partial or sub-total gastrectomy, and surgery to remove all of your stomach is known as a total gastrectomy. In some cases, your surgeon may remove part of your oesophagus as well as all of your stomach, using a procedure known as an oesophagogastrectomy. These operations may be carried out using either a large incision in your


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as all of your stomach, using a procedure known as an oesophagogastrectomy. These operations may be carried out using either a large incision in your tummy (open surgery), or a number of smaller incisions through which surgical tools can be passed (laparoscopic or keyhole surgery). Both of these techniques are carried out under general anaesthetic, which means you’ll be unconscious throughout the procedure. During these operations, your surgeon will also remove the lymph nodes (small glands that help fight infection) nearest to the cancer. It’s possible that your stomach cancer may have spread to these lymph nodes, and removing them helps prevent the cancer returning. Partial gastrectomy If your cancer is in the lower part of your stomach, you may have a partial gastrectomy to remove it. After surgery, your stomach will be smaller than it was before the operation. However, the top part of your stomach, where your oesophagus feeds into it, won’t be affected. Total gastrectomy or


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than it was before the operation. However, the top part of your stomach, where your oesophagus feeds into it, won’t be affected. Total gastrectomy or oesophagogastrectomy If your cancer is in the middle or at the top of your stomach, you may need to have a total gastrectomy. If the cancer is close to the end of your oesophagus, where it meets your stomach, you may need to have an oesophagogastrectomy. If you have a total gastrectomy, the end of your gullet will be joined to the top of your jejunum (the top part of your small intestine). If you have an oesophagogastrectomy, the remaining part of your gullet will be joined to your jejunum. Surgery to ease your symptoms If your stomach cancer has spread beyond your stomach, it may not be possible to remove it using surgery. However, if your stomach has been significantly affected by cancer it can cause a blockage, which prevents food from being properly digested. A blocked stomach can cause symptoms such as stomach pain, vomiting and


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it can cause a blockage, which prevents food from being properly digested. A blocked stomach can cause symptoms such as stomach pain, vomiting and feeling very full after eating. If your stomach is blocked, there are a few options: stenting – a stent is a plastic or wire mesh tube inserted through the oesophagus using an endoscope under local anaesthetic; after being inserted, the stent will be expanded and open up the stomach partial or total gastrectomy – to remove the blockage and improve your symptoms bypass surgery – an operation where part of your stomach above the blockage is joined to your small intestine, leaving the blocked part of your stomach out of your digestive system Chemotherapy Chemotherapy is a specialist treatment for cancer that uses medicines, called cytotoxic medicines, to stop cancer cells dividing and multiplying. As it circulates through your body, the medicine can target cancer cells in your stomach and any that may have spread to other parts of your body.


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As it circulates through your body, the medicine can target cancer cells in your stomach and any that may have spread to other parts of your body. You may have chemotherapy for stomach cancer before surgery to reduce the amount of cancer that has to be removed during the operation. Chemotherapy can also be used after surgery to destroy any remaining cancer cells and prevent the cancer from coming back. Chemotherapy can also help to slow the progression of cancer and ease the symptoms of more advanced stomach cancer, which may not be suitable for surgery. If may be given orally (as tablets) or intravenously (by injection or a drip through a vein directly into your bloodstream), or a combination of both. Intravenous chemotherapy is usually given in hospital, while oral chemotherapy is taken at home. Chemotherapy is often given in cycles, each usually lasting about three weeks. Alternatively, chemotherapy may be administered through a small pump, which gives you a constant low dose over


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usually lasting about three weeks. Alternatively, chemotherapy may be administered through a small pump, which gives you a constant low dose over a few weeks or months. The pumps are portable and can be worn at home, which means fewer trips to hospital. Side effects of chemotherapy Chemotherapy works by preventing cancerous cells from growing rapidly. However, it also destroys non-cancerous cells such as hair follicles and red and white blood cells. Side effects may include: tiredness nausea and vomiting nerve damage (peripheral neuropathy) hair loss diarrhoea anaemia (a lack of red blood cells) weight loss skin changes – such as redness, swelling and a tingling sensation in the palms of the hands and/or soles of the feet The side effects you experience after having chemotherapy will depend on the type of chemotherapy and the number of treatment sessions you need. You’ll be told who to contact if you’re experiencing serious side effects from chemotherapy, and it’s very important that


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sessions you need. You’ll be told who to contact if you’re experiencing serious side effects from chemotherapy, and it’s very important that this contact information is recorded carefully. If you experience nausea and vomiting as a result of chemotherapy, you may be able to take anti-sickness medication to counter it. This may be given intravenously (by injection directly into your bloodstream) at the same time as your chemotherapy. The side effects of chemotherapy will only last for as long as your course of treatment lasts. Once your treatment is over, the hair follicles and blood cells will repair themselves. This means your hair will grow back, although it might look or feel different from how it did before chemotherapy (for example, it may be a slightly different colour, or be softer or curlier than before). Radiotherapy Radiotherapy uses beams of high energy radiation to destroy cancer cells. It’s not often used to treat stomach cancer because there’s a risk that other organs


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uses beams of high energy radiation to destroy cancer cells. It’s not often used to treat stomach cancer because there’s a risk that other organs close to your stomach might be damaged by the treatment. However, if you have advanced stomach cancer that’s causing pain or bleeding, you may need to have radiotherapy. In some cases, following surgery, you may have chemotherapy and/or radiotherapy to help prevent the stomach cancer from recurring. If a cancer is bleeding slowly and causing anaemia, a single fraction of radiotherapy can be used to try to prevent further bleeding. If you need radiotherapy, your treatment will usually begin 2 or 3 months after surgery or chemotherapy, to give your body a chance to recover. This is a painless procedure where you lie under a radiotherapy machine while it directs radiation at your stomach. You’ll be positioned by a radiographer (a specialist in radiotherapy) so that the machine targets the cancer cells and avoids as much healthy tissue as


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be positioned by a radiographer (a specialist in radiotherapy) so that the machine targets the cancer cells and avoids as much healthy tissue as possible. Radiotherapy often involves having treatment sessions 5 days a week. Each session will only last a few minutes. The radiation doesn’t stay in your system afterwards, and it’s perfectly safe to be around others between your treatments. How long you’ll need to have radiotherapy for will depend on how it’s used. Radiotherapy used after surgery to help prevent stomach cancer coming back usually lasts 5 weeks. If it’s being used to control symptoms of advanced stomach cancer, it may only last 1 or 2 weeks. Side effects of radiotherapy You may experience the following side effects after having radiotherapy: tiredness nausea diarrhoea irritation and darkening of your skin where the treatment takes place These side effects will usually improve within a few weeks of treatment finishing. Trastuzumab Trastuzumab (sold under the brand name


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takes place These side effects will usually improve within a few weeks of treatment finishing. Trastuzumab Trastuzumab (sold under the brand name Herceptin) is a medication used to treat breast cancer and some cases of advanced stomach cancer. Some stomach cancers are stimulated by a type of protein called human epidermal growth factor receptor 2 (HER2). Trastuzumab works by blocking the effects of this protein. This doesn’t cure stomach cancer, but it can slow its growth and increase survival time. If you’re diagnosed with advanced stomach cancer and tests show high levels of the HER2 protein in the cancerous cells, your doctors may recommend treatment with a combination of chemotherapy and trastuzumab. Trastuzumab is given intravenously, through a drip, and you’ll have the treatment in hospital. Each treatment session takes up to 1 hour and you’ll usually need a session once every 3 weeks. Trastuzumab can cause side effects, including heart problems. Therefore, it may not be


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1 hour and you’ll usually need a session once every 3 weeks. Trastuzumab can cause side effects, including heart problems. Therefore, it may not be suitable if you have a heart problem such as angina, uncontrolled high blood pressure (hypertension) or heart valve disease. If you need to take trastuzumab, you’ll also need regular tests on your heart to check for any problems. Other side effects of trastuzumab may include: an initial allergic reaction to the medication, which can cause nausea, wheezing, chills and fever diarrhoea tiredness aches and pains Living with stomach cancer Being diagnosed with cancer is a tough challenge for most people, but support is available to help you cope. You may find the following advice helpful: keep talking to your friends and family – they can be a powerful support system talk to others in the same situation research your condition set reasonable goals take time out for yourself Cancer charities, such as Macmillan Cancer Support, are a good source


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research your condition set reasonable goals take time out for yourself Cancer charities, such as Macmillan Cancer Support, are a good source of information and support. Recovery Getting back to normal after surgery can take time. It’s important to take things slowly and give yourself time to recover. During your recovery, avoid lifting heavy things such as children or shopping bags, and strenuous tasks such as housework. You may also be advised not to drive. Some other treatments, particularly chemotherapy and radiotherapy, can make you very tired. You may need to take a break from some of your normal activities for a while. Don’t be afraid to ask for practical help from family and friends. Follow-up After your treatment has finished, you’ll be invited for regular check-ups, usually every three months for the first year. During the check-up, your doctor will examine you and may arrange blood tests or scans to see how you’re responding to treatment. Diet after surgery If you’ve had an


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your doctor will examine you and may arrange blood tests or scans to see how you’re responding to treatment. Diet after surgery If you’ve had an operation to remove part of your stomach (partial gastrectomy), you’ll only be able to eat small amounts of food for a while after your operation. This is because your stomach won’t be able to hold as much food as it could before the surgery, and your body will need to adjust to its new stomach capacity. You should gradually be able to increase the amount you eat as your stomach begins to expand. If you’ve had surgery to remove all of your stomach (total gastrectomy), it may be some time before you can eat normally again. As with a partial gastrectomy, you’ll only be able to eat small amounts of food until your body adjusts. You may have to eat little and often, and make changes to the types of food you eat. Your care team will be able to advise you about what and when you should eat. Having surgery to remove your stomach also means you’ll


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food you eat. Your care team will be able to advise you about what and when you should eat. Having surgery to remove your stomach also means you’ll need to have regular injections of vitamin B12. Vitamin B12 is usually absorbed through your stomach from the food you eat and is needed to help prevent a condition called anaemia and nerve problems. Looking after yourself Eat regularly and healthily. You may not have time to sit down for every meal, but you should make time to do so at least once a day. It’s understandable if there are times when you feel resentful, and then guilty for feeling so. You may also feel exhausted, isolated and worry about the person you care for. Remember: you’re human, and those feelings are natural. Dealing with dying If your stomach cancer can’t be cured, your GP will give you support and any necessary pain relief (often alongside chemotherapy or radiotherapy, which can be used to reduce your symptoms). This is called palliative care. Support is also


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relief (often alongside chemotherapy or radiotherapy, which can be used to reduce your symptoms). This is called palliative care. Support is also available for your family and friends. Source: NHS 24 - Opens in new browser window Last updated: 10 December 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Cancer Research UK: Stomach cancer Macmillan Cancer Support: Stomach cancer Scottish Cancer Network: Cancer patient information Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages


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feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/stomach-ulcer/


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https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/streptococcus-a-strep-a/


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Streptococcus A (Strep A) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Infections and poisoning Streptococcus A (strep A) Streptococcus A (strep A) Group A Streptococcus (GAS), also known as Strep A, are bacteria commonly found on the skin or in the throat. Under some circumstances these bacteria can cause disease. GAS infection commonly presents as a mild sore throat (‘strep throat’) and skin/soft tissue infections such as impetigo and cellulitis. Phone 999 or go to A&E if: you or your child is having difficulty breathing (you may notice grunting noises or their tummy sucking under their ribs) there are pauses when you or your child breathes you or your child’s skin, tongue or lips are blue you or your child is floppy and will not wake up or stay awake your child is less than 3 months old and has a temperature of 38°C (101°F) or above and has


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your child is floppy and will not wake up or stay awake your child is less than 3 months old and has a temperature of 38°C (101°F) or above and has not had a vaccination in the past 2 days your child is less than 3 months old and has a temperature of 36°C (97°F) or less and has not had a vaccination in the past 2 days Contact your GP if you or your child: is getting worse is feeding or eating much less than normal is showing signs of dehydration, like sunken eyes, drowsiness has not passed urine for 12 hours is older than 3 months and has a temperature of 39°C or higher feels hotter than usual when you touch their back or chest, or feels sweaty is very tired or irritable If your GP is closed, phone the 111 service. If you feel that you or your child is seriously unwell, trust your own judgement and seek medical assistance. Strep A tests are not available through the NHS in Scotland for self-testing at home. Should you or your child need to be tested for Strep A, your GP or other


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are not available through the NHS in Scotland for self-testing at home. Should you or your child need to be tested for Strep A, your GP or other healthcare professional will advise you. GAS infections GAS bacteria can cause a wide variety of skin, soft tissue and respiratory tract infections ranging in severity from mild to life-threatening. These include: tonsillitis sore throat scarlet fever impetigo erysipelas (a type of cellulitis) cellulitis pneumonia In rare cases, patients may go on to develop post-streptococcal complications, such as: rheumatic fever glomerulonephritis (heart and kidney diseases caused by an immune reaction to the bacteria)​ iGAS infections GAS can very rarely cause more serious conditions, known as invasive group A Streptococcus (iGAS) infections. These can include: bacteraemia (an infection of the bloodstream) septic arthritis meningitis necrotising fasciitis (a severe infection involving death of areas of soft tissue below the skin) Streptococcal toxic


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septic arthritis meningitis necrotising fasciitis (a severe infection involving death of areas of soft tissue below the skin) Streptococcal toxic shock syndrome (rapidly progressive symptoms with low blood pressure and multi-organ failure) iGAS infections tend to happen in the elderly, the very young, or people with an underlying risk factor with groups considered to be at risk of serious GAS infection being: people with existing health conditions such as diabetes, cardiovascular disease, or a weakened immune system people who have recently had flu or chickenpox newborn babies women who are pregnant or have recently given birth people who are homeless or inject drugs Treating GAS infections Most GAS infections are relatively mild illnesses that clear up on their own without the need for antibiotics. Often symptoms that look like GAS infections, like sore throats, are more commonly caused by viruses than GAS bacteria. If you or your child has a runny nose with their sore throat, it’s


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like sore throats, are more commonly caused by viruses than GAS bacteria. If you or your child has a runny nose with their sore throat, it’s likely to be a virus infection. Sore throats caused by viruses do not need to be treated with antibiotics unless there are concerns about complications. More about sore throat symptoms, self-care at home, and what to do if your condition worsens Your healthcare professional will consider antibiotics if they think: you or your child need medication to get better or to ease symptoms you or your child are at risk of serious complications from a GAS infection you or your child has scarlet fever If you or your child is prescribed antibiotics, they could be in liquid or pill form. It’s not uncommon for someone to have GAS bacteria on their skin or in their throat without being unwell. These people often don’t know they have the bacteria and won’t need antibiotics. Preventing GAS infection GAS are spread by close contact between individuals, through


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don’t know they have the bacteria and won’t need antibiotics. Preventing GAS infection GAS are spread by close contact between individuals, through respiratory droplets (moisture in your breath) and direct skin contact. To help reduce the risk of picking up or spreading infections: Do wash your hands properly with soap for 20 secondsuse a disposable tissue to catch coughs and sneezes and wash your hands afterwardskeep away from others if you feel unwell Don’t do not share contaminated food, utensils, cups and glasses, baths, bed linen or towels GAS can be a secondary infection, developing in people who are already unwell with illnesses like the flu. You can help protect your child from this risk by making sure they get their free flu vaccine this winter. New evidence also shows that the nasal spray flu vaccine offered to children may also protect them from GAS infection. Source: NHS 24 - Opens in new browser window Last updated: 01 May 2025 How can we improve this page? Help us


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also protect them from GAS infection. Source: NHS 24 - Opens in new browser window Last updated: 01 May 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Self-help guide: Sore throat Self-help guide: Fever in adults Self-help guide: Fever in babies Fever in adults Fever in children Other health sites Group A strep in Scotland NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/arm-shoulder-and-hand-problems-and-conditions/subacromial-pain-syndrome/


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Subacromial pain syndrome | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Arm, shoulder and hand problems and conditions Subacromial pain syndrome Subacromial pain syndrome This information is useful for those who have been diagnosed with subacromial pain syndrome. People who are experiencing new or ongoing symptoms should contact their healthcare professional. Read more about self-managing a shoulder problem What is subacromial pain syndrome? Subacromial pain syndrome is a general term used to describe pain which originates from the shoulder and can spread towards the neck or down the arm. It’s the most common reason for shoulder pain. The shoulder joint is the most mobile joint in the body. It’s a ball and socket joint which enables a very wide range of movement supported by the rotator cuff muscles and tendons. Often,


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joint in the body. It’s a ball and socket joint which enables a very wide range of movement supported by the rotator cuff muscles and tendons. Often, with this condition, these tendons can be weakened. Subacromial pain syndrome can develop due to: age related changes repetitive strain injury or trauma However, this condition can sometimes appear without any apparent reason. Other factors that can affect tendon health include: smoking obesity high fat diet high cholesterol levels diabetes (Type 1 and 2) Symptoms of subacromial pain syndrome? The main symptom is pain in the upper arm caused by specific movements or activities. These are usually activities that involve lifting the arm above shoulder level and reaching behind the back, for example when putting a jacket on. It may be difficult to lie on the affected shoulder which can disturb your sleep. Diagnosis In order for subacromial pain syndrome to be diagnosed you’ll need an assessment from a healthcare professional. They’ll


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your sleep. Diagnosis In order for subacromial pain syndrome to be diagnosed you’ll need an assessment from a healthcare professional. They’ll initially ask you questions about your shoulder issue and then carry out a physical examination. This may include checking your range of movement and strength. You may sometimes need to have a further examination to rule out other possible health conditions. Treatment Treatment options depend on the severity of your symptoms. Although, most cases improve on their own, some cases can take time to resolve. Your arm may feel really painful but it’s important to keep moving your shoulder. To help manage your pain, break activities you normally do down into smaller amounts. These should be short term measures to help your pain. As soon as you’re able, try to get back to your normal activities, as this is the best way to help your recovery. Exercise Targeted shoulder exercises to encourage movement, stretching and strengthening exercises can help to


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is the best way to help your recovery. Exercise Targeted shoulder exercises to encourage movement, stretching and strengthening exercises can help to improve your arm movement and pain. Read about exercises for shoulder problems Pain treatments Pain medication can help you move more comfortably, which can help your recovery. More about taking painkillers Corticosteroid Injections If painkillers aren’t helping to control the pain, your healthcare professional may discuss the option of having a corticosteroid injection into your shoulder joint. Corticosteroids are medicines that help reduce pain and inflammation. They may also be given with a local anaesthetic. Injections won’t cure your condition or reduce shoulder stiffness, they are used to help with the pain. Read more about corticosteroids Work A shoulder problem can sometimes mean you need to take some time off work to help recovery. How long you’re off will depend on the nature of your condition and your role at work. You do not


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need to take some time off work to help recovery. How long you’re off will depend on the nature of your condition and your role at work. You do not need to be symptom free before you consider returning to work. Continuing to go to work, or returning to work as soon as is possible for you, will help your recovery. Gradually getting back to your normal daily activities can help to build up your strength and stamina levels. Help and support Following this advice, you should see gradual improvements over time. If your symptoms haven’t improved, or it’s got worse, within 6 weeks of following this advice, talk to a healthcare professional about your symptoms. Find out how to access MSK services in your area When dealing with any health condition it’s important to also look after your mental wellbeing as this can impact your recovery. Source: MSK Expert Panel - Opens in new browser window Last updated: 06 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your


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MSK Expert Panel - Opens in new browser window Last updated: 06 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Shoulder problems NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cardiovascular-disease/heart-disease/supraventricular-tachycardia/


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Swollen glands | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Glands Swollen glands Swollen glands Swollen lymph glands are usually a sign of infection. Swollen lymph glands that are caused by an infection usually get better by themselves in 1 to 2 weeks. Sometimes swollen lymph glands can have a more serious cause and may need to be seen by a doctor. Phone 111 or ask for an urgent GP appointment if: You have swollen glands and you: are finding it very difficult to swallow have difficulty breathing Speak to your GP practice if: You have swollen glands and: they’re getting bigger they’ve not gone down within 1 week they feel hard or do not move when you press them you’re having night sweats or have a very high temperature (you feel hot and shivery) you have no other signs of illness or infection you have swollen lymph glands just above or below


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a very high temperature (you feel hot and shivery) you have no other signs of illness or infection you have swollen lymph glands just above or below your collar bone (the bone that runs from your breastbone to each of your shoulders) What are the lymph glands? The lymph glands (or lymph nodes) are small lumps of tissue that contain white blood cells. These help to fight bacteria, viruses and anything else that causes infection. They’re an important part of the immune system and are found throughout the body. What swollen lymph glands feel like The lymph glands can swell to more than a few centimetres in response to infection or disease. Swollen glands feel like tender, painful lumps. You may feel them: on each side of the neck under the chin in the armpits around the groin Common causes of swollen glands Swollen glands are usually caused by a viral or bacterial infection like: a cold tonsillitis glandular fever a throat infection an ear infection a dental abscess cellulitis (a skin


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by a viral or bacterial infection like: a cold tonsillitis glandular fever a throat infection an ear infection a dental abscess cellulitis (a skin infection) The glands in the affected area will often become suddenly tender or painful. You may also have other symptoms like a sore throat, cough, or fever. These infections usually clear up on their own and the swollen glands will soon go down. Swollen lymph glands are rarely caused by anything more serious. Managing swollen glands at home When an infection causes swollen glands you can help to ease symptoms at home. Do drink plenty of fluids rest use over-the-counter medicines like paracetamol or ibuprofen Source: NHS 24 - Opens in new browser window Last updated: 20 February 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters


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personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


key: source
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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/arm-shoulder-and-hand-problems-and-conditions/tennis-elbow/


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/testicular-cancer/


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Testicular cancer | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Testicular cancer Testicular cancer About testicular cancer Symptoms of testicular cancer Diagnosing testicular cancer Treating testicular cancer Causes of testicular cancer About testicular cancer Cancer of the testicle is one of the less common cancers. It tends to mostly affect men and anyone with testicles between 15 and 49 years of age. The most common symptom is a painless lump or swelling in one of the testicles. It can be the size of a pea or it may be much larger. Other symptoms can include: a dull ache in the scrotum a feeling of heaviness in the scrotum It’s important to be aware of what feels normal for you. Get to know your body and speak to your GP if you notice any changes. Read more about the symptoms of testicular cancer and diagnosing


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for you. Get to know your body and speak to your GP if you notice any changes. Read more about the symptoms of testicular cancer and diagnosing testicular cancer. The testicles The testicles are the 2 oval-shaped male sex organs that sit inside the scrotum on either side of the penis. The testicles are an important part of the male reproductive system because they produce sperm and the hormone testosterone, which plays a major role in male sexual development. Types of testicular cancer The different types of testicular cancer are classified by the type of cells the cancer begins in. The most common type of testicular cancer is ‘germ cell testicular cancer’, which accounts for around 95% of all cases. Germ cells are a type of cell that the body uses to create sperm. There are 2 main subtypes of germ cell testicular cancer. They are: seminomas – which have become more common in the last 20 years and now account for 50 to 55% of testicular cancers non-seminomas – which account for most


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– which have become more common in the last 20 years and now account for 50 to 55% of testicular cancers non-seminomas – which account for most of the rest and include teratomas, embryonal carcinomas, choriocarcinomas and yolk sac tumours Both types tend to respond well to chemotherapy. Less common types of testicular cancer include: Leydig cell tumours – which account for around 1 to 3% of cases Sertoli cell tumours – which account for around 1% of cases lymphoma – which accounts for around 4% of cases This topic focuses on germ cell testicular cancer. You can contact the Macmillan Support Line for more information about Leydig cell tumour and Sertoli cell tumours. Their helpline number is 0808 808 00 00 and it’s open Monday to Friday, 8am to 8pm. Read more about Hodgkin lymphoma and non-Hodgkin lymphoma. How common is testicular cancer? Testicular cancer is a relatively rare type of cancer. Testicular cancer is unusual compared to other cancers because it tends to affect younger men


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Testicular cancer is a relatively rare type of cancer. Testicular cancer is unusual compared to other cancers because it tends to affect younger men and anyone with testicles. Although it’s relatively uncommon overall, testicular cancer is the most common type of cancer to affect men and anyone with testicles between the ages of 15 and 49. For reasons that are unclear, white men and anyone with testicles have a higher risk of developing testicular cancer compared with other ethnic groups. The number of cases of testicular cancer that are diagnosed each year in the UK has roughly doubled since the mid-1970s. Again, the reasons for this are unclear. Causes of testicular cancer The exact cause or causes of testicular cancer are unknown, but a number of factors have been identified that increase a man’s risk of developing it. The 3 main risk factors are described below. Undescended testicles Undescended testicles (cryptorchidism) is the most significant risk factor for testicular cancer.


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factors are described below. Undescended testicles Undescended testicles (cryptorchidism) is the most significant risk factor for testicular cancer. About 3 to 5% of boys are born with their testicles inside their abdomen. They usually descend into the scrotum during the first year of life, but in some boys the testicles don’t descend. In most cases, testicles that don’t descend by the time a boy is 1 year old descend at a later stage. If the testicles don’t descend naturally, an operation known as an orchidopexy can be carried out to move the testicles into the correct position inside the scrotum. It’s important that undescended testicles move down into the scrotum during early childhood because boys with undescended testicles have a higher risk of developing testicular cancer than boys whose testicles descend normally. It’s also much easier to observe the testicles when they’re in the scrotum. People with undescended testicles are about 3 times more likely to develop testicular


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easier to observe the testicles when they’re in the scrotum. People with undescended testicles are about 3 times more likely to develop testicular cancer than those whose testicles descend at birth or shortly after. Family history Having a close relative with a history of testicular cancer or an undescended testicle increases your risk of also developing it. For example, if your father had testicular cancer, you’re around 4 times more likely to develop it than someone with no family history of the condition. If your brother had testicular cancer, you’re about 8 times more likely to develop it. A number of genes may be involved in the development of testicular cancer in families where more than 1 person has had the condition. This is an ongoing area of research in which patients and their families may be asked to take part. Previous testicular cancer People who’ve previously been diagnosed with testicular cancer are between 4 to 12 times more likely to develop it in the other testicle.


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cancer People who’ve previously been diagnosed with testicular cancer are between 4 to 12 times more likely to develop it in the other testicle. For this reason, if you’ve previously been diagnosed with testicular cancer, it’s very important that you keep a close eye on the other testicle. If you’ve been diagnosed with testicular cancer, you also need to be observed for signs of recurrence for between 5 and 10 years, so it’s very important that you attend your follow-up appointments. Cancer Research UK has more information about testicular cancer risks and causes. Outlook Testicular cancer is one of the most treatable types of cancer, and the outlook is one of the best for cancers. Almost all men and anyone with testicles who are treated for testicular germ cell tumours are cured, and it’s rare for the condition to return more than 5 years later. Treatment almost always includes the surgical removal of the affected testicle – called orchidectomy or orchiectomy – which doesn’t usually


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later. Treatment almost always includes the surgical removal of the affected testicle – called orchidectomy or orchiectomy – which doesn’t usually affect fertility or the ability to have sex. In some cases, chemotherapy or, less commonly, radiotherapy may be used for seminomas (but not non-seminomas). Read more about treating testicular cancer. Symptoms of testicular cancer The most common symptom of testicular cancer is a lump or swelling in 1 of your testicles. The lump or swelling can be about the size of a pea, but may be larger. Most lumps or swellings in the scrotum aren’t in the testicle and aren’t a sign of cancer. But they should never be ignored. Visit your GP as soon as you notice a lump or swelling in your scrotum. Associated symptoms Testicular cancer can also cause other symptoms, including a: dull ache or sharp pain in your testicles or scrotum, which may come and go feeling of heaviness in your scrotum change in the texture or increase in firmness of a testicle


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in your testicles or scrotum, which may come and go feeling of heaviness in your scrotum change in the texture or increase in firmness of a testicle difference between one testicle and the other When to speak to your GP Speak to your GP as soon as you notice any lump or swelling on your testicle. They’ll examine your testicles to help determine whether or not the lump is cancerous. Lumps within the scrotum can have many different causes and testicular cancer is rare. If your GP thinks the lump is in your testicle they may consider cancer as a possible cause. Research has shown that less than 4% of scrotal lumps or swellings are cancerous. For example, varicoceles (swollen blood vessels) and epididymal cysts (cysts in the tubes around the testicle) are common causes of testicular lumps. If you do have testicular cancer, the sooner treatment begins, the greater the likelihood that you’ll be completely cured. If you don’t feel comfortable visiting your GP, you can go to your local sexual


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begins, the greater the likelihood that you’ll be completely cured. If you don’t feel comfortable visiting your GP, you can go to your local sexual health clinic, where a healthcare professional will be able to examine you. Metastatic cancer If testicular cancer has spread to other parts of your body, you may also experience other symptoms. Cancer that has spread to other parts of the body is known as metastatic cancer. Around 5% of people with testicular cancer will experience symptoms of metastatic cancer. The most common place for testicular cancer to spread to is nearby lymph nodes in your abdomen or lungs. Lymph nodes are glands that make up your immune system. Less commonly, the cancer can spread to your liver, brain or bones. Symptoms of metastatic testicular cancer can include: a persistent cough coughing or spitting up blood shortness of breath swelling and enlargement of male breasts a lump or swelling in your neck lower back pain Diagnosing testicular cancer Speak to your


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of breath swelling and enlargement of male breasts a lump or swelling in your neck lower back pain Diagnosing testicular cancer Speak to your GP as soon as possible if you notice a lump or other abnormality in your scrotum that you think may be on one of your testicles. Most scrotal lumps aren’t cancerous, but if you have a lump that you think may be in one of your testicles it’s important you have it checked as soon as possible. Treatment for testicular cancer is much more effective when started early. Physical examination As well as asking you about your symptoms and looking at your medical history, your GP will usually need to examine your testicles. They may hold a small light or torch against your scrotum to see whether light passes through it. Testicular lumps tend to be solid, which means light is unable to pass through them. A collection of fluid in the scrotum will allow light to pass through it. Tests for testicular cancer If you have a non-painful lump, or a change in shape


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of fluid in the scrotum will allow light to pass through it. Tests for testicular cancer If you have a non-painful lump, or a change in shape or texture of one of your testicles, and your GP thinks it may be cancerous, you’ll be referred for further testing within 2 weeks. Scrotal ultrasound A scrotal ultrasound scan is a painless procedure that uses high-frequency sound waves to produce an image of the inside of your testicle. It’s one of the main ways of finding out whether or not a lump is cancerous (malignant) or non-cancerous (benign). During a scrotal ultrasound, your specialist will be able to determine the position and size of the abnormality in your testicle. It will also give a clear indication of whether the lump is in the testicle or separate within the scrotum, and whether it’s solid or filled with fluid. A fluid-filled lump or collection around the testis is usually harmless. A more solid lump may be a sign the swelling is cancerous. Blood tests To help confirm a


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lump or collection around the testis is usually harmless. A more solid lump may be a sign the swelling is cancerous. Blood tests To help confirm a diagnosis, you may need a series of blood tests to detect certain hormones in your blood, known as ‘markers’. Testicular cancer often produces these markers, so if they’re in your blood it may indicate you have the condition. Markers in your blood that will be tested for include: AFP (alpha feta protein) HCG (human chorionic gonadotrophin) A third blood test is also often carried out as it may indicate how active a cancer is. It’s called LDH (lactate dehydrogenate), but it isn’t a specific marker for testicular cancer. Not all people with testicular cancer produce markers. There may still be a chance you have testicular cancer even if your blood test results come back normal. Histology The only way to definitively confirm testicular cancer is to examine part of the lump under a microscope. These tests and reports are called histology.


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only way to definitively confirm testicular cancer is to examine part of the lump under a microscope. These tests and reports are called histology. Unlike many cancers where a small piece of the cancer can be removed (a biopsy), in most cases the only way to examine a testicular lump is by removing the affected testicle completely. This is because the combination of the ultrasound and blood marker tests is usually sufficient to make a firm diagnosis. Also, a biopsy may injure the testicle and spread cancer into the scrotum which isn’t usually affected. Your specialist will only recommend removing your testicle if they’re relatively certain the lump is cancerous. Losing a testicle won’t affect your sex life or ability to have children. The removal of a testicle is called an orchidectomy. It’s the main type of treatment for testicular cancer, so if you have testicular cancer it’s likely you’ll need to have an orchidectomy. Other tests In almost all cases, you’ll need further tests to


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so if you have testicular cancer it’s likely you’ll need to have an orchidectomy. Other tests In almost all cases, you’ll need further tests to check whether testicular cancer has spread. When cancer of the testicle spreads, it most commonly affects the lymph nodes in the back of the abdomen or the lungs. Therefore, you may require a chest X-ray to check for signs of a tumour. You’ll also need a scan of your entire body. This is usually a CT scan (computerised X-ray) to check for signs of the cancer spreading. In some cases, a different type of scan, known as a magnetic resonance imaging (MRI) scan may be used. Stages of testicular cancer After all tests have been completed, it’s usually possible to determine the stage of your cancer. There are 2 ways that testicular cancer can be staged. The first is known as the TNM staging system: T – indicates the size of the tumour N – indicates whether the cancer has spread to nearby lymph nodes M – indicates whether the cancer has spread to


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T – indicates the size of the tumour N – indicates whether the cancer has spread to nearby lymph nodes M – indicates whether the cancer has spread to other parts of the body (metastasis) Testicular cancer is also staged numerically. The 4 main stages are: stage 1 – the cancer is contained within your testicle and epididymis (the tube at the back of the testicle) stage 2 – the cancer has spread from the testicles into the lymph nodes (small glands that help fight infection) at the back of the abdomen stage 3 – the cancer has spread to the lymph nodes in the middle of the chest or in the neck stage 4 – the cancer has spread to the lungs or, rarely, to other tissues or organs, such as the liver, bones or brain Cancer Research UK has more information about testicular cancer stages. Treating testicular cancer Chemotherapy, radiotherapy and surgery are the 3 main treatments for testicular cancer. Your recommended treatment plan will depend on: the type of testicular cancer you have –


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and surgery are the 3 main treatments for testicular cancer. Your recommended treatment plan will depend on: the type of testicular cancer you have – whether it’s a seminoma or a non-seminoma the stage of your testicular cancer The first treatment option for all cases of testicular cancer, whatever the stage, is to surgically remove the affected testicle (an orchidectomy). For stage 1 seminomas, after the testicle has been removed, a single dose of chemotherapy may be given to help prevent the cancer returning. A short course of radiotherapy is also sometimes recommended. However, in many cases, the chance of recurrence is low and your doctors may recommend that you’re very carefully monitored over the next few years. Further treatment is usually only needed for the small number of people who have a recurrence. For stage 1 non-seminomas, close follow-up (called surveillance) may also be recommended, or a short course of chemotherapy using a combination of different medications. For


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close follow-up (called surveillance) may also be recommended, or a short course of chemotherapy using a combination of different medications. For stage 2, 3 and 4 testicular cancers, 3 to 4 cycles of chemotherapy are given using a combination of different medications. Further surgery is sometimes needed after chemotherapy to remove any affected lymph nodes or deposits in the lungs or, rarely, in the liver. Some people with stage 2 seminomas may be suitable for less intense treatment with radiotherapy, sometimes with the addition of a simpler form of chemotherapy. In non-seminoma germ cell tumours, additional surgery may also be required after chemotherapy to remove tumours from other parts of the body, depending on the extent of the spread of the tumour. Deciding what treatment is best for you can be difficult. Your cancer team will make recommendations, but the final decision will be yours. Before discussing your treatment options with your specialist, you may find it useful to


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make recommendations, but the final decision will be yours. Before discussing your treatment options with your specialist, you may find it useful to write a list of questions to ask them. For example, you may want to find out the advantages and disadvantages of particular treatments. Orchidectomy An orchidectomy is a surgical procedure to remove a testicle. If you have testicular cancer, the whole of the affected testicle will need to be removed because only removing the tumour may lead to the cancer spreading. By removing the entire testicle, your chances of making a full recovery are greatly improved. Your sex life and ability to father children won’t be affected. About 1 in 50 people will get a second new testicular cancer in their remaining testicle. In such circumstances, it’s sometimes possible to only remove the part of the testicle containing the tumour. You should ask your surgeon about this if you’re in this position. If testicular cancer is detected in its very early


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testicle containing the tumour. You should ask your surgeon about this if you’re in this position. If testicular cancer is detected in its very early stages, an orchidectomy may be the only treatment you require. An orchidectomy isn’t carried out through the scrotum. It’s done by making an incision in your groin through which the testicle is removed with all of the tubes and blood vessels attached to the testicle that pass through the groin into the abdomen. The operation is carried out under general anaesthetic. You can have an artificial (prosthetic) testicle inserted into your scrotum so that the appearance of your testicles isn’t greatly affected. The artificial testicle is usually made of silicone (a soft type of plastic). It probably won’t be exactly like your old testicle or the one you still have. It may be slightly different in size or texture. After an orchidectomy, it’s often possible to be discharged quickly, although you may need to stay in hospital for a few days. If


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in size or texture. After an orchidectomy, it’s often possible to be discharged quickly, although you may need to stay in hospital for a few days. If only 1 testicle is removed, there shouldn’t be any lasting side effects. If both testicles are removed (a bi-lateral orchidectomy), you’ll be infertile. However, removing both testicles at the same time is very rarely required, and only 1 in every 50 cases require the other testicle to be removed at a later date. You may be able to bank your sperm before having a bi-lateral orchidectomy to allow you to father children if you decide to. Sperm banking Most people are still fertile after having 1 testicle removed. However, some treatments for testicular cancer can cause infertility. Some people with testicular cancer may have low sperm counts because of changes that occur in the testicles before the cancer develops. For some treatments, such as chemotherapy, infertility may occur, but standard chemotherapies have a less than 50% chance of


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the cancer develops. For some treatments, such as chemotherapy, infertility may occur, but standard chemotherapies have a less than 50% chance of causing infertility if the remaining testicle is normal. In people who need to have post-chemotherapy removal of lumps at the back of the abdomen, known as retroperitoneal lymph node dissection (RPLND), the ability to ejaculate (eject sperm from the penis) may be affected, even though the remaining testicle can still produce sperm. Before your treatment begins, you may want to consider sperm banking. This is where a sample of your sperm is frozen so that it can be used at a later date to impregnate your partner during artificial insemination. Before sperm banking, you may be asked to have tests for HIV, hepatitis B and hepatitis C. If you’re having complex chemotherapy for stage 2 to 4 testicular cancer, you should always be offered sperm banking. Ask if you’re concerned about your fertility. Not all men are suitable for sperm banking. For


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cancer, you should always be offered sperm banking. Ask if you’re concerned about your fertility. Not all men are suitable for sperm banking. For the technique to work, the sperm has to be of a reasonably high quality. There may also be situations where it’s considered too dangerous to delay treatment for sperm banking to take place. Most NHS cancer treatment centres offer a free sperm banking service. However, it’s up to each area of the country to decide whether they store sperm for free or whether you have to pay. Cancer Research UK has more information about sperm banking, including the cost of sperm storage. Testosterone replacement therapy If you still have a remaining testicle, in most cases (90%) your body will make enough testosterone so you won’t notice any difference. If there are any problems with your remaining testicle, you may experience symptoms due to a lack of testosterone. These symptoms can be caused for other reasons but can include: tiredness weight gain loss of


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may experience symptoms due to a lack of testosterone. These symptoms can be caused for other reasons but can include: tiredness weight gain loss of libido (sex drive) reduced beard growth reduced ability to achieve or maintain an erection (erectile dysfunction) Having both testicles removed will definitely stop you producing testosterone and you’ll develop the above symptoms. Testosterone replacement therapy is where you’re given testosterone in the form of an injection, skin patch or gel to rub into your skin. If you have injections, you’ll usually need to have them every 2 to 3 months. After having testosterone replacement therapy, you’ll be able to maintain an erection and your sex drive will improve. Side effects associated with this type of treatment are uncommon, and any side effects that you do experience will usually be mild. They may include: oily skin, which can sometimes trigger the onset of acne breast enlargement and swelling a change in normal urinary patterns, such as


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may include: oily skin, which can sometimes trigger the onset of acne breast enlargement and swelling a change in normal urinary patterns, such as needing to urinate more frequently or having problems passing urine (caused by an enlarged prostate gland that puts pressure on your bladder) There are also concerns that testosterone replacement may increase the risk of prostate cancer and you should discuss this with your doctor. However, the risks from having testosterone replacement are usually much lower than the benefits of receiving it. Lymph node and lung surgery More advanced cases of testicular cancer may spread to your lymph nodes. Lymph nodes are part of your body’s immune system, which helps protect against illness and infection. Lymph node surgery is carried out under general anaesthetic. The lymph nodes in your abdomen are the nodes most likely to need removing. In some cases, the nerves near the lymph nodes can become damaged, which means that rather than ejaculating semen


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nodes most likely to need removing. In some cases, the nerves near the lymph nodes can become damaged, which means that rather than ejaculating semen out of your penis during sex or masturbation, the semen instead travels back into your bladder. This is known as retrograde ejaculation. If you have retrograde ejaculation, you’ll still experience the sensation of having an orgasm during ejaculation, but you won’t be able to father a child. There are a number of ways of treating retrograde ejaculation, including the use of medicines that strengthen the muscles around the neck of the bladder to prevent the flow of semen into the bladder. Men and anyone with testicles who wants to have children can have sperm taken from their urine for use in artificial insemination or in-vitro fertilisation (IVF). There are also a number of newer surgical techniques that carry a lower risk of retrograde ejaculation and infertility. Some people with testicular cancer have deposits of cancer in their lungs


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that carry a lower risk of retrograde ejaculation and infertility. Some people with testicular cancer have deposits of cancer in their lungs and these may also need to be removed after chemotherapy if they haven’t disappeared or reduced sufficiently in size. This type of surgery is also carried out under general anaesthetic and doesn’t usually significantly affect breathing in the long-term. Nerve-sparing retroperitoneal lymph node dissection A newer type of lymph node surgery, called nerve sparing retroperitoneal lymph node dissection (RPLND), is increasingly being used because it carries a lower risk of causing retrograde ejaculation and infertility. In nerve-sparing RPLND, the site of the operation is limited to a much smaller area. This means there’s less chance of nerve damage occurring. The disadvantage is that the surgery is more technically demanding. Therefore, nerve-sparing RPLND is currently only available at specialist centres that employ surgeons with the required


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more technically demanding. Therefore, nerve-sparing RPLND is currently only available at specialist centres that employ surgeons with the required training. Laparoscopic retroperitoneal lymph node dissection Laparoscopic retroperitoneal lymph node dissection (LRPLND) is a type of ‘keyhole’ surgery that can be used to remove the lymph nodes. During LRPLND, the surgeon will make a number of small incisions in your abdomen. An instrument called an endoscope is inserted into one of the incisions. An endoscope is a thin, long, flexible tube with a light and a camera at one end, enabling images of the inside of your body to be relayed to an external television monitor. Small, surgical instruments are passed down the endoscope and can be used to remove the affected lymph nodes. The advantage of LRPLND is that there’s less post-operative pain and a quicker recovery time. Also, as with nerve-sparing RPLND, in LRPLND there’s a smaller chance that nerve damage will lead to retrograde


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pain and a quicker recovery time. Also, as with nerve-sparing RPLND, in LRPLND there’s a smaller chance that nerve damage will lead to retrograde ejaculation. However, as LRPLND is a new technique, there’s little available evidence regarding the procedure’s long-term safety and effectiveness. If you’re considering LRPLND, you should understand there are still uncertainties about the safety and effectiveness of the procedure. Radiotherapy Radiotherapy uses high-energy beams of radiation to help destroy cancer cells. Sometimes, seminomas may require radiotherapy after surgery to help prevent the cancer returning. It may also be needed in advanced cases where someone is unable to tolerate the complex chemotherapies that are usually used to treat stage 2, 3 and 4 testicular cancer. If testicular cancer has spread to your lymph nodes, you may require radiotherapy after a course of chemotherapy. Side effects of radiotherapy can include: reddening and soreness of the skin, which is similar


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require radiotherapy after a course of chemotherapy. Side effects of radiotherapy can include: reddening and soreness of the skin, which is similar to sunburn nausea diarrhoea fatigue These side effects are usually only temporary and should improve when your treatment is completed. Chemotherapy Chemotherapy uses powerful medicines to kill the malignant (cancerous) cells in your body or stop them multiplying. You may require chemotherapy if you have advanced testicular cancer or it’s spread within your body. It’s also used to help prevent the cancer returning. Chemotherapy is commonly used to treat seminomas and non-seminoma tumours. Chemotherapy medicines for testicular cancer are usually injected into a vein. In some cases, a special tube called a central line is used, which stays in a vein throughout your treatment so that you don’t have to keep having blood tests or needles placed in a new vein. Sometimes, chemotherapy medicines can attack your body’s normal, healthy cells. This is


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to keep having blood tests or needles placed in a new vein. Sometimes, chemotherapy medicines can attack your body’s normal, healthy cells. This is why chemotherapy can have many different side effects. The most common include: vomiting hair loss nausea sore mouth and mouth ulcers loss of appetite fatigue breathlessness and lung damage infertility ringing in your ears (tinnitus) skin that bleeds or bruises easily low blood counts increased vulnerability to infection numbness and tingling (pins and needles) in your hands and feet kidney damage These side effects are usually only temporary and should improve after you’ve completed your treatment. Side effects, such as infections that occur when you have a low blood count, can be life-threatening, and it’s essential that you always call your cancer care team if you’re worried between chemotherapy treatments. Bleomycin One of the medicines commonly used, called bleomycin, can cause long-term lung damage and you should discuss this with


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treatments. Bleomycin One of the medicines commonly used, called bleomycin, can cause long-term lung damage and you should discuss this with your doctors if damage to your lungs would have specific issues for your career or lifestyle. However, the advice may still be that you should receive it for the best chance of a cure. Having children You shouldn’t father children while having chemotherapy and for a year after your treatment has finished. This is because chemotherapy medications can temporarily damage your sperm, increasing your risk of fathering a baby with serious birth defects. Therefore, you’ll need to use a reliable method of contraception, such as a condom, during this time. Condoms should also be used during the first 48 hours after having a course of chemotherapy. This is to protect your partner from any potentially harmful effects of the chemotherapy medication in your sperm. Read more about the side effects of chemotherapy. Follow-up Even if your cancer has been


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effects of the chemotherapy medication in your sperm. Read more about the side effects of chemotherapy. Follow-up Even if your cancer has been completely cured, there’s a risk it will return. The risk of your cancer returning will depend on what stage it was at when you were diagnosed and what treatment you’ve had since. Most recurrences of non-seminoma testicular cancer occur within 2 years of surgery or completion of chemotherapy. In seminomas, recurrences still occur until 3 years. Recurrences after 3 years are rare, occurring in less than 5% of people. Because of the risk of recurrence, you’ll need regular tests to check if the cancer has returned. These include: a physical examination blood tests to check for tumour markers a chest X-ray a computerised tomography (CT) scan Follow-up and testing is usually recommended depending on the extent of the cancer and the treatment offered. This is usually more frequent in the first year or two but follow-up appointments may last for up to


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extent of the cancer and the treatment offered. This is usually more frequent in the first year or two but follow-up appointments may last for up to 5 years. In certain cases, it may be necessary to continue follow-up appointments for 10 years or longer. If the cancer returns following treatment for stage 1 testicular cancer, and it’s diagnosed at an early stage, it will usually be possible to cure it using chemotherapy and possibly also radiotherapy. Some types of recurring testicular cancer have a cure rate of over 95%. Recurrences that occur after previous combination chemotherapy can also be cured, but the chances of this will vary between individuals and you’ll need to ask your doctors to discuss this with you. Cancer Research UK has more information about follow-up for testicular cancer. Causes of testicular cancer The causes of testicular cancer are not fully understood. However, several things that increase your risk of developing the condition. Undescended testicles


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of testicular cancer are not fully understood. However, several things that increase your risk of developing the condition. Undescended testicles Undescended testicles is the most significant risk factor. When male babies grow in the womb, their testicles develop inside their abdomen. The testicles then normally move down into the scrotum when the baby is born or during their first year of life. However, for some children, the testicles fail to descend. The medical name for undescended testicles is cryptorchidism. Surgery is usually required to move the testicles down. If you have had surgery to move your testicles down into your scrotum, your risk of developing testicular cancer may be increased. Of surgery is performed before the child is 13 years of age, their risk of later developing testicular cancer is approximately double that of the rest of the population. However, if the operation is carried out after the boy is 13 years of age, the risk of developing testicular cancer is 5


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the rest of the population. However, if the operation is carried out after the boy is 13 years of age, the risk of developing testicular cancer is 5 times greater than that of the rest of the population. Previous testicular cancer Men and anyone with testicles who has previously been diagnosed with testicular cancer are 12 times more likely to develop testicular cancer in the other testicle. For this reason, it’s important to attend follow-up appointments if you have previously been diagnosed with testicular cancer. Age and race Unlike most other types of cancer, testicular cancer is more common in young and middle-aged men and anyone with testicles. Men and anyone with testicles aged 30 to 34 are most likely to be diagnosed with testicular cancer. Testicular cancer is more common in white men and anyone with testicles than other ethnic groups. It’s also more common in Northern and Western Europe compared with other parts of the world. Family history Having a close relative with a


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groups. It’s also more common in Northern and Western Europe compared with other parts of the world. Family history Having a close relative with a history of testicular cancer increases your risk of developing it. If your father had testicular cancer, you are 4 to 6 times more likely to develop it than a person with no family history of the condition. If your brother had testicular cancer, you are 8 to 10 times more likely to develop it (having an identical twin with testicular cancer means that you are 75 times more likely to develop it). The fact that testicular cancer appears to run in families has led researchers to speculate that there may be one or more genetic mutations (abnormal changes to the instructions that control cell activity) that make a person more likely to develop testicular cancer. Mutations in 2 genes (known as the KITLG and SPRY4 genes) may increase the risk of a person developing testicular cancer. Endocrine disruptors Examples of endocrine disruptors include:


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KITLG and SPRY4 genes) may increase the risk of a person developing testicular cancer. Endocrine disruptors Examples of endocrine disruptors include: some types of pesticide polychlorinated biphenyls (PCBs), chemical compounds used as a coolant dibutyl phthalate, a chemical used to manufacture cosmetics, such as nail polish In most countries, including the UK, many endocrine disruptors, such as PCBs, have been withdrawn as a result of their link to health problems. However, there is a concern that exposure to endocrine disruptors may still occur due to contamination of the food chain. However, there is not yet enough evidence to prove a definite link between indirect exposure to low levels of endocrine disruptors and health problems. Indirect exposure is the type of exposure that would occur if the food chain was contaminated. Infertility Men and anyone with testicles who are infertile are 3 times more likely to develop testicular cancer. The reasons for this are not clear. Smoking


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Men and anyone with testicles who are infertile are 3 times more likely to develop testicular cancer. The reasons for this are not clear. Smoking Research has found that long-term smokers (people who have been smoking a pack of 20 cigarettes a day for 12 years or 10 cigarettes a day for 24 years) are twice as likely to develop testicular cancer than non-smokers. HIV and AIDS Studies show that men and anyone with testicles with HIV or AIDS have an increased risk of testicular cancer. Source: NHS 24 - Opens in new browser window Last updated: 09 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Cancer Research UK: Testicular cancer Malecare Scottish Cancer Network: Patient information Search for cancer


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page to Info For Me Other health sites Cancer Research UK: Testicular cancer Malecare Scottish Cancer Network: Patient information Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-teenagers-and-young-adults/testicular-cancer-teenagers-and-young-adults/


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https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/testicular-lumps-and-swellings/


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Testicular lumps and swellings | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Sexual and reproductive Testicular lumps and swellings Testicular lumps and swellings Lumps and swellings in the testicles (balls) are relatively common in boys, men and anyone with testicles. It’s important to know what’s normal for you so you can notice any changes in your testicles. When to get medical advice Go to A&E immediately or phone 999 if you have any of these symptoms: • sudden, severe pain in a testicle• testicle pain along with feeling sick, being sick or pain in your tummy• testicle pain that has lasted more than an hour or continues when you’re restingThese can be signs of a serious problem that needs to be treated in hospital as soon as possible.Find your nearest A&E Speak to your GP practice if you have: a lump in your testicles swollen testicles a


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be treated in hospital as soon as possible.Find your nearest A&E Speak to your GP practice if you have: a lump in your testicles swollen testicles a change in the shape of your testicles a change in the way your testicles feel 1 testicle that has become bigger than the other aching or discomfort in your testicles that does not go away Diagnosing testicular lumps and swellings There is not a singular test for testicular lumps and swellings. The doctor will discuss your situation and carry out a physical examination. Your doctor may: look at and feel your testicles shine a torch through the bag of skin containing your testicles (scrotum) to check for a build-up of fluid refer you for an ultrasound scan take a urine (pee) sample if they suspect your lump or swelling may be caused by an infection If the lump or swelling is painful or very big, your doctor may refer you to a specialist for an operation to drain, shrink or remove it. What causes testicular lumps and swellings? Lumps and


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big, your doctor may refer you to a specialist for an operation to drain, shrink or remove it. What causes testicular lumps and swellings? Lumps and swellings in the testicles can have lots of different causes. The vast majority of testicular lumps and swellings are caused by non-cancerous (benign) conditions. Most of these may not need treatment. If you experience testicular lumps and swellings, they may be caused by: varicoceles – soft lumps that develop gradually above the testicle and on the left side of the scrotum hydroceles – swellings in the scrotum caused by a build-up of fluid epididymal cysts – a small, smooth fluid-filled swelling that slowly develops in the epididymis (a coil-like structure behind the testicles that helps to store and transport sperm) epididymo-orchitis – inflammation in the epididymis and the testicle caused by bacterial infections such as urinary tract infections (UTIs), sexually transmitted infections (STIs) and mumps inguinal hernias – when fatty


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by bacterial infections such as urinary tract infections (UTIs), sexually transmitted infections (STIs) and mumps inguinal hernias – when fatty tissue or part of the bowel pokes through into the groin at the top of the inner thigh testicular torsion– a benign but serious condition caused by the spermatic cord (the cord that supplies blood to the testicles) becoming severely twisted testicular cancer – a more serious health condition Treatment for testicular lumps and swellings Treatment for testicular lumps and swellings will vary depending on what’s causing it. Painkillers such as paracetamol can be taken to ease discomfort or pain. In some cases, surgery may be used to treat some testicular lumps and swellings. The surgery is carried out under either local anaesthetic or general anaesthetic depending on the procedure. Antibiotics may be prescribed if the cause is a bacterial infection. If you have been diagnosed with testicular cancer, you will be cared for by a team of clinicians


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be prescribed if the cause is a bacterial infection. If you have been diagnosed with testicular cancer, you will be cared for by a team of clinicians who will help decide the best treatment for you. Surgery to remove the affected testicle will be recommended in most cases and this may sometimes be followed by a course of chemotherapy or radiotherapy. Source: Scottish Government - Opens in new browser window Last updated: 24 May 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Cancer Research UK: Testicular cancer British Association of Urological Surgeons: Testicular lumps NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy


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lumps NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/threadworms/


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Threadworms | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Threadworms Threadworms Threadworms (pinworms) are tiny worms in your poo. They’re common in children and are spread easily. You can treat them without seeing a GP. Symptoms of threadworms You may spot threadworms in your poo. The worms look like threads of white cotton and are about 1cm long. You might also see them around your child’s bottom (anus). The worms usually come out at night while your child is sleeping. Other symptoms include: extreme itching around the anus or vagina, particularly at night irritability and wakening up during the night Less common symptoms include: weight loss wetting the bed irritated skin around the anus When to get medical advice If you or your child have threadworms you can get advice and treatment directly from a


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bed irritated skin around the anus When to get medical advice If you or your child have threadworms you can get advice and treatment directly from a pharmacy. Your pharmacist may recommend that you speak to your GP if required. Find your nearest pharmacy Treatment for threadworms Medication will kill the threadworms but not the eggs. Eggs can live for up to 2 weeks outside the body. There are hygiene methods you can follow to stop becoming infected again. Do these for 2 weeks if you’re taking medicine, or for 6 weeks if you’re not taking medicine. Things you can do Do wash hands and scrub under fingernails – particularly before eating, after using the toilet or after changing nappies encourage children to wash their hands regularly shower every morning rinse toothbrushes before using them keep fingernails short wash sleepwear, sheets, towels and soft toys (at a hot temperature) every day for several days after treatment disinfect kitchen and bathroom surfaces, using hot water vacuum


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and soft toys (at a hot temperature) every day for several days after treatment disinfect kitchen and bathroom surfaces, using hot water vacuum and dust with a damp cloth make sure everyone in the household wears underwear at night and changes it in the morning Don’t do not shake clothing or bedding, to prevent eggs from landing on other surfaces do not share towels or flannels do not bite nails or suck thumbs and fingers Treatment from a pharmacist Mebendazole is the main medication used to treat threadworm infection. It can be bought over the counter from your local pharmacy or prescribed by your GP. This is usually a chewable tablet or liquid you swallow. Treat everyone over 2 years old in your household, even if they do not have symptoms. Tell the pharmacist if you need to treat a child under 2 years old, or if you’re pregnant or breastfeeding. Treatment might not be suitable and you may need to speak to a GP. If you cannot take medicine you can treat threadworms by using hygiene


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Treatment might not be suitable and you may need to speak to a GP. If you cannot take medicine you can treat threadworms by using hygiene methods for 6 weeks. Who’s most at risk? Threadworm infection most commonly affects young children because they often forget to wash their hands and share toys with other children. People who are in close contact with someone with a threadworm infection also have a high risk of infection. This is why all members of a household need to be treated when someone has a threadworm infection. How are threadworms passed on? Threadworms spread when their eggs are swallowed. They lay eggs around your bottom (anus) or vagina, which can cause an itchy bottom. The eggs get stuck on your fingers when you scratch. They can then pass on to anything you touch, including: clothes toys toothbrushes kitchen or bathroom surfaces bedding food Eggs can pass to other people when they touch these surfaces and then touch their mouth. The eggs can survive up to 2 weeks. The


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bedding food Eggs can pass to other people when they touch these surfaces and then touch their mouth. The eggs can survive up to 2 weeks. The larvae hatch from the eggs in your gut after you swallow them, and take 1 to 2 months to mature into threadworms. Children can get threadworms again after they’ve been treated for them if they get the eggs in their mouth. This is why it’s important to encourage children to wash their hands regularly. Source: NHS 24 - Opens in new browser window Last updated: 16 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Impetigo Search for your nearest pharmacy Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS


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Search for your nearest pharmacy Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/arm-shoulder-and-hand-problems-and-conditions/thumb-fracture/


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Thumb fracture | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Arm, shoulder and hand problems and conditions Thumb fracture Thumb fracture Your thumb injury may be referred to as a fracture, break or crack. These terms all mean the same thing. When you have a fracture, it’s not just the bone that’s affected. You’ll also have injured some of the soft tissues around it. Soft tissues include the: muscles ligaments tendons nerves Recovery times Most of the healing happens between 3 to 6 weeks after your thumb fracture. It’s normal to have aches and discomfort beyond this. This usually happens when you try activities you haven’t done for a while. It’s also normal for the area to be more sensitive for a while after the injury. It’s good to use your hand in day-to-day activities. However, remember that this is exercise too.


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to be more sensitive for a while after the injury. It’s good to use your hand in day-to-day activities. However, remember that this is exercise too. Sometimes you might need to rest if your hand aches after doing some activities. What can affect your recovery? There are some things that might impact on your recovery. Smoking Smoking affects all of your tissues and slows facture healing times. In some people, it can stop healing altogether. Stopping smoking as your fracture heals will help to ensure the best recovery. Get help to stop smoking. General health Some medical conditions, like diabetes, may slow down the healing process. Eating a healthy diet and keeping yourself active will help your recovery. Medication Some medications can slow down fracture healing. If you have concerns about your medication, talk to a healthcare professional. Anti-inflammatory medication, like Ibuprofen or Naproxen, has been shown to delay healing. What to expect after a thumb fracture A thumb fracture


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Anti-inflammatory medication, like Ibuprofen or Naproxen, has been shown to delay healing. What to expect after a thumb fracture A thumb fracture is a minor fracture. It’s often treated in the same way as a sprain. Some people may be fitted with a splint or a wrist splint with a thumb piece. You may only need these for a couple of weeks. Pain after a thumb fracture It’s normal to have some discomfort in the areas around your fracture, including: other soft tissues nearby joints areas that have been immobilised Pain can change from day to day and it doesn’t always depend on what you’re doing. It’s common to have pain at rest. It’s normal to have some pain even when your fracture has healed. Some people also experience discomfort in the fracture site during colder weather. Your local pharmacy can give you advice on managing pain after a fracture. Find your local pharmacyUse Scotland’s Service Directory to find your local pharmacy.Pharmacies Swelling Swelling is the start of healing.


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fracture. Find your local pharmacyUse Scotland’s Service Directory to find your local pharmacy.Pharmacies Swelling Swelling is the start of healing. It’s normal to have swelling near the fracture. It can then spread into your hand or wrist. The swelling might change depending on: your position your activity the time of day Even when your fracture has healed it’s normal to have some swelling. This can last for several months. How can I help swelling? Having a lot of swelling can become uncomfortable or limit your movement. There are some things you can do to reduce the swelling. You can try to: raise your arm above your heart when you’re resting – you can do this by supporting it with pillows keep the other joints in your hand and arm moving normally avoid too much rest and too much activity massage the swelling Bruising It’s normal to have bruising after a fracture. Bruising can be widespread and may appear a long way from your fracture. It can be very purple to start with and may


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have bruising after a fracture. Bruising can be widespread and may appear a long way from your fracture. It can be very purple to start with and may change colour as you recover. Getting back to normal activities There are some things you should consider when trying to get back to your normal activities. Driving You should contact your insurance provider before driving. Your injury may affect your insurance. Once you’re out of your splint, you must be able to safely perform an emergency stop or manoeuvre. You should always be in full control of your vehicle. Work Your return to work will depend on the type of work you do and your employer. It may be possible to discuss a phased return to work or changed duties. You don’t need to see a healthcare professional to return to work. Hobbies and interests Keep doing any activities you’re able to, as your pain allows. Gradually increase what you do. Reduced flexibility and strength may make things more difficult to start with. This will get


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to, as your pain allows. Gradually increase what you do. Reduced flexibility and strength may make things more difficult to start with. This will get better as you slowly build up to all of your usual activities. Mood Frustration or low mood after an injury is normal. As you get back to normal life this should get better. Falls Loss of confidence is common after a fracture. Further advice about preventing falls. Rehabilitation plan There are things you can do to help your recovery after a thumb fracture. 0 to 3 weeks after your injury Between 0 to 3 weeks after your injury, you should: use the affected hand within the splint for light activities like eating, dressing or typing on a keyboard, as long as the pain allows increase the movement in your thumb, fingers and wrist with gentle exercises manage your pain and swelling wean yourself out of using your splint as far as comfort allows 3 to 6 weeks after your injury After 3 to 6 weeks you can gradually return your hand to full


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out of using your splint as far as comfort allows 3 to 6 weeks after your injury After 3 to 6 weeks you can gradually return your hand to full function. You can also begin to resume normal day to day activities. You should avoid contact sports or heavy lifting until at least 12 weeks post fracture. Thumb grip 52 Thumb circles 1:07 Thumb stretch 37 Palm on table 38 Tip of thumb bend 37 Thumb and finger touch 1:00 Stop exercising if it makes your symptoms worse, or it causes new pain. Help and support If your thumb function hasn’t improved within 6 weeks of following this advice, it’s a good idea to talk to a healthcare professional about your symptoms. Source: NHS 24 MSK Clinical Advisory Group - Opens in new browser window Last updated: 07 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message


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been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-teenagers-and-young-adults/thyroid-cancer-teenagers-and-young-adults/


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Thyroid cancer in teenagers and young adults | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in teenagers and young adults Thyroid cancer: Teenagers and young adults Thyroid cancer: Teenagers and young adults Introduction The thyroid and types of thyroid cancer Having tests for thyroid cancer Treating thyroid cancer Introduction This section is for teens and young adults. It’s about a type of cancer called thyroid cancer. If you’re looking for information about thyroid cancer in people of all ages, read our thyroid cancer section. Papillary and follicular thyroid cancers are the most common types of thyroid cancer in young adults. If you’d like to find out about a different type of thyroid cancer you could talk to Macmillan Cancer Support. It’s important to remember that thyroid cancer in young people can be successfully


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type of thyroid cancer you could talk to Macmillan Cancer Support. It’s important to remember that thyroid cancer in young people can be successfully treated. Most young people are completely cured. Symptoms The first sign of thyroid cancer is usually a painless lump or swelling in the front of the neck that gradually gets bigger. Less common symptoms are: a hoarse voice that doesn’t get better difficulty swallowing or breathing If you have any of these symptoms, it’s important to speak to a doctor. Remember – these symptoms can happen for lots of reasons other than cancer. What are the causes of thyroid cancer? It’s unknown exactly what causes thyroid cancer. But research into possible causes is going on all the time. Some things called risk factors increase your chance of developing cancer. But having these doesn’t mean you’ll get cancer. Genes Genes are the biological information in each cell that we inherit from our parents. Genes affect the way we look (for example, our eye


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cancer. Genes Genes are the biological information in each cell that we inherit from our parents. Genes affect the way we look (for example, our eye colour) and how our bodies grow and work. Some rare genetic conditions that run in families can increase the risk of thyroid cancer. But fewer than 1 in 10 cases of cancer are caused by an inherited faulty gene. Radiotherapy If you were exposed to radiation or had radiotherapy treatment to the neck area when you were younger, you may be at a higher risk of developing thyroid cancer many years later. If you’re worried about thyroid cancer If you think you might have some of these symptoms you should go straight to your GP. They’ll be able to talk to you about your symptoms. If they think the symptoms could be because of cancer, they can do tests to find out more. The thyroid and types of thyroid cancer The thyroid is a small gland in the front of the neck just below the voice box (larynx). It is made up of 2 parts, or lobes, 1 on each side


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cancer The thyroid is a small gland in the front of the neck just below the voice box (larynx). It is made up of 2 parts, or lobes, 1 on each side of the neck. It’s part of a network of glands throughout the body that make up the endocrine system. This system is responsible for producing the body’s hormones that help to control and influence various body functions. The thyroid produces 2 hormones: thyroid hormone that controls your metabolism calcitonin that helps to control the calcium levels in your body Types of thyroid cancer There are 4 main types of thyroid cancer: papillary is the most common type of thyroid cancer – it’s usually slow-growing follicular is the second most common type – it’s also usually slow-growing medullary is a rare type of thyroid cancer which sometimes runs in families anaplastic is another rare type of thyroid cancer, which is more common in older people Young people are mostly affected by the papillary and follicular types. Rarely other types of cancer


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cancer, which is more common in older people Young people are mostly affected by the papillary and follicular types. Rarely other types of cancer occur in the thyroid gland such as lymphoma, or other cancers that have spread from another part of the body. This section is for teens and young adults. It’s about a type of cancer called thyroid cancer. If you’re looking for information about thyroid cancer in people of all ages, read our thyroid cancer section. Having tests for thyroid cancer This information is for teenagers and young adults who may be having tests to find out if they have thyroid cancer. If you think you might have some of the symptoms of thyroid cancer, you should talk to your GP. If they think the symptoms could be because of cancer, they can do tests to find out more. Visiting your GP When you go to your GP they will usually examine you and arrange some blood tests. There may be a number of reasons why you have these symptoms. If your GP is concerned that you may


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usually examine you and arrange some blood tests. There may be a number of reasons why you have these symptoms. If your GP is concerned that you may have thyroid cancer they will make an appointment for you with a specialist at the hospital. At the hospital You’ll probably be seen by lots of people at the hospital during and after the tests they do to find out what is happening to you. They work as a team and all have an important part in your care, even though you may only meet some of them. They may include: a doctor who specialises in thyroid problems (endocrinologist) a surgeon who specialises in thyroid surgery a pathologist who looks at blood and tissue samples to diagnose diseases a cancer specialist (oncologist) an X-ray specialist (radiologist) a clinical nurse specialist Your doctor will examine you and arrange for more detailed tests, which may include an ultrasound, a fine needle aspiration (FNA) or a biopsy. An FNA involves having a very small needle placed into your


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tests, which may include an ultrasound, a fine needle aspiration (FNA) or a biopsy. An FNA involves having a very small needle placed into your thyroid gland to remove a few cells for the pathologist to look at under the microscope. A biopsy involves removing a small piece of the thyroid to be analysed. You might have a general anaesthetic and so will be asleep when it is done. You may only need a local anaesthetic, which numbs the area. There is more information about having an anaesthetic in the surgery section. If the biopsy shows that it is thyroid cancer you will have some other tests to check the size of the tumour and whether it has spread. Macmillan Cancer Support has information on these tests. These tests may include: a chest X-ray to check your lungs a CT, MRI or PET scan a radioisotope scan You won’t necessarily need all of these tests. It will depend on the results of the first ones. Having tests and waiting for the results can be an anxious time. Talking about how you


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these tests. It will depend on the results of the first ones. Having tests and waiting for the results can be an anxious time. Talking about how you feel and getting support from your family, friends, specialist nurse or doctor can help. If you’re looking for information about thyroid cancer in people of all ages, read our general thyroid cancer information. Treating thyroid cancer It’s important to remember that thyroid cancer in young people can be successfully treated. Most young people are completely cured. If the tests you’ve had show you have thyroid cancer, your team of specialists will discuss treatment with you. Surgery Surgery to remove the thyroid gland is the main treatment for thyroid cancer. You might hear the doctors talk about a thyroidectomy, which is the medical name for the operation. Sometimes the surgeon will only need to remove part of your thyroid. Lymph nodes In the neck, close to the thyroid, there are lymph nodes. These are part of the body’s immune system


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need to remove part of your thyroid. Lymph nodes In the neck, close to the thyroid, there are lymph nodes. These are part of the body’s immune system and help fight infection. Sometimes cancer cells settle in these lymph nodes, so the surgeon might remove some or all of the nodes as well. They may also remove some tissue from the area around the thyroid if they suspect that there are any cancer cells there. After the operation You will probably need to spend a few days in hospital after the operation. There will be a scar on your neck – usually just above the collarbone. Sometimes you can have a low calcium level in your blood or a hoarse voice after the operation. You may need to take tablets to replace the thyroid hormone. The tissue removed will be carefully looked at under the microscope. Sometimes another operation is needed after this. The results will help your doctors decide if you need radioactive iodine treatment and other treatments. Your team will talk through the results


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The results will help your doctors decide if you need radioactive iodine treatment and other treatments. Your team will talk through the results of the operation with you. You may feel really shocked and scared by the thought of having this operation. But it does give a really good chance of a cure. Your specialist will talk things over with you in detail and make sure that you fully understand what’s involved. If you want to know more about what happens when you go in for an operation, there’s lots more information in the general surgery section. Radioactive iodine If you’ve been told that you need to have treatment with radioactive iodine, you may be worried about what’s going to happen. Knowing what to expect can help. Your doctors and nurses will also explain things to you and give you support. How does it work? There’s a mineral called iodine in the bloodstream. Normal thyroid tissue takes iodine from the bloodstream and uses it to make thyroid hormones. Some thyroid cancers can


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iodine in the bloodstream. Normal thyroid tissue takes iodine from the bloodstream and uses it to make thyroid hormones. Some thyroid cancers can take iodine from the bloodstream too. Radioactive iodine is often used after surgery when the whole thyroid gland has been removed. Any thyroid cancer cells left behind soak up the iodine which contains high doses of radiation. This helps to destroy them. Radioactive iodine doesn’t usually affect other parts of the body because other cells don’t take up iodine the way thyroid cells do. How is it given? You may have radioactive iodine as a capsule, as a drink or as an injection into a vein in your arm through a cannula. Preparing for treatment There are 2 ways to prepare your body for the radioiodine treatment, either you’ll: be given an injection of a drug called thyrotropin alfa (Thyrogen®) need to stop taking your thyroid hormone tablets 2 to 4 weeks before the treatment Some people won’t be started on thyroid hormones until after surgery


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to stop taking your thyroid hormone tablets 2 to 4 weeks before the treatment Some people won’t be started on thyroid hormones until after surgery and radioactive iodine treatment. You’ll probably feel very tired during this time. But, if you are not having the injections, it’s important that you stop taking thyroid hormones or the radioactive iodine treatment won’t work. For 2 weeks before treatment, you’ll be asked to eat a low-iodine diet and avoid certain foods. This encourages the body to use up its stores of iodine. Then when the radioactive iodine is given, the cancer cells will soak it up because the amount of iodine in the body is so low. You’ll be given information about what foods you should eat and what to avoid. You can’t have this treatment if you are pregnant. If there is any chance of this tell your team and they can test you. What happens during treatment? This treatment makes you slightly radioactive for several weeks. Your body will gradually get rid of the


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can test you. What happens during treatment? This treatment makes you slightly radioactive for several weeks. Your body will gradually get rid of the radioactivity through your wee, sweat and saliva. You will be kept in hospital when the radioactivity is highest, which is usually between 1 to 5 days. You will be looked after in a side room on the ward, either on your own or with someone else having the same treatment. During this treatment, the amount of contact you can have with your friends, family and the nurses will be limited, to protect them from exposure to the radiation. Anyone pregnant or younger than 18 usually isn’t allowed to visit. This can make you feel lonely. You will be able to keep in touch with your friends and family by phone and internet. There should be plenty of books, magazines, DVDs, computer games and a TV in the room. You can take in a few of your own things in to help pass the time. Ask your team whether you can take a computer or an MP3 player into the


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the room. You can take in a few of your own things in to help pass the time. Ask your team whether you can take a computer or an MP3 player into the room with you. Anything that comes back out of your room will be checked for radiation levels. Sometimes your things may have to be kept on the ward for a while if the radiation levels are high. But they’ll be returned to you when they’re safe again. What happens after treatment? Once your radiation levels are safe, you’ll be allowed home. You’ll also be able to start eating your usual foods again. Check with the staff about what you can and can’t do when you get home. There are likely to be some precautions to take for up to a few weeks. You might need a scan shortly after your treatment. This shows if you need more radioiodine treatment. If you need more treatment it is usually given every 3 to 6 months. Your fertility won’t be affected by the treatment. But it’s safer not to become pregnant or get someone else pregnant during


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every 3 to 6 months. Your fertility won’t be affected by the treatment. But it’s safer not to become pregnant or get someone else pregnant during treatment, and for a year after. You should avoid all sex and open-mouthed kissing for a few days after treatment. Travelling on public transport can be restricted just after treatment, so you may not be able to go on holiday just after treatment. For a few months after treatment you might set off the alarms at the security gates. If you are planning a holiday, discuss it with your team. External beam radiotherapy You may also have external beam radiotherapy. For this treatment you come to hospital and lie on a bed in the radiotherapy department for about 10 to 20 minutes every day. You will have treatment every weekday for several weeks. It is like having an X-ray, so it doesn’t hurt and you cannot feel it. Hormone therapy after treatment for thyroid cancer If you’ve had all your thyroid gland removed, your body can’t produce thyroid


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you cannot feel it. Hormone therapy after treatment for thyroid cancer If you’ve had all your thyroid gland removed, your body can’t produce thyroid hormones anymore. Without these hormones, your metabolism slows down. This can cause dry skin and hair, tiredness, poor concentration and lack of energy. What can help? These hormones can be replaced by taking tablets. You’ll need to take them for the rest of your life. The usual long-term hormone treatment is thyroxine (levothyroxine) and you normally start taking it once your radioactive iodine treatment is finished. As well as replacing the hormones you’re missing, thyroxine can also help stop papillary or follicular thyroid cancer coming back. So if you have only had part of your thyroid gland removed you may still need to take thyroid hormone tablets. Blood tests You’ll need to have your blood checked regularly to monitor the hormone levels. It can sometimes take months to find the right dose of thyroxine for you. But once the right


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blood checked regularly to monitor the hormone levels. It can sometimes take months to find the right dose of thyroxine for you. But once the right dose is found, there shouldn’t be any side effects, because they are simply replacing normal thyroid hormones. It’s important to remember to take your tablets every day. It can help to take them at the same time every day so you get into a routine. Macmillan Cancer Support has more general information about cancer treatments like radiotherapy and surgery. This information is written for people of all ages, not just young adults with thyroid cancer. This information is for teenagers and young adults and is about having treatment for thyroid cancer. If you’re looking for information about thyroid cancer in people of all ages, read our thyroid cancer information. Source: Macmillan - Opens in new browser window Last updated: 09 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t


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browser window Last updated: 09 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Butterfly Thyroid Cancer Trust British Thyroid Foundation Scottish Cancer Network: Patient information Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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Tonsillitis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Ears, nose and throat Tonsillitis Tonsillitis Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers × You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Tonsillitis is an infection that causes inflammation (redness and swelling) of the tonsils. Tonsillitis is a common condition in children, teenagers and young adults. What are the tonsils? The tonsils are 2


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and swelling) of the tonsils. Tonsillitis is a common condition in children, teenagers and young adults. What are the tonsils? The tonsils are 2 small glands that sit on either side of the throat. In young children, they help to fight germs and act as a barrier against infection. When the tonsils become infected, they stop it spreading further into the body. As a child’s immune system gets stronger, the tonsils become less important and usually get smaller. In most people, the body is able to fight infection without the tonsils. Sore throat self-help guide Complete our self-help guide to check your symptoms and find out what to do next. Symptoms of tonsillitis The symptoms of tonsillitis include: a sore throat pain when swallowing earache high temperature (fever) over 38°C (100.4°F) coughing headache feeling sick feeling tired swollen, painful lymph glands in your neck white pus-filled spots on the tonsils bad breath loss of voice or changes to your voice Symptoms usually get better


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painful lymph glands in your neck white pus-filled spots on the tonsils bad breath loss of voice or changes to your voice Symptoms usually get better within 3 to 4 days. When to get medical advice Speak to your GP practice if: symptoms last longer than 4 days and don’t show any signs of getting better symptoms are severe – for example, if you’re unable to eat or drink due to the pain, or you have difficulty breathing you keep getting throat infections If your GP practice is closed, phone 111. Diagnosing tonsillitis If needed, your GP will examine your throat and ask you some questions about your symptoms. They may take a swab of your throat to check if its caused by a viral or bacterial infection. It’ll usually take a few days to get your results. If you develop severe tonsillitis as a teenager or adult, your GP may recommend a blood test for glandular fever. Treating tonsillitis There’s no specific treatment for tonsillitis. It usually gets better on its own within a week. Things you


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for glandular fever. Treating tonsillitis There’s no specific treatment for tonsillitis. It usually gets better on its own within a week. Things you can do to help your symptoms Do take paracetamol or ibuprofen to help relieve pain drink plenty of fluids get plenty of rest Always read the leaflet that comes with your medicine before taking it. Follow the recommended dosage instructions. If you’re not sure which treatments are suitable for you or your child, speak to a pharmacist for advice. Treatments from your doctor If test results show that your tonsillitis is caused by a bacterial infection, a short course of oral antibiotics may be prescribed. If oral antibiotics do not help and your symptoms are getting worse, your GP may refer you to hospital for antibiotics to be given into a vein (IV antibiotics). Surgery to remove the tonsils (tonsillectomy) A small number of children and adults have tonsillitis for longer, or it keeps returning. This is called chronic tonsillitis and


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(tonsillectomy) A small number of children and adults have tonsillitis for longer, or it keeps returning. This is called chronic tonsillitis and surgery may be needed. Surgery to remove the tonsils (a tonsillectomy) is usually only recommended if: you’ve had several severe episodes of tonsillitis over a long period of time repeated episodes are disrupting normal activities What causes tonsillitis? Most cases of tonsillitis are caused by a viral infection, such as cold or flu. Some cases can also be caused by a bacterial infection, typically a strain of bacteria called group A streptococcus bacteria. Tonsillitis itself isn’t contagious, but the infections that cause it are. How to prevent infections spreading Do wash your hands often, especially after touching your nose or mouth and before handling food always sneeze and cough into tissues throw used tissues away and wash your hands Complications of tonsillitis Complications of tonsillitis are rare and usually only occur if it’s caused


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throw used tissues away and wash your hands Complications of tonsillitis Complications of tonsillitis are rare and usually only occur if it’s caused by a bacterial infection. They’re usually the result of the infection spreading to another part of the body. Possible complications of tonsillitis include: quinsy (peritonsillar abscess) – an abscess (collection of pus) that develops between one of the tonsils and the wall of the throat obstructive sleep apnoea (OSA) – where the walls of the throat relax during sleep, which causes breathing difficulties and poor sleep Other complications of tonsillitis are very rare. They usually only occur if an underlying bacterial infection is left untreated. Source: ENT Scotland - Opens in new browser window Last updated: 15 June 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g.


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You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Earache Glandular fever Middle ear infection (otitis media) Other health sites GOSH: what happens when your child’s tonsils are removed NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/tourettes-syndrome/


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Tourette's syndrome | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Tourette’s syndrome Tourette’s syndrome Tourette’s syndrome is a neurological condition that causes you to make involuntary movements and sounds called tics. Tics are fast, repetitive muscle movements that cause sudden body jerks or sounds. Symptoms of Tourette’s syndrome The main symptoms of Tourette’s syndrome are tics. There are different types of tic. Motor tics might include: eye blinking neck and head jerks arm and leg movements pinching kicking hitting falling to the ground Vocal tics might include: throat clearing grunting sniffing coughing repeating words or phrases animal sounds stuttering singing Swearing is a rare tic that affects a small number of people with Tourette’s syndrome. Contact your GP if: you or your child start having tics


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Swearing is a rare tic that affects a small number of people with Tourette’s syndrome. Contact your GP if: you or your child start having tics Children often have tics for several months before growing out of them. These are known as transient tics. Having a tic does not necessarily mean your child has Tourette’s syndrome. Premonitory sensations (urges) Some people with Tourette’s syndrome feel a strong urge before a tic. This urge is described as a similar feeling to before you need to sneeze or itch. This feeling is called a premonitory sensation or urge. It’s only relieved after the tic has been carried out. Premonitory sensations can include: a dry or sore throat before grunting a burning feeling in the eyes before blinking an itchy joint or muscle before jerking Suppressing tics Some people can control or suppress their tics for a short while in certain social situations like in a classroom. This requires concentration and effort but can get easier with practise. This is called


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short while in certain social situations like in a classroom. This requires concentration and effort but can get easier with practise. This is called suppressibility. It can be tiring to try to control tics. You might have a sudden intense release of tics when you get home if you’ve been controlling them all day while in school or work, for example. Tics might be less noticeable when you’re concentrating on a certain activity like reading a book or playing sports. Sometimes tics might be more noticeable when you’re relaxing. Tics are not normally harmful but physical tics can be painful. Tic triggers There are times when tics can become worse. Tics might be triggered by: stress anxiety excitement sensory overload feeling nervous confrontation fatigue (tiredness) Associated health conditions Tourette’s syndrome often comes with other health conditions like: attention deficit hyperactivity disorder (ADHD) obsessive compulsive disorder (OCD) depression or anxiety Causes of Tourette’s


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conditions like: attention deficit hyperactivity disorder (ADHD) obsessive compulsive disorder (OCD) depression or anxiety Causes of Tourette’s syndrome The cause of Tourette’s syndrome is unknown. It’s not known why more males are likely to be affected by Tourette’s syndrome than females. Sometimes tics run in families. Diagnosing Tourette’s syndrome There’s no single test for Tourette’s syndrome. You might be offered tests and scans like an MRI scan to rule out other conditions. You can be diagnosed with Tourette’s syndrome at any age. You might be diagnosed with Tourette’s syndrome if you’ve had several movement and sound tics for at least a year and these started before you turned 18 years of age. Your GP might refer you to different specialists to help get a diagnosis. For example, a psychiatrist or neurologist. A neurologist is a doctor who specialises in conditions affecting the brain and nervous system. Getting a confirmed diagnosis can help you and others understand your


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a doctor who specialises in conditions affecting the brain and nervous system. Getting a confirmed diagnosis can help you and others understand your condition. It can also allow you to access treatment and support. Treating Tourette’s syndrome There’s no cure for Tourette’s syndrome. Most children with tics do not need treatment for them. Tics can significantly improve or disappear altogether as patients move into their early 20s. However, some people find their tics continue or worsen in adulthood. Treatment might be recommended to help you control your tics. There are treatment options available through the NHS. Treating associated health conditions Treating associated health conditions like OCD, depression or anxiety can help improve tics. Cognitive behavioural intervention therapy This includes different types of behavioural therapy available to help reduce tics like: habit reversal training – involves identifying the triggers that cause tics then find an another way of relieving


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available to help reduce tics like: habit reversal training – involves identifying the triggers that cause tics then find an another way of relieving the urge to tic exposure with response prevention (ERP) – trains you to control your urge to tic tolerating the feeling without doing the tic until the urge passes Medicine If your tics are more severe and affect your daily activities, you might benefit from medicine to help treat your tics. Medicines for Tourette’s syndrome don’t help everyone and can cause side effects. Source: Scottish Government - Opens in new browser window Last updated: 26 June 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Obsessive compulsive disorder (OCD) Depression Anxiety Other health


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of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Obsessive compulsive disorder (OCD) Depression Anxiety Other health sites Tourette's Action Tourette Scotland NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/transient-ischaemic-attack-tia/


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https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/transverse-myelitis/


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Transverse myelitis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Transverse myelitis Transverse myelitis Transverse myelitis is a rare neurological condition. It’s caused by inflammation (swelling) of the spinal cord. The swelling damages the nerves and can leave permanent scars or lesions. The scars or lesions interrupt the communication between the nerves in the spinal cord and the rest of the body. ‘Transverse’ refers to the swelling being across the width of the spinal cord. It’s also sometimes used to describe swelling that only affects part of the width of the spinal cord. Symptoms of transverse myelitis The symptoms of transverse myelitis can include: muscle weakness in the legs, and sometimes the arms mobility problems unusual sensations and numbness bladder problems bowel problems sexual problems pain


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weakness in the legs, and sometimes the arms mobility problems unusual sensations and numbness bladder problems bowel problems sexual problems pain Transverse myelitis can happen to anyone at any time in their life. In most cases there might only be one episode of symptoms, but sometimes it can happen repeatedly. Transverse myelitis can be the first sign of MS or another condition. Causes of transverse myelitis There are several different causes of transverse myelitis. Sometimes a cause isn’t found, and this is called idiopathic transverse myelitis. Autoimmune disease Sometimes transverse myelitis is caused by an autoimmune reaction. In autoimmune diseases, the immune system mistakes the body’s own tissue as dangerous and attacks it. This causes swelling that results in damage to the myelin sheath. This includes: MS-like swelling neuromyelitis optica (NMO) myelin oligodendrocyte antibody (MOG) associated myelitis sarcoidosis Sjögrens syndrome lupus Viral infection Sometimes transverse


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optica (NMO) myelin oligodendrocyte antibody (MOG) associated myelitis sarcoidosis Sjögrens syndrome lupus Viral infection Sometimes transverse myelitis is caused indirectly by a viral infection, although often the virus responsible isn’t identified. Transverse myelitis often develops after a viral infection like: echovirus enterovirus Epstien-Barr hepatitis A herpes simplex HIV rubella influenza (flu) varicella zoster (the virus that causes chicken pox and shingles) Bacterial infection Bacterial infections such as syphilis might also lead to transverse myelitis. Cancer Some cancers might trigger an unusual immune response that can lead to transverse myelitis. Diagnosing transverse myelitis If your GP thinks you could have transverse myelitis, you should see a neurologist (a specialist in conditions of the nervous system) for a specialist assessment. Some of the tests you may need to confirm transverse myelitis are: neurological examination magnetic resonance imaging (MRI) scan lumbar


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assessment. Some of the tests you may need to confirm transverse myelitis are: neurological examination magnetic resonance imaging (MRI) scan lumbar puncture blood tests Sometimes your neurologist will do other tests to look for conditions that cause transverse myelitis. This might include CT scans. Treating transverse myelitis Sometimes transverse myelitis requires no treatment as it will improve on its own. Sometimes patients may require treatment for their symptoms, the swelling, or the underlying cause. Treatment for transverse myelitis symptoms There are different treatments available for transverse myelitis symptoms. Muscle weakness Physiotherapy can help improve strength, and the muscle spasms and stiffness that may sometimes develop. Techniques such as stretching exercises can help if your movement is restricted. If your muscle spasms are more severe, you may be prescribed a medicine that can relax your muscles. This will usually be either baclofen, gabapentin or tizanidine.


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spasms are more severe, you may be prescribed a medicine that can relax your muscles. This will usually be either baclofen, gabapentin or tizanidine. These medicines all have side effects. You might experience dizziness, weakness, nausea and diarrhoea. Discuss which of these would be best for you with your healthcare professional. Mobility problems Mobility problems are often the result of muscle spasms and spasticity. Muscle weakness, or problems with balance can also cause mobility problems. If you have problems with mobility, your healthcare professional might suggest: an exercise programme supervised by a physiotherapist mobility aids, such as a walking stick, or a wheelchair home adaptations such as stair lifts or railings An occupational therapist can carry out an assessment of your home and suggest adaptations. Treatment of the inflammation (swelling) Sometimes your neurologist might offer treatment with steroids. This can help with some types of transverse myelitis. Steroids


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(swelling) Sometimes your neurologist might offer treatment with steroids. This can help with some types of transverse myelitis. Steroids are only given for a short period of time to avoid possible steroid side effects. The side effects could include reflux and stomach irritation, worsening infection, mood swings, and difficulty sleeping. Bladder problems Medication might help if you have an overactive bladder or need to pee frequently during the night. If you find it difficult to empty your bladder, advice from a continence nurse or physiotherapist can help. Hand-held external stimulators can help some people to start peeing or to empty the bladder. Sometimes a catheter can empty the bladder when needed. You might be taught how to do intermittent self catheterisation (ISC). In rare cases, people with transverse myelitis may need a long-term catheter to keep the bladder emptying safely. You might be referred to a continence adviser or urologist, for specialist treatment and advice.


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catheter to keep the bladder emptying safely. You might be referred to a continence adviser or urologist, for specialist treatment and advice. Read more about treating urinary incontinence. Bowel problems It might be possible to treat mild to moderate constipation by changing your diet or taking laxatives. More severe constipation may need to be treated with suppositories, which are inserted into your bottom, or an enema. During an enema, liquid medication is rinsed through your bottom and large bowel, which softens and flushes out your stools. Anti diarrhoea medication or pelvic floor exercises might help bowel incontinence. Sexual problems If you experience problems with less interest in sex or difficulty reaching orgasm, relationship counselling or seeing a sex therapist might help. If you have transverse myelitis and find it hard to get or maintain an erection (erectile dysfunction) you may be prescribed medication to increase the blood flow to the penis. Musculoskeletal pain A


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get or maintain an erection (erectile dysfunction) you may be prescribed medication to increase the blood flow to the penis. Musculoskeletal pain A physiotherapist might be able to help with this pain by suggesting exercises or better seating positions. If your pain is more severe, you may be prescribed painkillers. Or, you might have a transcutaneous electrical nerve stimulation (TENS) machine that stimulates your nerves. Neuropathic pain Neuropathic pain is caused by damage to your nerves and is usually sharp and stabbing. It can also occur in the form of extreme skin sensitivity, or a burning sensation. This type of pain can be treated using neuropathic painkillers. Other treatments for transverse myelitis You may be offered other treatments depending on the cause of your transverse myelitis. Your neurologist will discuss your options with you. Source: Scottish Government - Opens in new browser window Last updated: 27 February 2024 How can we improve this page? Help us improve NHS


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with you. Source: Scottish Government - Opens in new browser window Last updated: 27 February 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Neurological Alliance of Scotland Siegel Rare Neuroimmune Association Scotland Support Group NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/trigeminal-neuralgia/


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Trigeminal neuralgia | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Trigeminal neuralgia Trigeminal neuralgia About trigeminal neuralgia Symptoms of trigeminal neuralgia Causes of trigeminal neuralgia Diagnosing trigeminal neuralgia Treating trigeminal neuralgia About trigeminal neuralgia Trigeminal neuralgia is a sudden, severe facial pain, described as sharp, shooting or like an electric shock. It usually occurs in sudden short attacks lasting from a few seconds to about two minutes, which stop just as abruptly. In the vast majority of cases it affects part or all of one side of the face, with the pain most commonly felt in the lower part of the face. Very occasionally it affects both sides of the face, but not normally at the same time. People with the condition may experience attacks of pain regularly for days,


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it affects both sides of the face, but not normally at the same time. People with the condition may experience attacks of pain regularly for days, weeks or months at a time. In severe cases, attacks may occur hundreds of times a day. It’s possible for the pain to improve or even disappear altogether for several months or years at a time (known as a period of remission), although these periods of remission tend to get shorter with time. Some people may then go on to develop a more continuous aching, throbbing and burning sensation, sometimes accompanied by the sharp attacks. Typically, the attacks of pain are brought on by activities that involve lightly touching the face, such as washing, eating and brushing the teeth, but they can also be triggered by wind (even a slight breeze or air conditioning) or movement of the face or head. Sometimes, the pain can occur without any trigger whatsoever. Living with trigeminal neuralgia can be very difficult and it can have a significant impact


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the pain can occur without any trigger whatsoever. Living with trigeminal neuralgia can be very difficult and it can have a significant impact on a person’s quality of life, resulting in problems such as weight loss, isolation and depression. Read more about the symptoms of trigeminal neuralgia When to seek medical advice You should see your GP if you experience frequent or persistent facial pain, particularly if standard painkillers such as paracetamol and ibuprofen do not help and a dentist has ruled out any dental causes. Your GP will try to identify the problem by asking about your symptoms and ruling out conditions that could be responsible for your pain. However, diagnosing trigeminal neuralgia can be difficult, and it can take a few years for a diagnosis to be confirmed. Read more about diagnosing trigeminal neuralgia What causes trigeminal neuralgia? In the vast majority of cases, trigeminal neuralgia is caused by compression of the trigeminal nerve. This is the largest nerve


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trigeminal neuralgia? In the vast majority of cases, trigeminal neuralgia is caused by compression of the trigeminal nerve. This is the largest nerve inside the skull, which transmits sensations of pain and touch from your face, teeth and mouth to your brain. This compression is usually caused by a nearby blood vessel pressing on part of the nerve inside the skull. In rare cases, trigeminal neuralgia can occur as a result of damage to the trigeminal nerve, caused by an underlying condition such as multiple sclerosis (MS) or a tumour. Read more about the causes of trigeminal neuralgia Who is affected It’s not clear exactly how many people are affected by trigeminal neuralgia, but the condition is thought to be rare. Some studies have suggested that around 27 in every 100,000 people are diagnosed with the condition in the UK each year, although this figure is probably too high as the condition tends to be over-diagnosed by doctors. Other estimates have suggested that there are about


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although this figure is probably too high as the condition tends to be over-diagnosed by doctors. Other estimates have suggested that there are about 6,500 new cases diagnosed each year in the UK. The condition affects women more often than men and is rare in people under the age of 40, although it can occur in younger people. Most cases are first seen in people between the ages of 50 and 60. How trigeminal neuralgia is treated Trigeminal neuralgia is usually a long-term condition, and the periods of remission often get shorter over time. However, most cases can be controlled to at least some degree with treatment. The first treatment offered will usually be with an anticonvulsant medication (usually used to treat epilepsy) called carbamazepine. To be effective, this medication needs to be taken several times a day, with the dose gradually increased over the course of a few days or weeks so that high enough levels of the medication can build up in your bloodstream. Unless your pain


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increased over the course of a few days or weeks so that high enough levels of the medication can build up in your bloodstream. Unless your pain starts to diminish or disappears altogether, the medication is usually continued for as long as is necessary, sometimes for many years. If you are entering a period of remission and your pain goes away, stopping the medication should always be done slowly over days or weeks, unless you are advised otherwise by a doctor. Carbamazepine was not originally designed to treat pain, but it can help relieve nerve pain by slowing down electrical impulses in the nerves and reducing their ability to transmit pain messages. If this medication is ineffective, unsuitable or causes too many side effects, you may be referred to a specialist to discuss alternative medications or surgical procedures that may help. There are a number of minor surgical procedures that can be used to treat trigeminal neuralgia – usually by damaging the nerve to stop it sending


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There are a number of minor surgical procedures that can be used to treat trigeminal neuralgia – usually by damaging the nerve to stop it sending pain signals – but these are generally only effective for a few years. Alternatively, your specialist may recommend having surgery to open up your skull and move away any blood vessels compressing the trigeminal nerve. Research suggests this operation offers the best results in terms of long-term pain relief, but it is a major operation and carries a risk of potentially serious complications, such as hearing loss, facial numbness or, very rarely, a stroke. Read more about treating trigeminal neuralgia Symptoms of trigeminal neuralgia The main symptom of trigeminal neuralgia is sudden attacks of severe, sharp and shooting facial pain that last from a few seconds to about two minutes. The pain is often described as an excruciating sensation, similar to an electric shock. The attacks can be so severe that you are unable to do anything during


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is often described as an excruciating sensation, similar to an electric shock. The attacks can be so severe that you are unable to do anything during them, and the pain can sometimes bring you to your knees. Trigeminal neuralgia usually only affects one side of your face. In rare cases it can affect both sides, although not at the same time. The pain can be in the teeth, the lower jaw, upper jaw, cheek and, less commonly, in the forehead or the eye. You may feel aware of an impending attack of pain, though these usually come unexpectedly. After the main, severe pain has subsided, you may experience a slight ache or burning feeling. There may also be a constant throbbing, aching or burning sensation between attacks. You may have episodes of pain lasting regularly for days, weeks or months at a time. It is possible for the pain to then disappear completely and not recur for several months or years (a period known as “remission”). However, in severe cases, attacks may occur hundreds of


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completely and not recur for several months or years (a period known as “remission”). However, in severe cases, attacks may occur hundreds of times a day, and there may be no periods of remission. Symptom triggers Attacks of trigeminal neuralgia can be triggered by certain actions or movements, such as: talking smiling chewing brushing your teeth washing your face a light touch shaving or putting on make-up swallowing kissing a cool breeze or air conditioning head movements vibrations, such as walking or a car journey However, pain can occur spontaneously with no triggers whatsoever. Further problems Living with trigeminal neuralgia can be extremely difficult, and your quality of life can be significantly affected. You may feel like avoiding activities such as washing, shaving or eating to avoid triggering pain, and the fear of pain may mean you avoid social activities. However, it’s important to try to live a normal life, and be aware that becoming undernourished or dehydrated can


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mean you avoid social activities. However, it’s important to try to live a normal life, and be aware that becoming undernourished or dehydrated can make the pain far worse. The emotional strain of living with repeated episodes of pain can lead to psychological problems, such as depression. During periods of extreme pain, some people may even consider suicide. Even when pain-free, you may live in fear of the pain returning. When to see your GP You should see your GP if you experience frequent or persistent facial pain, particularly if standard painkillers such as paracetamol and ibuprofen do not help and a dentist has ruled out any dental causes. Your GP will try to identify the problem by asking about your symptoms and ruling out conditions that could be responsible for your pain. Trigeminal neuralgia can be a difficult condition to diagnose, so it’s important to try to describe your symptoms as accurately and in as much detail as possible. Read more about diagnosing trigeminal


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diagnose, so it’s important to try to describe your symptoms as accurately and in as much detail as possible. Read more about diagnosing trigeminal neuralgia Causes of trigeminal neuralgia Although the exact cause is not known, trigeminal neuralgia is often thought to be caused by compression of the trigeminal nerve or an underlying condition affecting this nerve. The trigeminal nerve The trigeminal nerve (also called the fifth cranial nerve) is the largest nerve inside the skull. You have two trigeminal nerves, one in each side of your face. Small branches from different parts of the face join into three major nerve branches. These are: the upper branch (ophthalmic) – which carries sensory information from the skin above the eye, forehead and front of the head the middle branch (maxillary) – which carries sensory information from the skin through the cheek, side of the nose, upper jaw, teeth and gums the lower branch (mandibular) – which carries sensory information from the skin


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skin through the cheek, side of the nose, upper jaw, teeth and gums the lower branch (mandibular) – which carries sensory information from the skin through the lower jaw, teeth and gums These branches enter the skull through three different routes and then join together in what is called the Gasserian ganglion, before connecting to the brainstem in the part of the skull called the posterior fossa. Trigeminal neuralgia can involve one or more branches of the trigeminal nerve. The maxillary and mandibular branches are affected most often, and the ophthalmic branch is the least commonly affected. Pressure on the trigeminal nerve Evidence suggests that in up to 95% of cases, the cause of trigeminal neuralgia is pressure on the trigeminal nerve close to where it enters the brain stem (the lowest part of the brain that merges with the spinal cord), past the Gasserian ganglion. In most cases, this pressure seems to be caused by an artery or vein compressing the trigeminal nerve, although


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cord), past the Gasserian ganglion. In most cases, this pressure seems to be caused by an artery or vein compressing the trigeminal nerve, although it’s not known why this happens. It’s also not clear exactly why this pressure can cause painful attacks, as not everyone with a compressed trigeminal nerve will experience pain. It may be that, in some people, the pressure on the nerve wears away its protective outer layer called the myelin sheath, which may cause uncontrollable pain signals to travel along the nerve. However, this does not fully explain why periods of remission (periods without symptoms) can occur and why pain relief is immediate after a successful operation to move the blood vessels away from the nerve. Other underlying causes Other reasons why the trigeminal nerve can become compressed or damaged include: a tumour (a growth or lump) a cyst (fluid-filled sac) arteriovenous malformation (an abnormal tangle of arteries and veins) multiple sclerosis (MS) – a long-term


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growth or lump) a cyst (fluid-filled sac) arteriovenous malformation (an abnormal tangle of arteries and veins) multiple sclerosis (MS) – a long-term condition that affects the central nervous system (the brain and spinal cord) Diagnosing trigeminal neuralgia As the pain caused by trigeminal neuralgia is often felt in the jaw, teeth or gums, it is common for people to visit their dentist initially, rather than their GP. If you visit your dentist, they will ask you questions about your symptoms and investigate your facial pain using a dental X-ray and other means to look for other more common causes, such as a dental infection or cracked tooth. If the dentist cannot find a cause, it is important not to undergo unnecessary treatment such as a root canal filling or an extraction, even though you may be convinced that it is a tooth problem. If your dentist can’t find anything wrong, do not try to persuade them to remove a particular tooth, as this will not solve the problem. Often, the


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If your dentist can’t find anything wrong, do not try to persuade them to remove a particular tooth, as this will not solve the problem. Often, the diagnosis of trigeminal neuralgia is made by a dentist, but if you have already seen your dentist and they have not been able to find an obvious cause of your pain, visit your GP. Seeing your GP There is no specific test for trigeminal neuralgia, so a diagnosis is largely based on your symptoms and your description of the pain. If you have experienced facial pain, your GP will ask you questions about your symptoms, such as how often they occur, how long the pain attacks last and which areas of your face are affected. The more details about your pain you can provide, the better. Your GP will consider other possible causes of your pain and may also examine your head and jaw to identify which parts are painful. Ruling out other conditions An important part of the process of diagnosing trigeminal neuralgia involves ruling out other conditions


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are painful. Ruling out other conditions An important part of the process of diagnosing trigeminal neuralgia involves ruling out other conditions that can also cause facial pain. By asking about your symptoms and carrying out an examination, your GP may be able to rule out other conditions, such as: migraine joint pain in the lower jaw giant cell arteritis (temporal arteritis) – a condition in which medium and large arteries in the head and neck become inflamed and cause pain in the jaw and temples a possible injury to one of the facial nerves Your medical, personal and family history will also need to be taken into consideration when determining possible causes of your pain. For example, trigeminal neuralgia is less likely if you are under 40 years old, and multiple sclerosis (MS) may be more likely if you have a family history of the condition or if you have some other form of this condition. However, trigeminal neuralgia is very unlikely to be the first symptom of MS. MRI scans If


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or if you have some other form of this condition. However, trigeminal neuralgia is very unlikely to be the first symptom of MS. MRI scans If your GP is not sure about your diagnosis, or if you have unusual symptoms, they may refer you for a magnetic resonance imaging (MRI) scan of your head. An MRI scan uses strong magnetic fields and radio waves to create detailed images of the inside of your head. It can help identify potential causes of your facial pain, such as sinusitis (inflammation of the lining of the sinuses), tumours on one of the facial nerves, or nerve damage caused by MS. An MRI can also sometimes detect whether a blood vessel in your head is compressing one of the trigeminal nerves, which is one of the main causes of trigeminal neuralgia. However, highly sophisticated MRI scans may be needed to show this accurately, although this may not necessarily be helpful, because not everyone with a compressed trigeminal nerve has trigeminal neuralgia. Treating trigeminal neuralgia


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this may not necessarily be helpful, because not everyone with a compressed trigeminal nerve has trigeminal neuralgia. Treating trigeminal neuralgia There are a number of treatments available that can offer some relief from the pain caused by trigeminal neuralgia. Identifying triggers and avoiding them can also help. Most people with trigeminal neuralgia will be prescribed medication to help control their pain, although surgery may be considered for the longer term in those cases where medication is ineffective or causes too many side effects. Avoid triggers The painful attacks associated with trigeminal neuralgia can sometimes be triggered or made worse by a number of different things. Therefore, in addition to your medical treatment, it may help to try to avoid these triggers, if possible. For example, if your pain is triggered by wind or even a draught in a room, it may help to avoid sitting near open windows or the source of air conditioning, and wearing a scarf wrapped around


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or even a draught in a room, it may help to avoid sitting near open windows or the source of air conditioning, and wearing a scarf wrapped around your face in windy weather. A transparent dome-shaped umbrella can also protect your face from the weather. Hot, spicy or cold food or drink may also trigger your pain, so avoiding these can help. Using a straw to drink warm or cold drinks may also help prevent the liquid coming into contact with the painful areas of your mouth. It is important to eat nourishing meals, however, so if you are having difficulty chewing, consider eating mushy foods or liquidising your meals. Certain foods seem to trigger attacks in some people, so you may want to consider avoiding things such as caffeine, citrus fruits and bananas. Medication As normal painkillers such as paracetamol are not effective in treating trigeminal neuralgia, you will normally be prescribed an alternative medication, such as an anticonvulsant medication (usually used to treat epilepsy)


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neuralgia, you will normally be prescribed an alternative medication, such as an anticonvulsant medication (usually used to treat epilepsy) to help control your pain. These medications were not originally designed to treat pain, but they can help relieve nerve pain by slowing down electrical impulses in the nerves and reducing their ability to transmit pain. They need to be taken regularly, not just when the pain attacks occur, but can be stopped when the episodes of pain cease and you are in remission. Unless otherwise instructed by your GP or specialist, it is important to build up the dosage slowly and reduce it again gradually over a few weeks. Taking too much too soon and stopping the medication too quickly can cause serious problems. Initially, your GP will probably prescribe a type of anticonvulsant called carbamazepine, although a number of alternatives are available if this is ineffective or unsuitable. Carbamazepine The anticonvulsant carbamazepine is currently the only


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a number of alternatives are available if this is ineffective or unsuitable. Carbamazepine The anticonvulsant carbamazepine is currently the only medication licensed for the treatment of trigeminal neuralgia in the UK. It can be very effective initially, but may become less effective over time. You will usually need to take this medicine at a low dose once or twice a day, with the dose slowly increasing up to four times a day until it provides satisfactory pain relief. Carbamazepine often causes side effects, which may make it difficult for some people to take. These include: tiredness and sleepiness dizziness (lightheadedness) difficulty concentrating and memory problems confusion feeling unsteady on your feet feeling sick and vomiting double vision a reduced number of infection-fighting white blood cells (leukopenia) allergic skin reactions, such as urticaria (hives) You should speak to your GP if you experience any persistent or troublesome side effects while you are taking


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reactions, such as urticaria (hives) You should speak to your GP if you experience any persistent or troublesome side effects while you are taking carbamazepine, especially allergic skin reactions, as these could be dangerous. Carbamazepine has also been linked to a number of less common but more serious side effects, including thoughts of self-harm or suicide. You should immediately report any suicidal feelings to your GP. If this is not possible, call the NHS 24 111 service. Other medications Carbamazepine may stop working over time. If this occurs, or if you experience significant side effects while taking it, you should be referred to a specialist to consider alternative medications or procedures. There are a number of specialists you may be referred to for further treatment, including neurologists specialising in headaches, neurosurgeons and pain medicine specialists (for example, at a pain clinic). In addition to carbamazepine, there are a number of other medications that have


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and pain medicine specialists (for example, at a pain clinic). In addition to carbamazepine, there are a number of other medications that have been used to treat trigeminal neuralgia, including: oxcarbazepine lamotrigine gabapentin pregabalin baclofen None of these medications are specifically licensed for the treatment of trigeminal neuralgia, which means they have not undergone rigorous clinical trials to determine whether they are effective and safe to treat the condition. However, this is largely only because trigeminal neuralgia is a rare condition, and clinical trials are difficult to carry out on such a painful condition because giving some people an inactive, “dummy” medication (placebo) to compare these medications to would be unethical and impractical. However, many specialists will prescribe an unlicensed medication if they think it is likely to be effective and the benefits of treatment outweigh any associated risks. If your specialist is considering prescribing an


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they think it is likely to be effective and the benefits of treatment outweigh any associated risks. If your specialist is considering prescribing an unlicensed medication to treat trigeminal neuralgia, they should inform you that it is unlicensed and discuss possible risks and benefits with you. With most of these medications, the side effects can be quite difficult to cope with initially. Not everyone experiences side effects, but if you do, try to persevere because they do tend to diminish with time or at least until the next dosage increase, when you may find a further period of adjustment is necessary. Talk to your GP if you are finding the side effects unbearable. Surgery and procedures If medication does not adequately control your symptoms or is causing persistently troublesome side effects, you may be referred to a specialist to discuss the different surgical and non-surgical options available to relieve your pain. There a number of procedures that have been used to treat


