Dr Dixon answers your health questions

A: It is very common for psoriasis to occur on the scalp and can be prone to quite a thick build-up of scaly skin, which may cause dandruff-like flakes to fall.

It can be very uncomfortable to live with and can make the scalp feel itchy and tight.

In severe cases, the thickness of the scale can cause thinning of the hair, but usually this is temporary and goes back to normal with effective treatment of the psoriasis.

The good news is that it is treatable and there are lots of things that can help from moisturisers to prescribed treatments.

Moisturisers make the skin much more comfortable – they decrease the dryness, scaling, cracking and soreness, and itching.

Good moisturisers that can help include coconut oil and olive oil. As the dryness improves and the scale decreases this will allow more active treatments which have been prescribed to work more effectively.

Treatments that can be prescribed include coal tar, salicylic acid, steroid creams and ointments and Vitamin D based treatments.

It is important to get the method of applying scalp treatment right – the treatment needs to be on the scalp rather than on the hair. It might be best to part the hair in sections and apply the treatment on the exposed areas of scalp.

You may need someone to help you to reach the top and back of your head properly. Do follow the instructions that come with the product or the advice of your doctor, nurse or pharmacist.

Steroids you apply to your skin are one of the first treatment options for people whose psoriasis covers 5% or less of their body or is currently flaring.

They are easy to apply and can have positive results in a short period of time. However, steroid treatments should not be used for too long a period of time, as they can cause side effects such as skin thinning, and can cause psoriasis to become ‘unstable’ (prone to flaring)

Vitamin D treatments act by slowing down the production of skin cells and having an anti-inflammatory effect. This leads to an improvement in psoriasis symptoms for some people. Vitamin D treatments are only available on prescription.

You should continue to brush or comb your hair gently and regularly. It may take time for you to find the right treatment for you, so give treatments a chance to work: weeks, rather than days. For more information on psoriasis, visit https://www.psoriasis-association.org.uk/.

Q: I have put on half a stone during lockdown, how can I start to lose weight?

A: With everything that has gone on in the last few months, it’s hardly surprising if you have gained a few pounds.

The uncertainty and sudden change to routine has caused anxiety for a lot of people, which can lead to comfort eating.

This, coupled with less physical activity - especially for those working at home - can lead to weight gain.

It helps if you aim to be healthier, rather than concentrating too much on the scales. If you eat more healthily and increase your exercise then you will most likely feel better and it can be a gradual shift towards making healthier choices rather than a really strict diet that is hard to stick to.

Remember: increasing your exercise can also help your emotional well being which will have positive impact on you.

One simple thing you could start with is writing a list of your unhealthy habits, for example ‘eating too many biscuits’ or ‘snacking between meals’ or ‘not moving around enough’ and then think about how you can turn it around - for example ‘I will only have a few biscuits at the weekend’, ‘I will only have nuts, fruit or vegetables between meals’ and ‘I will go for a 20 minute walk every day’.

Setting yourself small achievable goals will help you to concentrate on the things that you can control, and as you achieve them you will feel more positive about setting new goals. Small changes will lead to big changes overtime.

It’s good to have short term goals, but also having long term goals help to keep you motivated for longer.

Creating a balance is also a good idea; if you deprive yourself of all your favourite things then it could lead to a binge if your self-control becomes limited when having a bad day.

Avoid cutting things out completely at first and just focus on cutting down - once you start to change your habits it becomes easier to avoid certain foods. The important thing is to try and lose weight gradually; crash diets generally don’t lead to a long-term healthy lifestyle..

There is a new app called ‘NHS Weight Loss Plan’ that you can download, which is designed to help you develop healthier eating habits, be more active and get on track to start losing weight.

The app will guide you through an easy-to-follow NHS 12-week diet and exercise plan, guiding you towards a balanced diet and helping you stick to a daily calorie target. Find out more and download the app here: https://www.nhs.uk/better-health/.

Finally, don’t be too hard on yourself. You’re only human, if you have a bad day, that’s okay - just start again the next day rather than writing the whole week off.