You are losing too much hair or your feet and your breath stink. POON CHIAN HUI looks into the causes of four distressing yet blush-inducing ailments and finds out if they are worth a trip to the doctor

Bad breath

What causes it?
Trapped food particles, eating pungent foods and smoking can cause bad breath, as well as gum disease and a dry mouth condition known as xerostomia.

Xerostomia results from hormonal changes, for example, during menopause, as well as from taking some types of medication, said Dr Helena Lee, a peridontist at Mount Elizabeth Medical Centre.

The characteristic stale smell of bad breath arises from sulphur compounds that form in the mouth due to poor oral hygiene, said Associate Professor Lim Lum Peng, a senior consultant in the
department of preventive dentistry at the National University Hospital.

“The accumulation of bacteria andsubstances that form when bacteria decomposes result in the formation of volatile sulphur compounds, which is probably the main source of bad breath,” she said.

Both doctors said that medical conditions such as diabetes, lung infections and gastrointestinal problems, can contribute to bad breath too.

What you can do
Practice good oral hygiene.

Dr Lee recommends brushing teeth twice a day, flossing and using a non-alcohol-based mouthwash.

“Make sure to brush around the gums and the tongue,” she added.

Is it worth seeing a doctor?
Yes, said Prof Lim, if the bad breath problem persists despite good oral health care. A doctor will also help exclude possible medical causes.

Smelly feet

What causes it?
A combination of excessive sweating and a bacterial or fungal infection.

What you can do
Keep your feet as hygienic as possible by applying powder several times daily to absorb excess moisture. Change your socks daily.

Also, dry your feet thoroughly after showering, said Dr Derrick Aw, a consultant dermatologist at the National University Hospital.

“Make sure the areas between the toes are dry. If your feet sweat persistently, buy an antiperspirant that contains aluminium chloride and apply it every night,” he said.

Aluminium chloride is an active ingredient that helps to reduce sweating when applied on the skin.

Is it worth seeing a doctor?
Yes, in order to diagnose the fungal or bacterial infection. If the above measures fail to control sweating, see a dermatologist to discuss other treatment options, said Dr Aw.

Balding

What causes it?
When hair loss is described as “male-pattern” or “female-pattern”, it is genetically determined, said Dr Derrick Aw, a consultant dermatologist at the National University Hospital.

Such hair loss is common.

However, non-genetic external factors like hair styling may also play a part.

“Excessive hair treatment, such as the use of hot curlers, may also cause hair to become fragile,” he said.

Dr Pang Shiu Meng, the head of the dermatology department at the Singapore General Hospital, said that hair loss may occur after major health events such as surgery, a severe illness or after giving birth.

The result – a sudden onset of bald patches.

“Your hairdresser is usually the one who will discover the bald patches,” said Dr Pang. “Occasionally, other parts of the body, such as the beard in men, may be affected.”

Medical conditions like thyroid disorders are linked to hair loss.

There is also trichotillomania, a condition in which one has an uncontrollable urge to pull out hair to relieve stress. It usually
affects young girls and their parents may not be aware of it, said Dr Pang.

What you can do
Unfortunately, treatment for hair loss is lifelong, said Dr Aw. Topical products such as Regaine contains minoxidil, which is effective for treating hair loss. One has to apply and massage the product into the scalp as directed.

However, people who do not respond well to treatment or are at an advanced stage of hair loss may consider surgical alternatives such as hair transplants, said Dr Pang.

Dr Aw added that alternative treatments for hair loss, such as herbal treatment, are not validated by clinical trials, so their effectiveness is unproven.

As for bald patches and hair loss induced by illness or giving birth, hair will usually regrow in a few months’ time. Bald patches can also be treated with hormone injections, although the regrown hair may be white, said Dr Pang.

Is it worth seeing a doctor?
Men may want to approach their doctor for a prescription drug called Propecia, which specifically treats male-pattern hair loss, said Dr Aw.

Heavy periods

What causes it?
There is often no actual cause, said Dr Wee Horng Yen, a consultant gynaecologist at KK Women’s and Children’s Hospital.In other cases, it could be due to hormonal imbalance, such as the polycystic ovary syndrome.

“When imbalance occurs, the lining of the uterus develops in excess and eventually sheds by way of heavy periods,” he said.

Other possibilities include fibroids which are non-cancerous growths that affect about 25 per cent of women.

Dr Tan Eng Loy, an associate consultant gynaecologist at the Singapore General Hospital, said: “Heavy periods may be due to the presence of uterine fibroids, especially if they protrude into the womb cavity.

“Or it could be adenomyosis, where the walls of the womb are abnormally thick.”

Blood clotting, thyroid and ovary disorders are contributing factors as well.

Contraceptives, such as the intra-uterine device, may also cause excessive bleeding.

However, bleeding in-between periods or after menopause may indicate cancer, said Dr Tan.

What you can do
Not much, but one can consider an iron-rich diet or iron supplements to help prevent anaemia, which results from excessive blood loss, he said.

Another tip is to keep a menstrual calendar detailing the days of menstrual flow, as well as the amount of bleeding in order to spot any abnormalities, he added.

Is it worth seeing a doctor?
Lethargy, giddiness, breathlessness and heart palpitations are signs of anaemia and one should see a doctor for a check-up, said Dr Tan.

Dr Wee added that a doctor can help to pinpoint the underlying cause to ensure the patient gets proper treatment.

While both doctors noted that heavy periods can be subjective, the flow can be gauged by the number of sanitary pads used.

“Seek medical advice if you have a heavy flow that soaks through one or more sanitary pads or tampons every hour for several consecutive hours; and if you have periods with large blood clots or irregular periods that last for more than seven days,” said Dr Tan, adding that these signs could indicate serious problems.