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Your health | KRY

The teenage years can be emotionally turbulent. This year, the pandemic has presented additional challenges for young people and many are facing increased struggles with their mental health. As a parent, how can you spot the signs and encourage them to open up to you? And what are the best ways to suggest getting help — without alienating your teenager?

A new UK study shows that almost half of 16 to 24 year-olds reported higher levels of stress. Almost 1 in 2 without previous mental health problems reported high levels of depressive symptoms, and 1 in 3 experienced moderate to high anxiety. Almost half said they were overeating to cope with their moods.

But while around 50% would ask for help for a personal or emotional problem, from a partner, friend or parent, and one-third would seek help from a mental health professional – worryingly, around 1 in 3 wouldn’t ask for help.

‘The teenage years are a formative period in life when you start to forge your identity,’ says Martin Forster, child psychologist at Kry. ‘So, the pandemic restrictions are having an effect on teenagers, not only on a practical level, but also on an existential one.’ 

Here, Forster answers questions for any parents worried about their teen’s mental health.

### What’s going on in a teenage brain?

‘It’s normal for teenagers to become more moody,’ says Martin. ‘This is mainly down to a complex interplay between hormonal shifts during puberty and brain development that occurs in this period.’ 

Research shows that the prefrontal cortex — the area to do with planning, prioritising and impulse control — is one of the last regions of the brain to mature, and this can take until 25 to reach maturity, Forster explains. 
‘Quite often, teenagers are described as being very emotional and not having the best judgement when it comes to taking risks,’ he says. But in recent years, research has shown that this is actually not true — teenagers don’t have a lesser ability to assess risks than adults. 

‘But, what is specific to the adolescent brain is that there’s an increase in activity in the neural circuits using dopamine, a neurotransmitter central to creating the drive for reward,’ Forster explains. ‘This means they may react more strongly to temptation and find it harder to resist different types of rewards such as alcohol, drugs or sexual behaviour.’

It’s also natural for teenagers to become more rebellious as they transition from childhood to adulthood. ‘This is a time when they crave more freedom and this can lead to conflicts with parents,’ he says. ‘But, as a parent it’s important to remember that this is a normal and even healthy part of a teenage development. Teenagers need boundaries to rebel against.

The key is to help them navigate this difficult period by remaining calm, firm and steadfast, and giving them just enough leeway without totally crushing their will.’ 

### How can I handle my difficult teen?

- Involve your teenager in negotiations on boundaries and house rules, but stick to your agreements
- Try to remain calm, firm and consistent
- Talk about your concerns to friends, or join a support group
- Look after your own mental health, so you’re better equipped to handle tricky situations

### What are the signs of mental health problems in teenagers?

If mood swings are normal during adolescence, how can you tell if there’s something more serious going on? ‘If your teen is moody, this in itself isn’t necessarily a sign that they’re having mental health issues,’ says Forster. ‘The general sign to look for is any sudden change in behaviour or habits — this could indicate they’re struggling’.  

Here are some more key signs:

- __Generalised anxiety:__ They seem excessively worried about everyday matters and can be restless and on edge
- __Depression:__ They seem persistently sad or low, can’t seem to function normally, are having problems with energy, sleep and concentration and have lost interest in doing things they used to once enjoy
- __Substance abuse:__ Their behaviour has become erratic. They might be talking more quickly or slowly than usual. They seem spaced out or high. You notice physical changes. For example, they may look thinner or their pupils may be dilated
- __Self-harming:__ You notice cuts or scratches on their body that they try to hide
- __Eating disorders:__ They’re avoiding food, are rapidly losing weight, or overeating. They may also be spending more time in the bathroom (this suggests they may be making themselves sick, which is a sign of bulimia)

### How can I talk to my teen about their mental health?

‘If you’re worried, it’s crucial to get the right help,’ says Dr Forster. ‘Confronting a teenager directly probably isn’t the best tactic‘.

Instead, Forster advises trying to spend more time with them, even if this means cancelling things in your diary. ‘Find things that you can do together where they can feel safe and relaxed such as watching a film, doing sport, going for a walk, preparing a meal or giving them a lift in the car,’ he suggests. ‘That way, there’s more chance they’ll open up to you.’ 

When they do speak up, really listen to what they’re saying, Forster says. ‘At this point, it’s important not to shy away from sensitive matters and dare to ask straight questions, even if you as a parent may be afraid of the answer,’ he asserts. ‘For example, if your child hints that he or she is having suicidal thoughts — do ask about that. 

‘Don’t be judgmental or overanxious and gently suggest that it might be helpful to talk to a doctor, psychologist or other health professional.’

### How a doctor can help

‘A doctor will evaluate the physical and emotional symptoms, and advise on the appropriate treatment,’ says Forster. 

This may be a referral to a psychologist, a specialist clinic, for example for eating disorders or substance abuse, or a support group. 

Cognitive behavioural therapy (CBT), for example, can be effective for treating anxiety disorders and depression. In some cases, medication may be prescribed.

__This article has been reviewed by Dr. Martin Forster, child psychologist__


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Kry.co.uk > Your health > Could your teenager have a mental health problem? A child psychologist explores

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Mental health struggles among teenagers are on the rise. Here’s expert help on how to deal with this sensitive issue 

Expert advice for mental health problems in teenagers | Kry UK

Mental health

Could your teenager have a mental health problem? A child psychologist explores

Skin complaints are among the most common reasons people see their doctor. And whether it’s itching, flaking or [spots](/your-health/acne-types-and-their-treatments-help-to-clear-your-skin/), the good news is there are many treatments available, from things you can do yourself, to over-the-counter measures, and medical help. These are the 6 most common skin conditions our doctors see in patients...

### 1. Eczema

There are different types of this non-contagious, inflammatory, dry skin condition, but the most common is atopic eczema (atopic dermatitis).

__What it looks like:__ The skin will be itchy, dry, cracked and sore.
Inflamed skin can become red on lighter skin, and darker brown, purple or grey on darker skin. Atopic eczema can affect any part of the body, but it most commonly affects hands, insides of the elbows, backs of the knees, face and scalp.

__Causes:__ It’s not known exactly what causes eczema. It often occurs in people who are susceptible to allergies. People with eczema tend to have an over-reactive immune system that responds to certain triggers by producing inflammation that causes red, itchy, painful skin. There may also be a genetic component and it often develops alongside other conditions such as asthma and hay fever.

__Self-help:__ Keep a diary to help you become aware of potential triggers such as metals, soaps, fragrances, antibacterial lotions, shampoo or body wash. Include what you eat and how you feel, as food allergies and intolerances, as well as stress, can also trigger outbreaks. Moisturise skin regularly (five to six times a day can be required) with an emollient cream.

If your eczema is particularly inflamed, or not improving with regular emollient use, then you can also try a small amount of an over-the- counter cortisone cream such as hydrocortisone. Only use this for a maximum of two weeks and if there is no improvement see your GP. These creams should not be used in children under 2 years. Adding oatmeal or baking soda to the bath can help to soothe itchy skin.

__When to see a doctor:__ If the eczema is spreading, has become infected and/or isn’t responding to over-the-counter treatment, speak to a doctor. Treatment includes prescription creams as well as medical light treatments, in some cases.

### 2. Rosacea

A common skin condition that mainly affects the face, rosacea is more common in women and people with fair skin, though symptoms can be worse in men.

__What it looks like:__ Rosacea causes redness (like a blush) across the nose, cheeks, forehead and chin. There may also be tiny, broken blood vessels and small pinkish-red bumps filled with pus. Other symptoms may include swelling around the eyes, sore eyelids and thickened skin on the nose. Many cases are mild and not everyone develops all the symptoms.

__Causes:__ Genetics, the immune system and environmental factors may all play a part, but the exact cause isn’t known. Certain triggers can worsen symptoms, especially alcohol and spicy foods but also cheese, caffeine, hot drinks, vigorous exercise, stress and sunlight.

__Self-help:__ Avoid the triggers that make your symptoms worse and always wear a high SPF sunscreen (30+).

__When to see a doctor:__ There’s no cure for rosacea but your doctor can advise you on the best treatments. These include prescription gels and creams, antibiotics, or light treatments. Sometimes rosacea can affect the eyes (ocular rosacea) so always see your doctor if you develop a red, painful, gritty eye or blurred vision. These may be symptoms of keratitis (inflammation of the cornea) which needs to be treated urgently.

### 3. Fungal infection

There are many types of fungal infections affecting skin, hair and nails and nearly a billion people are affected worldwide.

__What it looks like:__ An itchy, scaly rash, sometimes with skin discolouration. Common forms include:

- __Athlete’s Foot (tinea pedis):__ Symptoms include itchy, white patches between the toes. There may also be red, sore, flaky patches on the feet. Skin may crack and bleed. Athlete’s Foot can spread, causing fungal nail infection.
- __Ringworm__ can appear anywhere on the body, including the scalp and groin. The main symptom is a red or silver rash that is dry, scaly, swollen and itchy. The rash is usually circular.
- __Intertrigo__ is a fungal infection that appears under the breasts, in the groin or skin folds. Typical symptoms are inflammation, soreness, discomfort, itching, discolouration and a strong, musty smell.

__Causes:__ Common fungal infections are caused by yeasts such as candida or the fungus dermatophytes. Certain conditions cause them to proliferate. Obese people and diabetics are more susceptible.

__Self-help:__ If you suffer from Athlete’s Foot, a cream, spray or powder from the pharmacy can help. Always wash and dry your feet, wear clean tights or socks every day and alternate shoes regularly. For intertrigo, keep the area as dry and clean as possible. Most fungal infections can be helped with an antifungal ointment, gel or cream from the pharmacy. If you’re concerned about ringworm, make sure you get any pets examined by a vet, as they might carry the fungus.

__When to see a doctor:__ If the rash covers large parts of the body or you’ve been using over-the-counter medication for two weeks and it hasn’t helped, see a doctor as you may need prescription cream.

### 4. Psoriasis

Common and non-infectious, psoriasis is an autoimmune disease that affects at least 100,000 million people worldwide.

__What it looks like:__ The most common type is plaque psoriasis which causes red, flaky, crusty patches of skin covered in silvery scales, most
commonly affecting the elbows, knees, scalp and lower back. Psoriasis causes shedding skin which can be distressing and may also affect the nails. In some sufferers, it can also lead to psoriatic arthritis, an inflammatory disease in which joints may swell and become red and hot.

__Causes:__ Psoriasis is an autoimmune disease, which causes the body to attack its own tissue, leading to an increased production of skin cells. This creates a build-up of patches of dry, scaly skin. It’s not known exactly what causes the immune system to behave in this way, although certain genes and environmental triggers, such as stress, may play a role.

__Self-help:__ If you think you have psoriasis, make sure you keep the area well-lubricated with an over-the-counter emollient. It’s important to see a doctor as quickly as possible (see below).

__When to see a doctor:__ There are many treatments a GP or dermatologist can prescribe, including topical creams and ointments as well as oral and injected medications and phototherapy, where skin is exposed to ultraviolet light. Normally psoriasis can be diagnosed on a clinical examination, but if there’s doubt, sometimes a skin sample (biopsy) is needed to confirm the diagnosis.

### 5. Shingles

Shingles is an infection that causes a painful rash. Get medical advice
as soon as you can if you suspect you have it.

__What it looks like:__ The first sign of shingles is a painful, tingling sensation. You may also have a headache and feel unwell. This is followed a few days later by a red, itchy, blotchy rash on only one side of the body, usually on the chest and stomach, but it can also affect the face, eyes and genitals. The rash then turns to itchy blisters that ooze fluid.

__Causes:__ Most people have chickenpox in childhood but after the illness has gone, the varicella-zoster virus remains inactive in the nervous system. Later in life, this virus can be reactivated and cause shingles.

__Self-help:__ Take paracetamol and keep the rash clean. Do not apply sticky dressings, plaster, or antibiotic creams. Wear loose clothing and keep the area clean. Use a cool compress a few times a day. It can take up to 4 weeks for shingles to heal.

__When to see a doctor:__ Get medical advice as soon as you think you have shingles. Ideally, speak to a doctor within 3 days of your symptoms starting as you may need medicine to speed up your recovery.

### 6. Acne

Acne is a common skin condition that affects the tiny pores of the skin, particularly on the face, back and chest.

__What it looks like:__ Acne can vary from mild to severe. There are six different types of acne. Non inflammatory acne includes blackheads (small, dark dots) and whiteheads (small, white bumps). Inflammatory acne includes papules (small red bumps that may be tender), pustules (similar to papules, but with a small white tip filled with pus), nodules (large, hard bumps below the surface of the skin) and cysts (large pus-filled lumps).

__Causes:__ Acne is caused when the tiny pores in the skin, known as hair follicles, become blocked with excess sebum (a mixture of oils and waxes) produced by the sebaceous (oil) glands. This creates the ideal environment for the propionibacterium (a bacteria present on human skin) to thrive. Sebaceous glands most commonly produce too much sebum during times of hormonal changes such as puberty. Some women may develop ‘adult acne’ during perimenopause and menopause, when a drop in oestrogen and progesterone hormones creates a temporary imbalance in circulating androgens (male hormones, including testosterone). Androgens are a potent stimulator of the sebaceous glands in the skin, and this can lead to an excess of sebum that causes acne.

__Self-help:__ If you’ve got mild acne, over the counter topical treatments that contain benzoyl peroxide (an antiseptic that helps to reduce bacteria) may help. Do not wash affected areas of skin more than twice a day, as this can irritate the skin and make acne worse. Lifestyle changes may also help, for example, avoiding sugar and processed foods, as these may increase inflammation and exacerbate acne.

__When to see a doctor:__ If your acne is not clearing up, talk to your  doctor. Prescription medicines that can be used to treat acne include topical retinoids, topical and oral antibiotics, azelaic acid and the combined oral contraceptive pill (in women). For severe acne, your doctor can refer you to a dermatologist for further treatment.

Find out more about the [treatments and causes of acne.](/your-health/acne-types-and-their-treatments-help-to-clear-your-skin/)

__Reviewed by: Rhianna McClymont, Lead GP, Kry__


Kry.co.uk > Your health > Ultimate guide to the 6 most common skin conditions

Ultimate guide to the 6 most common skin conditions

There’s no need to suffer in silence with a skin condition. Our doctor’s guide explains what to look for and the help available.

Livi.co.uk > Your health > Ultimate guide to the 6 most common skin conditions

General health

General health and seasonal

Just as our bodies age, our brains age too. As we get older, the areas of the brain that control emotional expression, problem-solving, attention and mental abilities start to get smaller.

Research shows that the overall volume of the average brain shrinks by around 5% each decade after the age of 40, with the rate of decline increasing after 70. These changes can make you increasingly susceptible to cognitive dysfunctions like memory loss, impaired thinking and dementia.

In fact, around 50 million people worldwide have dementia, according to the World Health Organization (WHO). In the UK, there are 850,000 people with dementia, and this is projected to rise to 1.6 million by 2040.

While these statistics may sound scary, there’s no cause for alarm. Evidence shows there are plenty of things you can do to help prevent cognitive decline.

### 1. Do 30 minutes’ aerobic exercise 4 to 5 times a week

People who are physically active are less likely to develop cognitive decline. Exercise improves blood flow and oxygen supply and this stimulates chemical changes in the brain that enhance cognitive function. One study found that doing aerobic exercise in particular, for half an hour, 4 to 5 times a week, could help to slow shrinking of the hippocampus, the part of the brain that deals with memory. [Exercising regularly](https://www.livi.co.uk/your-health/how-to-fit-exercise-into-your-daily-life/) also reduces your risk of developing high blood pressure, heart disease and stroke, all of which can have an adverse effect on brain health.

### 2. Eat a MIND diet

The MIND diet consists of eating plenty of wholegrains such as quinoa, oats and barley; plenty of leafy greens; brightly coloured vegetables; nuts; berries, especially strawberries and blueberries; beans, lentils and soybeans; poultry and oily fish at least once a week, and cooking with olive oil. It also suggests avoiding or minimising red meat, processed food, salt, cheese and butter, and sugar. Get tips on [how to make healthier food choices](https://www.livi.co.uk/your-health/8-ways-to-make-healthier-food-choices-every-day/).

### 3. Get musical

Learning to play a musical instrument may enhance brain function as we get older, and could also help prevent age-related cognitive problems — according to a systematic review of scientific research. But if you’re no Mozart, don’t despair. Just listening to music you enjoy is also beneficial for healthy brain function as research shows it can help memory and reasoning.

Learning new dance moves may help support your brain health too. Dancing reduces stress, increases levels of feel-good endorphins and also helps develop new neural connections, especially in those parts of the brain involved in executive function, long-term memory and spatial recognition.

### 4. Stay socially connected

Being [socially engaged and supporting others](https://www.livi.co.uk/your-health/supporting-others-during-difficult-times/) is important for a healthy brain. When you interact with others, whether it’s spending time with friends, volunteering or having a chat with a neighbour, parts of your brain are stimulated. Research shows that just one hour a week of social interaction is beneficial for people with dementia.

### 5. Meditate

Meditation has many benefits. It can help to calm the mind, reduce stress and lower blood pressure. Research also shows it may help reduce age-related memory loss — and benefits can be seen in as little as 12 minutes a day of regular meditation.

### 6. Reduce your stress levels

Stress can be a contributing factor for many health problems, including heart disease, insomnia and anxiety disorders. Research also shows that higher blood levels of the stress hormone cortisol are associated with memory impairment and reduced brain size in middle-aged adults. So, if your [stress levels are high](https://www.livi.co.uk/your-health/physical-signs-of-stress-on-the-body/), protect your brain by finding ways to manage your stress better, such as yoga or meditation.

__Reviewed by: Rhianna McClymont, Lead GP, Livi__


Livi.co.uk > Your health > 6 ways to keep your brain healthy

2100x1200px Article Hero Memory

These simple lifestyle changes can help prevent cognitive decline as you grow older

Kry.co.uk > Your health > 7 ways to keep your brain healthy

7 ways to keep your brain healthy

kry.co.uk > medical reviewer

IMG 20200730 224911 865-33- 1 .jpg

Dr Rhianna McClymont

Lead GP at Kry

Health tips

6 ways to keep your brain healthy

Just as our bodies age, our brains age too. As we get older, the areas of the brain that control emotional expression, problem-solving, attention and mental abilities start too get smaller.

Research shows that the overall volume of the average brain shrinks by around 5% each decade after the age of 40, with the rate of decline increasing after 70. These changes can make you increasingly susceptible to cognitive dysfunctions like memory loss, impaired thinking and dementia.

In fact, around 50 million people worldwide have dementia, according to the World Health Organization (WHT). In the UK, there are 850,000 people with dementia, and this is projected to rise to 1.6 million by 2040.

While these statistics may sound scary, there’s no cause for alarm. Evidence shows there are plenty of things you can do to help prevent cognitive decline.

### 1. Do 30 minute’s aerobic exercise 4 to 5 times a week

People who are physically active are less likely to develop cognitive decline. Exercise improves blood flow and oxygen supply and this stimulates chemical changes in the brain that enhance cognitive function. One study found that doing aerobic exercise in particular, for half an hour, 4 to 5 times a week, could help to slow shrinking of the hippocampus, the part of the brain that deals with memory. [Exercising regularly](/your-health/how-to-fit-exercise-into-your-daily-life/) also reduces your risk of developing high blood pressure, heart disease and stroke, all of which can have an adverse effect on brain health.

### 2. Eat a MIND diet

The MIND diet consists of eating plenty of wholegrains such as quinoa, oats and barley; plenty of leafy greens; brightly coloured vegetables; nuts; berries, especially strawberries and blueberries; beans, lentils and soybeans; poultry and oily fish at least once a week, and cooking with olive oil. It also suggests avoiding or minimising red meat, processed food, salt, cheese and butter, and sugar. Get tips on [how to make healthier food choices](/).

### 3. Get musical

Learning to play a musical instrument may enhance brain function as we get older, and could also help prevent age-related cognitive problems — according to a systematic review of scientific research. But if you’re no Mozart, don’t despair. Just listening music you enjoy is also beneficial for healthy brain function as research shows it can help memory and reasoning.

Learning new dance moves may help support your brain health too. Dancing reduces stress, increases levels of feel-good endorphins and also helps develop new neural connections, especially in those parts of the brain involved in executive function, long-term memory and spatial recognition

### 4. Stay socially connected

Being [socially engaged and supporting others](/your-health/supporting-others-during-difficult-times/) is important for a healthy brain. When you interact with others, wether it’s spending time with friends, volunteering or having a chat with a neighbour, parts of your brain are stimulated. Research shows that just one hour a week of social interaction is beneficial for people with dementia.

### 5. Meditate

Meditation has many benefits. It can help to calm the mind, reduce stress and lower blood pressure. Research also shows it may help reduce age-related memory loss — and benefits can be seen in as little as 12 minutes a day of regular meditation.

### 6. Reduce your stress levels

Stress can be a contributing factor for many health problems, including heart disease, insomnia and anxiety disorders. Research also shows that higher blood levels of the stress hormone cortisol are associated with memory impairment and reduced brain size in middle-aged adults. So, if your stress levels are high, protect your brain by finding ways to manage your stress better, such as yoga or meditation.

__Reviewed by: Rhianna McClymont, Lead GP Lead GP, Kry__

Kry.co.uk > Your health > 7 ways to keep your brain healthy (1)

## Quick facts

- Itching from eczema may be relieved by emollient creams, though severe cases may require prescription medication
- Infants often get nappy rash which usually clears up in a few days
- Urticaria or ‘hives’ is triggered by allergies, so antihistamines may be an option

A child or baby suddenly developing a skin rash can be alarming for parents. The good news is that most rashes are not serious and can easily be treated at home.

That said, it’s helpful to be aware of the serious symptoms which mean that you should seek immediate medical help.

### Red flag symptoms not to ignore

If your child seems unwell or has a fever, you should see your doctor. And if they have a rash that doesn’t fade when you press a glass against it, seek emergency medical treatment via A&E. This could be meningitis. Other signs — which may appear before this tell-tale rash — are:

- a stiff neck
- your child being bothered by light
- your child seeming confused
- uncontrollable shaking
- a high fever you can’t control
- unusually cold hands and feet

Fortunately, most parents will never encounter meningitis. In Europe there are just 0.6 cases reported for every 100,000 people — but it’s important to be alert to the warning signs.

Here we reveal the five most common rashes new parents see our doctors about, and what you can do as well as when to consult a doctor.

## Different types of rashes on babies & children:

### 1. Eczema

[Eczema](/medical-advice/skin-conditions/eczema/) affects 5-15% of children and is characterised by itchy, dry, cracked skin. It can appear anywhere but in children it most commonly affects the hands, insides of the elbows, the backs of the knees, face and scalp. The most common form is atopic eczema, which is also known as atopic dermatitis.

Eczema can be set off by food allergies, chemicals in soaps and detergents, stress, and even cold weather, so it may take a little detective work to identify every trigger. It sometimes coincides with your baby teething or another infection, such as a cold. Eczema often runs in families, where it is closely linked to asthma and allergic nasal conditions causing a runny nose and sneezing (like hayfever). Together, these three conditions, linked by genetics, are termed atopy.

Treatments focus on reducing itching and using special moisturisers called emollients which provide a barrier to protect the area. These are available as lotions, sprays and creams from pharmacies. As a general rule, try to use the richest one which is comfortable. Avoid aqueous cream as this can make eczema worse. Severe cases may need a short course of cortisone cream prescribed by a doctor.

### 2. Impetigo

[Impetigo](/medical-advice/skin-conditions/impetigo/) is a common, and highly contagious, skin infection which starts with red sores or blisters that burst and leave crusty yellow scabs. It usually affects skin that has already been damaged, and is sometimes associated with bad eczema.

If you think your child has impetigo, see your doctor — who may prescribe an antibiotic cream or tablets. The affected area should be kept clean and dry, and covered with loose clothing or gauze bandages.

Wash yours and your child’s hands regularly and wash bedding, towels and flannels at a high temperature to reduce the risk of the infection spreading. It’s also a good idea to wash or wipe down toys and anything else your child touches regularly.

### 3. Chickenpox

[Chickenpox](/medical-advice/infections/chicken-pox/) is another common, and very contagious, childhood infection, which starts with red spots that then fill with fluid. Unlike impetigo, chickenpox is not associated with broken skin and your child will probably have other symptoms. Before the spots appear, your child may also:

- Feel unwell
- Develop a high fever (over 38°C)
- Complain of aches and pains, or
- Lose their appetite.

Chickenpox is intensely itchy and your child will probably feel miserable. Paracetamol will help with discomfort, but do not use ibuprofen as this can trigger skin infections. Encourage your child to drink plenty of fluids to prevent dehydration.

Simple anti-itch measures such as cutting their nails and putting socks over their hands at night can help stop them scratching. A cool bath with added baking soda or finely ground oatmeal will help ease itching, but be careful to pat the skin dry, rather than rubbing it. Dabbing calamine lotion on the blisters will also help.

### 4. Hives (urticaria)

[Hives](/medical-advice/skin-conditions/hives/) is an allergic rash which comes in all shapes and sizes and can appear anywhere on the body. Sometimes urticaria, or ‘hives’ as it’s also known, emerges as large raised patches or red skin and sometimes it appears as a series of small red spots. It’s usually itchy and often stings or burns.

The rash is triggered by the body releasing histamines. These are chemicals the immune system releases as an allergic reaction to substances such as food, plant pollens, insect bites, infections or dust mites. Urticaria can settle down in a matter of minutes, and sometimes it can persist for a few days.

If the itching is severe, ask your pharmacist about antihistamines — there are some which can be given to children over 12 months of age — or ask your doctor, who may prescribe them for infants. Speak to your doctor if the rash doesn’t improve after two days, if your child develops a temperature or if they keep getting hives. Call emergency if the rash spreads quickly, if they have trouble breathing or develop other acute symptoms such as swelling on the face, lips or tongue.

### 5. Nappy rash

Nappy rash affects 1 in 3 babies and toddlers at some time. It develops if they have worn a soiled nappy for too long, the nappy has rubbed against their skin or they haven’t been cleaned thoroughly during nappy changes. Many parents say nappy rash is more common when a child is teething, and it can also be triggered by antibiotics or using alcohol-based baby wipes, soap, detergent or bubble-bath. 

It is characterised by red, irritated and sometimes sore skin. If you use a nappy rash cream, followed by a barrier cream, and change nappies regularly it generally clears in two or three days. Letting your baby lie on a towel without a nappy, and avoiding talcum powder and scented lotions can also help.

But if your child develops a bright red rash with red or white spots, particularly if it spreads into the folds of their skin, they may have a fungal infection, and you should ask your doctor for advice.

To prevent fungal infections spreading, it’s important to wash your hands thoroughly after nappy changes, use separate towels and wash them at a high temperature.

__Reviewed by: Rhianna McClymont, Lead GP, Kry__


Kry.co.uk > Your health > 5 common skin rashes in babies and children — and what to do

5 common skin rashes in babies and children — and what to do

It’s natural to worry when your child develops a rash — but most rashes aren’t serious, and can easily be treated at home

How to spot common rashes in babies and children | Kry UK

Family

Family health

2020 hasn’t gone quite as we expected. The pandemic has changed the way we have business meetings, use transport and interact with loved ones. While a lengthy lockdown put many UK childrens’ education on pause, children are now back to school, but with new social distancing measures in place.

Reassuringly, children are less likely to become unwell from COVID-19 than adults. But the virus is still around – along with the usual back-to-school infections like the common cold and stomach bugs – and we want to make sure kids are as safe and happy as possible. 

So, how can you help them feel comfortable both physically and mentally after a rollercoaster first half of the year? Follow these tips for peace of mind... 

## How to help your child settle back in at school

### 1. Have positive conversations about what’s different 

Nobody wants their child to feel surprised or confused because things aren’t quite the same as before. First things first, it’s important to have plenty of conversations about the new normal. But on top of informing them, make sure you gauge how they feel about the changes. Are they experiencing anxiety over separating after a long time spent at home? Do they miss playing with a group of friends? By communicating about these feelings early, you can help motivate and reassure your child as the term goes on.

### 2. Keep practicing excellent hygiene habits at home

The 20-second (or “happy birthday”) handwashing rule is nothing new – we’ve been doing this since we first became aware of coronavirus. But it’s super important not to let good hygiene habits slide. Keep up the good work when it comes to things like washing hands and wiping surfaces frequently. This will help your child transition to new hygiene rules at school. 

### 3. Make healthy food choices to boost immunity 

Preparing your child with good nutrition is a great way to help fight off illnesses – from ear infections to cold sores. And now coronavirus is part of our everyday lives, it’s more important than ever to promote a good diet that supports your child’s immune system.

Key nutrients for healthy immune function include vitamins A, C, D, zinc and selenium, which you can get from something as cheap and simple as an apple. Aim for five portions of nutrient-packed fruits and veg each day, limit sugary foods and boost brain function with plenty of protein. We have an informative [guide to healthy food choices](/your-health/8-ways-to-make-healthier-food-choices-every-day/) – see how many of these you can get in your little one’s lunch box. 

### 4. Keep a good routine 

Has lockdown thrown your child’s daily routine out the window? That’s totally normal. They may be finding the back-to-school adjustment a bit tricky, so it could be a good idea to practice proper routine at weekends too. Try starting the day a little earlier, going back to regular bedtimes (see these [tips on getting children to sleep](/your-health/tips-to-help-children-get-to-sleep/)) and limiting screen time.

### 5. Treat it as a fresh start 

‘Back to school’ this year doesn’t mean back to school as your child knew it before. There will be plenty of changes that make it feel like a new experience. So, make it an exciting one by helping your child with all the right resources. Read up on the new term curriculum and familiarise them with upcoming literature to help them get stuck in – you can use online resources or your local library if it’s open. If you can, upgrade their stationary to get them in a productive mindset, and maybe even get them a cool new haircut for a new term. Most children love to start a term with a few new things. 

As important as it is to help your child settle into an unprecedented return to school, it’s so important for you to be in the best frame of mind, too. Make sure you talk about your own concerns and anxieties to friends, family or a professional if you need. It could also be useful to talk to other parents to be mindful of what their worries are and how they’re handling them – chances are, you’re in the same boat. 


Kry.co.uk > Your health > Back to school 2020: 5 ways to help your child settle in

Back to school v01

Back to school 2020: 5 ways to help your child settle in

__Here are some practical tips…__

## 1. Use colour

One of the key principles of healthy eating is to ‘eat a rainbow of fruit and vegetables’. The more colour you can get into your family’s diet from varied, brightly-coloured fruit and vegetables, the healthier their diet will be.
 
The pigments in foods that give them their colour come from natural compounds called phytochemicals. Many of these are antioxidants (natural chemicals) thought to protect against harmful substances called free radicals. The richest sources of these are fresh fruit and vegetables, which are associated with lower levels of diseases such as heart disease and cancer. 
 
For example, red, purple and blue foods such as currants, berries and grapes are rich in phytochemicals called anthocyanins. Studies show that these have antioxidative and antimicrobial activities that might help improve visual and neurological health, and might help protect against various diseases. 
 
Here’s a simple guide to other coloured vegetables and fruit that are rich in protective phytochemicals – use a wide variety:
 
__Red__ - Tomatoes, red berries, watermelon, cherries, red peppers and pomegranates
__Yellow__ - Butternut squash, honeydew melons, lemons, papayas, peaches, persimmons, swedes, yellow peppers
__Orange__ - Carrots, butternut squash, pumpkins and sweet potatoes
__Beige/white__ - Bananas, celeriac, garlic, Jerusalem artichokes, mushrooms, onions, turnips, white peaches
__Purple/blue__ - Aubergines, blackberries, blackcurrants, purple grapes, red cabbage, purple/green vegetables such as purple kale, broccoli and artichokes
__Green__ - Broccoli, cabbage, Brussels sprouts, kale and pak choi.
 
## 2. Use your senses
Touching and smelling food during its preparation and cooking activates the hormonal, nervous and enzymatic processes that help us digest it and absorb nutrients. 

This can start from choosing fruits and vegetables by smelling for ripeness. It can continue when you appreciate the texture and delicious scents as you chop and squeeze pungent foods such as parsley, garlic and lemon. Cooking healthily is a delicious journey, long before you start eating. 

Try to get children involved in this process. Encouraging them to enjoy food preparation with you will help engender an ease around fresh food in them as they get older. Also, studies show children who are involved in cooking make better diet choices.

## 3. Hide the healthy 
Try not to declare ‘We’re going to start eating healthy food.’ This can make the family think they’re getting boring or bland food. Instead, slowly start to include healthy food into meals that look as appetising and delicious as the foods they’re used to. The following tiny hacks can make a big difference:

- When making Bolognese sauce, try substituting half the mince with tinned brown lentils (rinse them off to remove salty residue)
- To use less salt, which is associated with increased risk of high blood pressure, try substituting it with lemon or lime. It sounds odd but it works. Or, use fresh herbs instead (see below). Lower your salt use gradually and your family’s taste buds will adapt
- Try substituting half the mayonnaise in coleslaw for yogurt or cutting potatoes into chip-like shapes and roasting them so they look like chips. If it looks like the food they’re used to,  children are more likely to eat it

## 4. Emphasise wholegrains

One of the simplest changes that will make your cooking healthier is to use more wholegrains. Studies show that 2-3 daily servings of wholegrains might help prevent illnesses such as type 2 diabetes, cardiovascular disease, and colorectal, pancreatic, and gastric cancers.
 
Wholegrains contain more fibre, which is essential for digestion. They’re also unprocessed and retain many nutrients that their processed hybrids don’t. Many such foods also have a lower glycaemic index (GI), which means they take longer to be digested. That also means they can keep your blood sugar stable for longer so you avoid excessive cravings between meals. 
 
Here are some ways to add more wholegrains to your cooking:
 
- __Short grain brown rice instead of white__ - It has the same texture but is higher in fibre and nutrients
- __Opt for wholemeal sourdough bread__ - This is high in fibre and contains healthy bacteria that might help with gut health. It’s much more filling than regular bread, too
- __Swap porridge oats for whole (sometimes called ‘jumbo’) oats__ - They’re less processed, cook in a similar way and contain more essential heart-healthy beta-glucan fibres 
- __Use high-protein wholegrains__ - This will help increase the protein content of your meals (which can help with satiety as well as bone and muscle growth) as well as adding fibre and nutrients. Wholegrains that are high in protein include quinoa, buckwheat, wild rice, millet and couscous
 
## 5. Have a few healthy bases – and use them often

You can’t reinvent the wheel at every meal. And, if you try to create a brand new meal from scratch each time you cook at home, you might start to feel that healthy cooking is a chore. But it needn’t be. 
 
By knowing a few healthy essentials that work for you and using them often, you can save time looking for recipes and buying new ingredients. There’s nothing wrong with a little repetitive eating, if it helps you to make healthier choices. 
 
Here are some suggestions for go-to tricks that can help make healthy food tastier without much thought:
 
- __The healthy salad dressing__ - Take 2 tbsp olive oil, a drizzle of balsamic vinegar, a tsp honey and a pinch of mustard. Mix together to brighten up a leafy salad
- __The vegetable brighteners__ - Add lemon, fresh herbs and a little avocado, sesame or olive oil to give steamed vegetables more appeal. Foods like broccoli, asparagus and mangetout can be lightly sautéed in a little warm oil for about 2 minutes, then drizzled with lemon or lime and a pinch of black pepper
- __The satisfying stew__ - Use the following as your go-to stew recipe – then all you have to do is change the base. Sauté chopped onions or garlic in a little warm oil, add fresh spices or herbs and stir until translucent. Then stir in the stew base – this could be chicken, lean lamb or beef pieces, or it might be tinned beans or chopped tofu if you’re vegan – until brown. Add a litre of stock, some tomato purée, season and bring to the boil. Then lower the heat and simmer and reduce until the base is cooked through. You can add fresh vegetables near the end of cooking time for added nutrition 
- __The child-friendly dip__ - Studies show children are more likely to eat vegetables if they are served with a dip. Try this healthy garlic mayonnaise alternative: mix a little garlic powder, onion powder, a pinch of salt, soy sauce, paprika, and chopped spring onions into a cup of plain Greek yogurt and serve with raw vegetable crudités

## 6. Use fresh herbs

There’s no better way to flavour your food than using fresh herbs and avoid leaning on salt for taste.
 
But knowing which ones to use can be confusing. Herbs also have a short shelf life, which makes many people reluctant to use them often.
 
To minimise waste, figure out your family’s 3-4 favourite fresh herbs, especially those that pair well with lots of different foods. Then, keep these on hand for use in your staple meals. It’s easier to experiment with something you know the family like the taste of, than to constantly test out new flavours on them.
 
Here are some versatile suggestions: 
 
- __Basil__ - For Italian-based dishes, and tomato-based salads – tomato, mozzarella, avocado and fresh basil drizzled with olive oil and apple cider vinegar is a wonderful quick lunch
- __Coriander__ - For Asian- and Oriental-inspired foods, especially stir-fries and curries
- __Flat-leaf parsley__ - For everything, but especially for Middle Eastern-inspired dishes and fresh fish 
- __Chives__ - For fresh fish, dips and salads
 
For use in cooked foods, buy and chop fresh herbs then put into ice cube trays. Cover with water and freeze. Once they’re frozen, you can pop your herb ‘ice’ into plastic bags for use when you’re ready.
 
We hope these hacks have inspired you to experiment more with cooking healthy at home. Now, over to you.
 
__Reviewed by: Rhianna McClymont, Lead GP, Kry__

 


Kry.co.uk > Your health > 6 tips for healthy cooking at home

Header GettyImages-1062249974 cook healthy

There’s no inborn art to healthy cooking – it’s something that can be learned. The good news is a few simple principles can help you put together healthy, filling and nutritious food for the family, with minimum fuss.

6 tips for healthy cooking at home

Around a fifth of men have a low sperm count. For couples experiencing difficulties in conceiving, male infertility is the main cause in about 20% of cases.
  
But research has found that lifestyle factors play a key role in semen quality and healthy sperm motility (this refers to the sperm’s ability to move forward or ‘swim’ to fertilise an egg during conception).
 
In fact, 3 months before you’re planning to start trying for a baby, it’s advisable to deal with pre-existing health problems with your doctor and to make healthy lifestyle changes such as those listed below. This will help to make sure that your sperm quality is the best it can be.

## 1. Lose excess weight

If you have a raised body mass index (BMI), then try to lose weight. Obesity has a massive influence on male fertility problems, and studies show that it can affect hormone levels causing reduced sperm production and concentration. Similarly, although the evidence is more conflicted here, there may also be a link between obesity and reduced sperm motility and morphology (this refers to the shape of a sperm). All of this can reduce the chances of the sperm fertilizing the egg. 

It is also becoming clearer that male obesity can affect the molecular health of sperm and damage sperm DNA. Integrity of sperm DNA is essential for successful fertilization and normal development of a baby.
Some research shows that paternal obesity can even affect the health of your future children, through increased susceptibility of offspring to chronic disease. 

The best way to achieve an ideal weight is through healthy diet and exercise.  

## 2.  Stop smoking

Smoking can reduce ejaculate volume as well as sperm density and motility. Smokers might have a lower zinc content in their semen, which can reduce sperm production.
 
The tiny hairs that help semen move along the tubes of the epididymis (the tube that transports sperm produced in the testes) may be damaged in smokers, which can also negatively affect sperm function. Smoking can also harm erectile function.
 
Continuing to smoke also puts your partner at risk through passive smoking.
 
The good news is that these negative effects can be reversed if you give up smoking. Do ask your doctor if you need help stopping smoking, as there are NHS stop-smoking programmes that could improve your chances of stopping.

Want to give up smoking? Read our guide on the options available.


## 3.  Cut back (or cut out) alcohol

Drinking alcohol excessively can affect the quality of sperm. It lowers levels of testosterone, follicle-stimulating hormone and luteinising hormone (LH), which is one of the main hormones that controls the reproductive system. Alcohol raises oestrogen, which can contribute to reduced sperm production: one study found that drinking as little as 5 units of alcohol a week could adversely affect sperm quality.


## 4.  Avoid recreational drugs

Marijuana and cocaine are thought to affect male fertility, but large-scale studies are perceived as unethical, so it’s impossible to say for sure.
 
Anabolic steroids (sometimes taken by men to bulk up their bodies), amphetamines (speed), as well as heroin and methadone also damage sperm quality. If you’re using any of these drugs then talk to your doctor to work out a way to stop your habit.


## 5.   Do regular exercise

It’s important to be active for good cardiovascular health and to be at an ideal weight for fertility.
 
But research has repeatedly shown that generally active men also have higher sperm counts than their sedentary counterparts. Aim for at least 30 minutes of moderate exercise, 5 times a week.


## 6.   Manage your stress levels

Stress can reduce hormones such as LH and testosterone. In theory, this can affect sperm quality, although more studies are needed to make a definite connection.
 
‘Mental stress affects us in many ways. It affects our libido, potentially our reproductive abilities and probably also sperm quality,’ says Dr Rosen, Kry GP.
 
Learn a few simple breathing and meditation techniques that you can regularly turn to during stressful moments. [The Headspace app](https://www.headspace.com/headspace-meditation-app) is a great starting point.


## 7.    Keep an eye on temperature

Increased temperature of the testicles might impair sperm quality. Try to avoid sitting for prolonged periods with a warm laptop on your groin area or carrying a warm phone in your pocket. Also, don’t take long hot baths, saunas and Jacuzzis.
 
Instead, wear loose-fitting trousers and undergarments (such as boxer shorts). If you work in a hot environment or sit down for hours at a time, it’s important to move around and get outside regularly.


## 8.    Eat a healthy diet

Diets that are high in processed meat, caffeine, red meat, saturated fatty acids and trans fats are linked to low quality semen.
 
Fruit, vegetable, wholegrain and fish rich diets are linked to better sperm quality. In fact, a Mediterranean style diet for heart health will support fertility.
 
Make sure your diet is rich in antioxidants such as vitamin C, folate, zinc and B12. These are best obtained from your diet, so aim to eat at least 5 portions of fruit and vegetables each day. Talk to your doctor about your diet specifically, just in case you might need to take a food supplement - for example, because you’re vegan.
 
Foods rich in omega-3 fatty acids such as walnuts or oily fish (including salmon, sardines, mackerel and herring) help sperm production.


## 9.    Talk to your GP

If you have existing medical conditions that might affect fertility, such as sickle cell or thalassaemia or other hereditary diseases, take the opportunity to see your doctor for a preconception chat.

Similarly, if you are a man who has had groin surgery or treatment for testicular cancer, then you might want to discuss fertility with a doctor sooner.
 
Remember to get STI excluded (or treated) by being tested as soon as possible, if that’s appropriate.
 
If you have not conceived as a couple after having unprotected sex for a year, then consult your doctor together; fertility treatment options such as IVF might be a consideration.


__Reviewed by: Dr Rhianna McClymont, Lead GP, Kry__






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