Please don’t be alarmed — these are not contagious, and are not warts.
The flesh-coloured growths on the neck are called skin tags, and today I spent half an hour with one of my male patients removing about 20 of them from his neck and armpits.
Technically, these are called fibroepithelial polyps, and are harmless skin growths that appear in areas where the skin creases: typically the neck, armpits, groin, cleavage and under the breasts.
We do not know exactly what causes them, but they seem to be a consequence of the ageing of the skin.
Warts, by contrast, are caused by a type of virus called human papillomavirus.
These skin tags carry no health risks but can become irritated and sore if they catch on jewellery.
This, together with their unsightly appearance, is why people wish to remove them.
I do this by injecting a microscopic amount of local anaesthetic and then snipping them off with sharp sterile scissors.
Some doctors use a special hot wire to remove them, or liquid nitrogen to freeze them off.
CONTACT DR SCURRTo contact Dr Scurr with a health query, write to him at Good Health Daily Mail, 2 Derry Street, London W8 5TT or email drmartin@dailymail.co.uk — including contact details.Dr Scurr cannot enter into personal correspondence.His replies cannot apply to individual cases and should be taken in a general context.
Occasionally, big fleshy ones can bleed when excised, which is a good reason not to snip them off yourself even if you have the spirit to do so.
Visit your doctor instead — there is always a chance that it is not in fact a skin tag, and requires more investigation.
When there is bleeding, the doctor can seal the wound by cauterising it with a hot wire and applying a plaster — it takes a day or two at most to heal.
The flat lesions you describe may not be skin tags — they sound more like seborrhoeic keratoses, a different type of harmless skin growth.
These can be warty and rough in appearance, and range from a few millimeters across to a centimetre or two.
It is difficult to advise how to proceed in respect of these as they must be examined by a GP or dermatologist for an exact opinion as to how it should be removed.
However, because removal of both types of growth is largely for cosmetic, not medical reasons, the NHS is reluctant to fork out for this, so you will most likely have to pay for it yourself.
For a number of months I have been troubled with restless legs. I take the drug pramipexole, which eliminates the symptoms at night, but I still find it impossible to sit during the day or evening. I also find these tablets cause sleepiness and nausea. Is there anything else that can help? Mrs Pearl Etherington, Northampton.To many people this does not seem like a worrying or troublesome condition, yet for those who suffer with it, or for their partners, it can be utterly miserable.
Around 10 per cent of the population suffer from restless legs, though the condition is twice as common in women, and more frequently occurs with advancing age.
The exact cause is unclear, but there’s often a family history, suggesting genetics may play a role.
Another possible cause is low levels of a brain chemical called dopamine; it can also be triggered by a number of other conditions, including iron deficiency, kidney failure, diabetes, arthritic problems and even varicose veins.
Whatever the cause, the condition is characterised by spontaneous leg twitches and an unpleasant sensation in the legs, usually describing as crawling, stretching or pulling.
All this occurs mostly at night, and this sensation is only relieved by moving the legs. In severe cases such as yours, the symptoms also occur in the day, for instance when seated in a car.
Another symptom can be sudden jerks of the legs when asleep, which is known as periodic limb movement of sleep.
These sudden jerks can be violent enough to cause semi-waking, triggering subsequent daytime tiredness, which makes me wonder if it is this, rather than a side-effect of your medication, that is making you tired.
More from Martin Scurr... How can I get this heavy feeling off my chest? 03/06/13 Ask the doctor: Bad breath is ruining my self-confidence 27/05/13 Ask the doctor: Will my shingles pain ever go away? 20/05/13 Ask the doctor: Is blood in my urine a reason to worry? 13/05/13 Ask the doctor: Why am I seeing stars in my eyes? 07/05/13 Ask the doctor: What has caused my unbearable leg pain? 29/04/13 Ask the doctor: Why are my teeth starting to crumble? 22/04/13 Ask the doctor: Simple steps for easing a hormone headache 08/04/13 Ask the doctor: Why do my wife's hands bruise so easily? 01/04/13 VIEW FULL ARCHIVEYou tell me you are taking pramipexole, a drug that increases levels of dopamine.
Although this can cause side-effects — nausea and fatigue — these usually disappear after a week or two of regular doses.
There are various other medications that work differently; these include the tranquilliser clonazepam, and the epilepsy drug gabapentin, which helps reduce activity of nerve cells in the legs.
In some patients even opiates such as codeine have proved effective; and a boost with oral iron supplements is suggested for all patients.
A heated pad or electric blanket have also been shown to be beneficial, although we are unclear why.
In conclusion, I feel that you have found a semi-suitable treatment for your condition, but not the ideal one.
You might be helped by further assessment to try other possibilities, and hopefully your GP can consider these, or refer you to a neurologist or sleep clinic specialist who has the right specialist knowledge.
Have hope — there is every prospect of giving you some daytime relief without intolerable side-effects.
By the way. . .Placebos may be a trick — but they workI often feel embarrassed finding myself yet again replying to a reader’s letter with the words ‘the cause is unknown’.
The fact is, we know far less about the exact causes of disease than we suggest.
I also write regularly about the need for accurate diagnosis and good communication about that diagnosis, because nothing can be achieved in terms of relieving distress due to frightening symptoms until the nature of the problem is clearly defined.
Yet all too often there is no treatment that’s proven to be effective — when there is, then we are at the easy end of medicine, such as penicillin for a confirmed streptococcal throat.
Often what doctors do is hedge. Once sinister illness has been excluded, what is needed is confident reassuranceIn general practice, much of what we see is hard to pin down and impossible to relieve with a simple prescription.
Even if in the brief time allowed for consultation we do feel certain about a diagnosis — such as the patient with the uncomfortable bloating and intermittent constipation having a version of irritable bowel syndrome, rather than anything more sinister — what is there, really, to offer them?
And for the patient with widespread pain, chronic fatigue, and disturbed sleep pattern?
Maybe they do have fibromyalgia, but here, too, the options are limited.
Often what doctors do is hedge. Once sinister illness has been excluded, what is needed is confident reassurance.
At this point many GPs will prescribe something that is not an evidence-based specific treatment, but will prescribe a placebo.
A survey last week suggested most GPs do this at least some of the time.
This finding has caused an uproar, but unfairly, because a placebo is at least proven to stimulate our own natural mechanisms of healing.
And so, giving peppermint oil capsules for IBS, for which there is slender evidence of benefit at best, is not a con trick, but is given in hope as it brings a degree of relief for many.
And the advice to take Coenzyme Q10 to ease the symptoms of fibromyalgia may be a placebo, but it works for some.
I was smiling to myself recently as yet another patient requested a vitamin B12 shot to help her after a chest infection; a placebo if ever there was one, but much requested.
She asked why I was smiling and I said that it works well because of the pink colour, and we both laughed.
