FLU season may feel a little far off, but preparation starts now.

If you haven’t booked in your vaccine, this is your sign to do so!

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Flu jabs are free on the NHS if you’re over 65, pregnant, have certain health conditions or if you’re a healthcare worker, carer or live with someone who is immunocompromised.

Two and three-year-olds can get the flu nasal spray vaccine.

Booking takes just minutes.

Use the NHS app, call your GP, or 119 free, or go online to nhs.uk/nhs- services/pharmacies/book-flu- vaccination.

Technically, flu season starts in December but infection rates start to rise this month.

Why bother getting a jab?

Well, flu is not just a bad cold, it causes a more severe illness.

While most people will recover after a week or two, for those identified as “at risk” it can be worse, fatal in some cases.

In the past two winters, both mild,18,000 deaths were associated with flu.

If you are not eligible for a free flu vaccine, one at a pharmacy costs from £12.

Here’s a selection of what readers have asked this week . . .

HOT FLUSHES 16 YEARS AFTER LAST PERIOD

Q) I HAD my last period at age 58 and at almost 74, I’m still having hot flushes.

I had been on HRT for four years previously when I was perimenopausal.

One GP told me it could go on until I’m 100 and another told me to “just live with it”.

But they’re really difficult to live with. I recently went away for a few days and the weather was lovely and warm but I was uncomfortable, to say the least.

Can you recommend what, if anything, I can do?

A) It sounds like you’re having a hard time at the moment and I’m sorry to hear that.

It’s always important to ensure that hot flushes aren’t just put down to and assumed to be the menopause.

Other things must be ruled out, especially if at the age of 74 they are new or getting worse.

There are plenty of other conditions which can cause hot flushes such as thyroid disorders, some infections and certain types of cancer as well.

So please make sure your GP investigates if necessary.

If you’re wondering about starting HRT again then there are a few things to think about.

Whatever your age, it is important to understand and be able to assess the risks versus benefit of treatment.

That equation does change as we get older, making the risks of taking HRT more significant as we age.

That’s not to say you absolutely can’t take it, but it is not commonly started in women above the age of 60, or if they are more than ten years past menopause.

It would be worth asking if there is a GP or nurse at the practice who has a special interest in menopause and if not, you may need to be referred to a menopause specialist if you do want to explore HRT further.

Of course there are non-hormonal treatments that can treat hot flushes too, including some antidepressant medications, gabapentin and, just last year, a new drug called fezolinetant was licensed in the UK for moderate to severe vasomotor symptoms – however, it is currently licensed for those up to age 65.

IS OZEMPIC SAFE FOR EVERYONE?

Q) IS it safe for people who are not overweight to use Ozempic?

A) Ozempic is not licensed as a treatment for obesity or weight loss in the UK and should only be prescribed for diabetes.

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Wegovy, which contains the same drug, semaglutide, is licensed for weight loss.

Mounjaro is a slightly newer, similar drug which is also licensed for treating obesity.

These types of injectable medications work to help people lose weight, predominantly by suppressing appetite.

The causes of obesity are complex, with genetics being one of the major factors.

Our genes partly determine how much we need to eat before we feel full and play a part in how our brain responds to food cues, so a highly responsive person will feel the urge to eat more often on any given day.

With the changes to the world over the past few decades, with bigger portion sizes, calorie-dense foods and food cues everywhere we turn, it’s easy to see why some people, due to their genetics, find it difficult to remain a healthy weight more than others.

So one way to look at these drugs is that they level the playing field.

For people who are genetically predisposed to being more hungry, the medication makes their urge to eat more aligned to that of a person who finds it easy to stay slim.

In terms of safety, no medication is without any risk and the balance against benefits is different for each individual, but are more likely to lean towards being beneficial for people who have severe obesity, especially if they have related health issues.

For people of a healthy weight, or who carry excess weight but remain metabolically healthy, it’s much more likely that the risks outweigh any benefit.

Common side effects include nausea, vomiting, abdominal discomfort, gallstones and diarrhoea.

Less common, but more severe side effects include acute pancreatitis.

So in a nutshell, the simple answer to your question is no.

Q) MY son is 17 and has got some spots on his back and shoulders and I’m not sure what it could be.

A) Thank you for the picture, below, which shows the classic signs of acne, a common skin condition.

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Both blackheads and whiteheads can occur with acne and it can range from a few spots on the face, neck, back and chest, to something more problematic, with solid painful lumps under the skin which may cause scarring.

Acne usually starts during puberty but can come at any point and most of us will experience it at some point.

It’s caused by lots of different factors – sebaceous (oil-producing) glands are found near the surface of the skin and they’re affected by our hormones.

In acne, the glands are sensitive and can produce too much oil.

At the same time, dead skin cells build up and block the pores, leading to blackheads and whiteheads.

Fortunately, there are lots of treatments – your son could try going to your local pharmacist first and requesting some over-the-counter medications that don’t require a prescription such as benzoyl peroxide or azelaic acid.

Could you help him with applying this to the skin?

It could be several months before changes are seen so it’s worth persevering with whatever treatment you start with.

Often people stop using treatments after the first few days because they can cause some mild increase in redness, dryness and irritation at first.

But as long as the symptoms are mild you should continue, or use on intermittent days until the skin gets used to it.

Alongside any treatment it’s important to follow some simple lifestyle rules too – don’t wash more than twice a day or use strong soaps as this can strip the natural oils from the skin and make the sebaceous glands work even harder to produce more.

Moisturise using a fragrance-free water-based emollient and try to avoid picking spots.

If over-the-counter medications don’t work, your GP can prescribe something.

Options include antibiotic or retinoid topical treatments applied directly to the skin, oral antibiotics, or oral contraceptive pills in females.

Dermatologists can prescribe isotretinoin capsules (Roaccutane) which is highly effective but it’s important to understand the potential side effects on mental and sexual health.

OBESITY LEVELS TRIPLE

WE are wolfing down giant portions of food without even realising, experts have warned.

More than a third of us never think about how the size of a serving can affect the waistline, and regularly eat way too much pasta, rice, cheese and cereal to be healthy, research by MyFitnessPal found.

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Obesity levels here have more than tripled since 1994, with an estimated 26 per cent of people now in the category, according to the British Obesity Society.

But 77 per cent say they feel uncomfortably full after meals and two-thirds are going back for seconds.

One in five eat so quickly that they don’t realise they are full, with four in ten eating in front of the TV.

Only half of those surveyed checked packets for serving size suggestions.

It all means half of us are eating double the NHS-recommended portion of pasta (75g, one handful) and rice (75g, one and a half handfuls).

Half of us fill a cereal bowl to the top at breakfast time, instead of adhering to the recommended 40g.

A third of the survey participants said they have no grasp on what the recommended portion size for a meal should be.

MyFitnessPal head of nutrition Melissa Jaeger said: “By paying more attention to portion sizes and using a nutrition tracking app, we can make more informed choices that better support our health goals.”

QUALITY OF LIFE ISSUES

THOUGH modern medicine continues to evolve rapidly, increases in life expectancy have stalled, a study suggests.

Average life expectancy almost doubled over the course of the 19th and 20th centuries, but the rate of increase has dramatically slowed in the past 30 years, according to Chicago-based research.

Life expectancy at birth in the world’s longest-living populations has increased by only an average of six and a half years since 1990, according to the analysis of the longest-living countries in the world, reported in the journal Nature Aging.

The researchers say ageing and its complications are now the main obstacle to a longer life.

But aiming to extend life by reducing age-related disease could be harmful, if those additional years aren’t healthy, they maintain.

Lead author Professor Jay Olshansky said: “Most people alive today at older ages are living on time that was manufactured by medicine.

“But these medical Band-Aids are producing fewer extra years of life even though they’re occurring at an accelerated pace, implying that the period of rapid increases in life expectancy is now over.

“We should now shift our focus to efforts that slow ageing and extend ‘healthspan’.”

Some scientists had predicted that life expectancy would continue to improve over the 21st century thanks to advances in medicine and public health.

THEY come in all shapes and sizes –  and now spots are more common than ever before.

The British Journal of Dermatology shows that in 2021, 14.6 per cent of adolescents and young people were diagnosed with acne — a 7.4 per cent increase from 1990.

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More realistically, top experts believe closer to a staggering 95 per cent of youngsters have acne when accounting for those who self-manage their treatment.

While spots are something we typically associate with adolescence, they can strike throughout life.

Around three per cent of adults over the age of 35 have acne, the NHS says.

It is normal to feel self-conscious of spots — after all, they are on our face.

And only in recent years have skin imperfections been more openly discussed.

Kendall Jenner, Florence Pugh and Justin Bieber have publicly acknowledged their pimples — yes, celebrities are just like us (sometimes)!

Pimples can be triggered by hormonal imbalances, diet, smoking and some beauty products, the NHS says.

But the type of spot can give an indication of its cause, too, says Dr David Jack, dermatologist and founder of Dr David Jack clinics.

Here he reveals the most common types of spots, their causes and how best to treat them . . . 

WHITEHEADS AND BLACKHEADS

WHAT looks like small, skin-coloured or white bumps – that almost need a magnifying glass to see – are in fact a type of spot.

Dr Jack says: “Whiteheads are a type of acne that are caused by blocked pores.

“They occur when dead skin cells, oil and bacteria become trapped under the skin.

“They are typically associated with excess sebum production and are common in areas with more active oil glands, such as the forehead and nose.”

But they can occur on the cheeks too, as a result of dead skin build-up.

This may be more likely to occur with those prone to dry skin.
If you try to squeeze a whitehead, it won’t typically “pop” because it is medically known as a “closed comedone”.

Meanwhile, blackheads turn dark because they have been exposed to the air.

FIX: WHAT prevents these tiny spots can also be used to gently eliminate them once they have developed.

Dr Jack says: “They tend to occur more commonly when the skin isn’t exfoliated regularly, so some gentle exfoliation can help to prevent these blockages.

“Salicylic acid-based products are useful as they exfoliate and regulate oil production.”

Check if your products are “non-comedogenic,” which means they are designed to minimise pore blockages.

Some brands are exclusively non-comedogenic, such as Avène.

INFLAMED BREAKOUTS

EVER had a spot that pulsates under the skin but never amounted to a head?

They are formally known as papules or cysts, Dr Jack says, and are deeper lesions in the skin.

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Dr Jack says: “These are more severe forms of acne and can result from clogged pores that become irritated and infected.

“They tend to be quite painful.”

Cystic acne is considered a severe form of acne, and is the most likely to cause scarring.

Dr Jack says: “Inflammation can be linked to hormonal changes.”

Sudden acne in women can be a sign of hormonal imbalance, such as polycystic ovary syndrome, especially if there are accompanying symptoms like excessive body hair.

Dr Jack says: “If inflammation is more widespread across the face, it may indicate a condition like rosacea.”

Rosacea can sometimes be mistaken for acne but the two conditions are different.

In rosacea, the skin is not greasy and the spots do not cause scarring.
Instead, the skin may be dry, peeling and red, the NHS says.

There may be thickened skin, usually around the nose.

FIX: DR JACK says: “In cases of persistent inflammation, it’s crucial to avoid harsh scrubs or products that could further irritate the skin, and instead try anti-inflammatory treatments like niacinamide or azelaic acid.”

For conditions such as cystic acne and rosacea, see your GP.

PERSISTENT SPOTS

ANY spot that doesn’t seem to go away might not be a spot at all.

Skin cancer can present in more ways than one.

And while a dodgy mole is the most recognisable sign, there are others to look out for.

Basal cell skin cancers may cause a sore area of the skin that doesn’t heal, and it may look waxy or have small blood vessels.

It can also cause a shiny, pearly and hard lump.

Squamous cell cancers vary in their appearance but may also be an open sore, as well as a wart-like and raised area of skin.

Skin cancers can be itchy, painful, bleed or scab over and will generally feel scaly or rough in texture compared to a spot, which is more soft.

Spots tend to go away after around one week.

Dr Jack says: “It’s important to be vigilant about any changes or new spots that appear.

“This is particularly the case if you have had a long history of sun exposure, or family history of skin cancers.”

FIX: GO to your GP for any lumps and bumps that you are concerned about.

Skin cancer, of which there are several types, can be treated.

But as with any cancer, “early detection can dramatically improve outcomes”, Dr Jack says.

If it’s persistent acne or other skin complaints that are not improving despite trying yourself, see your GP.

They may prescribe antibiotics or the contraceptive pill to women.

The GP might refer you to a dermatologist if the condition is severe or no other treatments have worked.

SPOTS FILLED
WITH PUS

YELLOW-headed spots that contain pus are typical of acne.

Dr Jack says: “Pus-filled spots, or pustules, form when white blood cells rush to the site of a blocked pore to fight off bacterial infections.

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“These are generally a sign of more inflammatory acne and can be triggered by an overgrowth of bacteria within a clogged pore.

“They can be exacerbated by hormonal fluctuations, stress, or irritation from products.”

FIX: WHATEVER you do, don’t squeeze these spots.

Instead, wait and let the pus come out naturally.

Squeezing spots can cause harm to the surrounding skin and lead to scarring.

Look for treatments containing benzoyl peroxide or retinoids.

Dr Jack says: “These are helpful for killing bacteria and preventing future outbreaks.

“In-clinic treatments such as Theraclear or AviClear can help with these by reducing the bacterial load on the skin.”

RANDOM SPOTS

SPOTS can occur when we least expect them – and usually at the worst time.

But Dr Jack says: “There are usually underlying factors such as stress, poor diet – including high- sugar diets, dairy products and inflammatory processed foods – or hormonal imbalances.

“Sometimes these ‘random’ spots are the result of repeated touching of your face, or an allergic reaction to skincare products.”

Even when we think that we are doing something helpful for our skin, such as applying a new, fancy product, it can in fact upset the skin.

FIX: GO steady when introducing new skincare products.

The occasional spot is nothing to worry about, unless it is frequent enough to cause you embarrassment.

Dr Jack says: “The key to managing these spots is maintaining a consistent skincare routine that includes proper cleansing and hydration, while also considering any lifestyle factors like stress or diet that might be contributing to the random breakouts.”

PSYCHEDELIC drugs might still invoke images of The Beatles, Woodstock and flower power – but one day they could be prescribed by a doctor.

An emerging area of science is focusing on the idea that a “magic mushroom” trip can be beneficial for people with severe mental health issues.

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Psilocybin is the active ingredient in “shrooms”, which when taken recreationally, gives people the giggles, hallucinations and a sense of awe at their surroundings.

But evidence suggests it can help us confront our deepest fears and traumas, and get the brain firing in novel ways.

Psilocybin is an illegal Class A drug, which makes it difficult and expensive for the small number of research centres in the UK to study it.

And one of the biggest barriers to the drug being taken seriously is its reputation.

Sam Lawes of the Centre for Evidence Based Drug Policy, told Sun Health: “It’s seen as a recreational drug and a party drug for festivals, but in terms of research we should treat it like a medicine.

“If it’s not an effective medicine, studies will show that.

“But so far, studies are showing great promise.”

A quarter of Brits will experience some form of mental health problem each year.

For many, medicines don’t work, NHS therapy is hard to access and waiting lists are growing.

Sam says: “You can see we’ve got a burning need for an alternative solution.”

Researchers at Imperial College London published findings of a study last month that compared two doses of psilocybin to the SSRI antidepressant escitalopram.

Both treatments were effective at reducing depression at a six-month follow-up.

But, unlike antidepressants, psilocybin didn’t stall sex drive.

Small studies have also shown the positive impact of psilocybin on eating disorders, anxiety, addictions, PTSD and OCD.

Psychiatrist Professor David Nutt, the leading expert in psychedelic research in the UK working at the Department of Brain Sciences at Imperial College London, has seen lives transformed with psilocybin.

He tells Sun Health: “It is almost certainly the most promising development innovation in the treatment of mental illness and also some neurological illnesses for 50 years.”

Typically, a trial participant takes a dose comparable to that taken recreationally, closes their eyes and listens to music.

Afterwards, volunteers talk things through with a therapist.

Though science is only beginning to understand this compound’s effects, MRI brain imaging has been “remarkable”, Prof Nutt says.

Scans by the team at Imperial, published in the journal Nature Medicine, have shown that psilocybin boosts connectivity in brain regions that have become rigid in those with depression.

Essentially it cracks open unused networks of the mind in a way not seen with antidepressants and this was linked with improved depressive symptoms.

‘UNUSED NETWORKS’

Columbia University has also shown that patients with body dysmorphic disorder had increased brain activity just one day after taking a 25mg dose of psilocybin.

Those with the greatest boost in neural connectivity had the most improvement in BDD symptoms a week later.

The effects of a single dose of pure psilocybin can last weeks, research suggests.

It is almost certainly the most promising development innovation in the treatment of mental illness and also some neurological illnesses for 50 years

Psychiatrist Professor David Nutt

A paper published in the Journal of the American Medical Association in August found 25mg of psilocybin plus psychological support had a “rapid and sustained antidepressant effect” over six weeks.

But the long-term effects, including comparison to traditional treatments, still needs studying.

Prof Nutt and colleagues will soon start trials to explore if psilocybin could treat opioid and gambling addictions.

He explains: “These are disorders in which people get locked into ways of thinking that they can’t escape from.

“Gamblers know they shouldn’t gamble, but they can’t stop.

“Depressed people know that they’re not worthless and guilty, but they can’t stop those thoughts.

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“These ruminations in the brain can be broken by psychedelics.

“For most people in these studies, their lives have been ruined and they feel depressed or anxious.

“After taking the psychedelics, they can see they are not a worthless person, they can forgive themselves and that is a great release.”

The problem is that trial participants want more of what made them better.

Prof Nutt says: “Depression is deep-seated and after a few months, it creeps back and they plead to have psilocybin again.”

Regardless, taking magic mushrooms in a hospital setting with a therapist to hand is safer than doing so in your living room.

Now, experts want psilocybin to be medicalised as cannabis was in 2018.

This would speed up research, but more importantly, allow doctors to prescribe it in the real world, they argue.

While the UK is usually a world leader in health sciences, other countries have forged ahead with psilocybin.

Prescribing psilocybin and MDMA for treatment-resistant depression has been legalised in Australia, and Colorado and Oregon, in the US, have legalised some use of psychedelics.

The Home Office told Sun Health it is “considering advice from the Advisory Council on the Misuse of Drugs on how best to reduce barriers to research with controlled drugs, including psilocybin, while ensuring they are not misused or exploited by criminals”.

The UK is lagging behind, mired in outdated laws and stigma

Tara Austin, Psilocybin Access Rights

In 2022, it rejected a bid to reclassify psilocybin, arguing that even if an application for a product licence was made, it would be up to the Medicines and Healthcare Products Regulatory Agency to authorise it.

As psilocybin is a natural compound “it means drug companies won’t pay for the trials because they can’t reap financial reward afterwards,” says Prof Nutt.

Meanwhile, patients get caught in the middle. Labour MP Charlotte Nichols led a Commons debate on the topic last year.

She described her own PTSD as a “living hell” and said: “It feels like institutional cruelty to condemn us to our misery when there are proven, safe, and effective treatments if the Government would only let us access them.”

Steve Rolles, analyst at the Transform Drug Policy Foundation, added: “Politicians are very wary about being seen as soft on drugs.”

Tara Austin, of Psilocybin Access Rights, said: “The UK is lagging behind, mired in outdated laws and stigma.

“We’ve seen an alarming rise in antidepressant use in England, which is ineffective for many, with no innovative solutions in sight.

“Veterans with PTSD, and indeed all individuals facing mental health challenges, deserve better.”

While the future of magic mushrooms as medicine is uncertain, the advice for now is clear: “Don’t try this at home”.