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The doctor is in: Your questions answered

By Dr. Tyeese Gaines

Dr. Tyeese Gaines, an emergency medicine physician and health editor for theGrio.com, answers your questions about everything from shingles to concussions. Got a question you'd like her to answer in an upcoming column? Send it to askdoctorty@gmail.com.

Q: I am African-American and 52 years old. I have noticed my skin burning more than usual. Is this because of age, and what type of sunscreen should I look for?
- Cheryl B. 

A: Yes, skin becomes thinner as we age. However, much of what we attribute to age, such as wrinkles and spots, are actually due to sun damage accumulated over the years. It's never too late to prevent additional damage or further thinning. The American Academy of Dermatology recommends selecting a sunscreen that protects against both UVA and UVB rays with an SPF of 30 or higher. It should be used every day, even on cloudy days. But, it's important to know that sunscreens with a high SPF may not always prevent sunburn.

Q: I keep hearing this ad that people who have chickenpox will end up with shingles. What's shingles? What does it look like?

Dr. Tyeese Gaines, an emergency medicine physician at Raritan Bay Medical Center in New Jersey and health editor for theGrio.com, answers your questions.

- Lori S.

 A: Once a person gets over a bout of chickenpox, the virus remains dormant -- or "asleep" -- in certain nerves, sometimes for years. Shingles occurs when that "sleeping" virus awakens and creates a painful, chickenpox-like rash along that nerve. Shingles first looks like fluid-filled bumps in a cluster or a straight line, after which they will crust over and scab. 

Without having had chickenpox or receiving the vaccine, you cannot develop shingles. The virus has to already exist in the body. For this reason, you cannot pass shingles from one person to another. But, someone who has never had chickenpox or the vaccine can contract chickenpox from someone with shingles.

Regarding that ad, not everyone who has had chickenpox will develop shingles. But, the reason why some people develop it and others do not is unknown. We do know that shingles is more likely in people older than 60 and those with weak immune systems. So, that population is urged to get the shingles vaccine.

Q: My 13-year-old son recently suffered a concussion playing basketball but has been medically cleared to return to sports. Once a child experiences a concussion, are they more susceptible to getting another one? And, how do you know when a headache is just a headache or a concussion headache?

- Terri M.C.

A: Yes, once someone suffers a concussion they are three to four times more likely to develop another one. 

Let's first discuss what a concussion is. A concussion is, simply put, when a person sustains either a head injury or a force that shakes the brain around and develops symptoms as a result. Those symptoms can include headaches, nausea or vomiting, feeling groggy, sleeping more than usual, vision changes or amnesia. A diagnosis of concussion is made from this clinical criteria. No test, X-ray or CAT scan can determine a concussion. Scans are primarily done to look for skull fractures, bleeding or bruising of the brain -- all of which are different than concussions, and potentially life-threatening.

In order to be cleared to return to sports after a concussion, consensus guidelines recommend that the person be symptom-free and can ease into full participation without return of symptoms. If symptoms do recur, the person should wait at least 24 hours before returning to the activity. Some experts suggest that continuing to exercise while still having concussion symptoms can prolong recovery time.

So, if your son has a headache shortly after his concussion, whether it's related or not, still use caution and consider having him sit on the sidelines and give the brain more time to heal.

Q: I have an intense itch most of the time under my right breast situated over my liver. My doctor gave me a fungal cream and it temporarily got rid of it, but it still comes and goes. Do you think it's anything more?

- Jane V.K.

A: It's feasible that what you're experiencing is a recurrent fungal infection. Thus, it makes sense that your itching went away with the cream. Fungi like warm, dark, moist places. So if the area under your breast remains warm, dark and moist then it will likely happen again. Some people have better luck with fungal powders instead of creams to keep the area dry. Athlete's foot, jock itch, ringworm and diaper rash are examples of other fungal infections found on the body.

Liver disease can sometimes cause itching, but usually the whole body itches -- not just over the right upper abdomen where the liver is.

Dr. Tyeese Gaines is a physician-journalist with over 10 years of print and broadcast experience, now serving as health editor for theGrio.com (NBC News). Dr. Ty is also a practicing emergency medicine physician in New Jersey. Follow her on twitter at @doctorty.

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The information included in this post is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider with questions. Reading the information on this website does not create a physician-patient relationship.