Dear Dr. Roach: I live in a very dry climate, and I struggle with dry skin all over my body. Lately I have been having a lot of dry, flaky skin in my ear canal. I have no ear pain, and my ears are not itchy. I have been told by nonmedical professionals to put a couple drops of olive oil in my ears.
I looked in the pharmacy to see if there such a thing as a moisturizing eardrop to help with the flaky skin, but I don’t seem to be able to find one. Should I see a doctor for this, or is it safe to put olive oil in my ears for this issue?
N.E.S.
The skin lining the ear canal might be dry, just like the rest of your body skin, so applying something to help the skin retain moisture is reasonable. However, the ear is also susceptible to infection, by both bacteria and fungi; to eczema; and to irritation by allergens such as in shampoos or cosmetics. An evaluation by a general doctor or ear, nose and throat specialist is probably a good idea. If you get the OK, a drop of olive oil in the ears daily is an effective way to keep the skin in the ear moist.
Dear Dr. Roach: If I received my second shingles vaccine shot more than eight months after the first, do I need to get a third dose?
J.M.
No. It’s still considered a valid dose. Ideally, the second dose is given two to six months after the first, but there are times to give the second dose early — for example, it can be given after a month to a person who is about to start treatment that would suppress the immune system. After eight months, I would think the dose would be just as effective, but the evidence we have is only up to six months.
I frequently get letters from readers who have had complicated shingles imploring me to tell my readers to get the vaccine. I cannot emphasize how terrible the pain after shingles can be, and it can last not months, but years, and even for a lifetime in some unfortunate situations.
Also, both the European Medicines Agency and the Food and Drug Administration have recently approved the newer shingles vaccine for use in people over 18 with immune system damage or disease.
Dear Dr. Roach: My toes on both feet feel cold and numb. What could be causing them to feel that way?
C.C.
A noninvasive circulation test, such as an ultrasound arterial brachial index, is appropriate to do in a person with cold feet, if the person is older or has other risk factors for blockages in the arteries.
Most of my patients with numbness in their feet are concerned that they have a circulation problem, but it is more likely to be a nerve problem. There are several types of neuropathies — that’s a general term for conditions affecting the peripheral nerves — but when it is on both feet I would be concerned about the neuropathy from diabetes or from vitamin B12 deficiency, although there are many other possibilities.
The first place to start is your regular doctor for an exam. A careful physical exam can usually point your doctor toward the right diagnosis, but sometimes more sophisticated tests are needed.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
