The illness staring you in the face

Take a look in the mirror - it could save your life.

Take a look in the mirror - it could save your life.

Published Jun 17, 2011

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London - Take a look in the mirror - it could save your life. Those cracked lips can indicate diabetes. Wrinkles may show you’re prone to brittle bones. And droopy eyelids could be a sign of lung cancer .

We tend to see narcissism as an unattractive characteristic, best left for reality TV stars. However, studies show that taking more than a passing glance at ourselves in the mirror could be a good thing.

Last week, researchers from the Yale School of Medicine in the US suggested that facial wrinkles could be a warning sign of osteoporosis, or brittle bone disease.

They examined 114 post-menopausal women in their 40s and 50s, counting their wrinkles and then giving them X-rays. This revealed that those with the worst wrinkles had the weakest bones.

“Bones and skin share common building blocks - collagen,” says researcher Lubna Pal. “As we age, changes in collagen occur that account for wrinkles and sagging skin; they also contribute to deterioration in bone quality and quantity.”

“The face really can divulge some surprising secrets about your health,” adds Dr Helen Stokes-Lampard, of the Royal College of General Practitioners. “A flushed face, for instance, could be a sign of the heart condition mitral stenosis. As the heart valve doesn’t work properly, it can lead to increased blood pressure.”

Here, with the help of medical experts, we look at more of the surprising health problems a simple look in the mirror could reveal...

EYES

Droopy eyelids

Possible cause: Bell’s Palsy, stroke, lung cancer

Conditions that affect the nerves in the face such as Bell’s Palsy can cause a weakness or paralysis in one side of the face, which may make closing the eyelid difficult and cause a drooping mouth. This is thought to occur because a virus, usually herpes, causes a nerve to become inflamed. This, in turn, interferes with the signals the brain sends to the face muscles.

Droopy eyelids are also a symptom of a stroke, along with slurred speech and weakness in the mouth and arms.

“More rarely it can be a sign of lung cancer,” says Dr Stokes-Lampard. “One particular tumour - the pancoast tumour found at the top of the lung - can put pressure on a group of nerves that affect the eye. Accompanying symptoms include arm and shoulder pain, hand weakness and a tingling sensation in the hand.”

Bloodshot eyes

Possible cause: Hayfever, iritis, high blood pressure

“Red, itchy eyes are most often associated with hayfever - when the body’s immune system overreacts to a supposedly ‘harmless’ substance such as pollen, causing an allergic reaction,” says Dr Susan Blakeney of the Royal College of Optometrists.

Another cause is iritis, inflammation of the iris (the coloured part of the eye). Iritis is linked to the auto-immune disease Ankylosing Spondylitis, a form of arthritis where the body attacks its own tissues, including the eye.

Occasionally, the whole eye can turn red, as a result of a subconjunctival haemorrhage. Although more often simply due to accidental damage, this bleed behind the eyeball can, more rarely, be due to high blood pressure, which causes the small, fragile blood vessels to rupture.

Twitching eye

Possible cause: Stress, Multiple Sclerosis

Eye twitching - known as myokymia - occurs when the muscles in the eyelid randomly spasm every few seconds. Stress can cause these tics, as it stops the body absorbing essential Bvitamins, known to keep eye muscles strong; these “spasms” can also occur elsewhere in the body, such as the stomach.

“Persistent, prolonged twitching - over days or weeks - can also occur in conditions that affect the nervous system, such as multiple sclerosis,” says Dr Stokes-Lampard.

Other symptoms of MS include a problem with balance, numbness, and blurring of vision.

Rings in the eyes

Possible cause: High cholesterol, Wilson’s disease

“White rings around the iris, the coloured part of the eye, are a well known sign of high cholesterol levels in the blood,” says Dr Blakeney.

Cholesterol can also lead to xanthelasmas - flat, yellow-white fat deposits under the skin on or around your eyelids. “The hard, thick plaque is dumped in areas of the body with rich blood supplies, such as the eye,” adds Dr Blakeney. Rusty brown rings around the iris are a sign of Wilson’s disease, a genetic condition that prevents the body from getting rid of excess copper.

“This first affects the liver, but then copper enters into the bloodstream, travelling to other organs, including the eyes,” says Dr Stokes-Lampard.

“The copper causes tissue damage, which leads to symptoms including difficulty walking, tremors, and confusion. Typically, it occurs in younger people under the age of 35.”

Pale eyelids

Possible cause: Anaemia

“When the inside of the lower eyelid appears pale instead of a healthy red, you could be anaemic. This is a result of a lack of iron - integral for the making of oxygen-rich red blood cells,” says Dr Stokes-Lampard. Although this is particularly apparent in the eyes, you can also see it inside the mouth, the nail bed and on the cheeks.

Anaemia can make you feel weak, cold, dizzy and irritable. It is confirmed with a blood test.

Men need around 8.7mg of iron a day while women need 14.8mg a day, to compensate for blood loss during menstruation. You should, however, be able to get all you need from your daily diet. Good sources include red meat, beans, nuts and most dark-green leafy vegetables.

NOSE

Enlarged nose

Possible cause: Rosacea, acromegaly

A thickening of skin around the nose - known as rhinophyma - can occur in severe cases of rosacea, says Dr Stokes-Lampard.

This common but chronic skin condition is thought to be caused by abnormalities in the blood vessels of the face; the nose becomes bulbous due to an increase in the size of the oil-secreting glands.

Avoiding possible triggers (sun, stress, spicy foods, alcohol) and medication can help with redness, but in severe cases plastic surgery may be considered.

The hormonal condition acromegaly - also known as giantism - can also lead to a change in the appearance of the nose, as well as the hands, jaw and tongue. It occurs when the pituitary gland produces too much growth hormone, stimulating the growth of muscle, cartilage and bone. This is commonly due to a benign pituitary tumour.

SKIN

Flushing

Possible cause: Lupus, heart disease, menopause

Redness can be a sign of the auto-immune condition, systemic lupus erythematosus. Along with joint pain and fatigue, this causes a “butterfly” rash over the cheeks and nose. This is as a result of the body attacking its own tissues, including the skin, and is made worse by sunlight.

Mitral stenosis, where the mitral valve (on the left of the heart) doesn’t open fully, can also cause pinkish-purple patches as a result of the increased blood pressure throughout the body and reduced oxygen content in the blood, says Dr Iain Simpson, of the British Cardiovascular Society.

The effects are most obvious on the face, where the skin is thinner and blood vessels are packed closer together.

Red, patchy flushing on the face and neck is also a common sign of the menopause. Changes in hormone levels affect the hypothalmus, the area in the brain that regulates heat.

As a result, the brain thinks the body temperature is too high and must be lowered - it does this by dilating the blood vessels in the skin, causing redness and a hot, burning sensation.

Fat, puffy face

Possible cause: Underactive thyroid, mumps

When the thyroid isn’t producing enough of the hormone thyroxine - which controls how much energy your body uses - your metabolism slows down. This can lead to weight gain, including on the face.

Certain auto-immune conditions including Hashimoto’s disease, a damaged thyroid, and drugs for depression and heart disorders can all lead to the thyroid not working properly. Early symptoms may also include tiredness, depression and muscle aches. It can be treated with hormone replacement tablets, says Dr Stokes-Lampard.

A distinctive “hamster face” is also a result of mumps, the highly contagious viral infection which has seen an increase due to the lack of uptake of the MMR vaccine.

This occurs when the parotid glands, just below the ears, become infected.

Other symptoms include pain and tenderness in the glands, loss of appetite and joint pain. Although not usually serious (apart from in young males where it can lead to infertility), mumps shares symptoms with more serious infections such as glandular fever, so it’s important to have these ruled out by your GP.

Colour change

Possible cause: Bronchitis, asthma, jaundice

Respiratory diseases such as bronchitis and emphysema can lead to a sallow, grey skin - simply because there isn’t enough oxygen going around the body. Sallow skin in a very young child is a good way to spot an imminent asthma attack, says Dr Stokes-Lampard.

A yellow tinge to the skin can be a sign of jaundice, caused by a build-up of bilirubin, the yellow substance produced when red blood cells are broken down. Normally it’s passed out of the body in urine.

However, if there’s something wrong with the liver, an excess amount can build up. In both cases, you should be checked out immediately.

ItchinesS

Possible cause: Eczema, pregnancy, antibiotic sensitivity

Skin that’s dry, itchy and sore is a well known symptom of eczema.

It normally occurs in areas with folds of skin such as around the eyes and ears, says Dr Catherine Hardman, a dermatologist at BMI The Clementine Churchill Hospital in London. But pregnancy can also result in itchy skin, especially in the latter stages.

It’s thought high hormone levels interfere with the secretion of bile (a yellow fluid that helps with digestion) from the liver cells. Instead of going into the digestive tract, it spills into the blood, causing intense itching.

Certain drugs - such as the antibiotic Doxyclycine used to treat chronic respiratory diseases, sexually transmitted infections and malaria - can also cause itchiness.

Spots in women

Possible cause: Polycystic Ovary Syndrome

The hormonal condition polycystic ovary syndrome can lead to a range of symptoms including problems getting pregnant, excessive hair growth and acne - the latter are because some women have higher levels of the male hormone testosterone, which play a role in the increase of the production of sebum, a natural oil in the skin.

What causes the condition is unknown, although there is a genetic link. Diagnosis involves a scan and blood tests.

LIPS

Cracks

Possible cause: Anaemia, diabetes

Open cracks or sores on the corners of the mouth, known as angular chelosis, can be a sign of anaemia - caused by a deficiency in iron. Production of red blood cells (vital for healthy skin) slows down - which means cracks that do appear will be equally slow to recover.

Another possible cause is diabetes, a condition which leads to too much glucose in the blood.

“The main symptoms include feeling very thirsty, going to the bathroom frequently and extreme tiredness,” says Dr Stokes-Lampard. “However, these high levels also encourage the growth of candida, a type of fungus, that attacks the corners of the mouth.”

EARS

Twisted shaped

Possible cause: Skin cancer, repeated injury

Tumours - benign or malignant - on the external ear or in the inner ear canal can cause the ear to change shape or direction.

“The ear is a common spot for basal cell carcinomas, the most common form of skin cancer,” says Dr Hardman. “They are also found around the eyes and on the scalp.”

These tend to appear as white or skin-coloured, smooth, pearly nodules.

Another form of skin cancer, squamous cell carcinoma, looks like an ulcer or reddish patch of skin. If you notice any changes you should consult your doctor immediately.

Rugby players and boxers are the best examples of what’s known as cauliflower ear.

Repeated injury causes a build up of fluid and swelling which left untreated can cause scar tissue.

Creased lobes

Possible cause: Heart disease

Diagonal creases across the ear lobes may be linked to cardiovascular problems, according to a study published in the British Heart Journal in 1989.

One theory is that they occur as a result of malformed blood vessels - replicating those supplying the heart. More likely is that the creases are a result of age, when heart disease is also more likely, says Dr Simpson. - Daily Mail

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