Q I endure terrible hay fever and as I am taking exams this summer how can I prevent it stifling my performance?

SN from Norwich

A Research has shown that hay fever sufferers can drop an entire grade compared with their mock exams, typically taken in January. Avoid antihistimines with a sedating side-effect, such as chlorphenamine (Piriton), in favour of “non-drowsy” treatments such as cetirizine (Zyrtec). Also consider the new prescription nasal spray Avamys (fluticasone furoate), which if used once a day, can give relief for both the nasal and eye symptoms.

Some patients report that eating locally produced, unfiltered honey helps, on the basis that it introduces manageable amounts of pollen to the body and so desensitises them to it. No study has proven this yet but there is no downside, even if it is a placebo effect. Whichever treatment you opt for, start several weeks ahead of your exams to get maximum benefit. Try to travel in a car with air-conditioning, as this helps to filter out pollen.

Q I have several thread-like veins visible on my nose and chin. Will “miracle” creams get rid of these? If not, what do you suggest?

CS from Cardiff

A Facial thread-veins, sometimes known as telangiectasia, are usually dilated capillaries on the face — typically on the cheeks and nose — that are bright red, thin and tend to blanch when pressed, only to refill immediately afterwards.

Their cause is unclear but temperature changes, smoking, hormonal changes and alcohol may all play a part. Miracle creams will, I’m sorry to say, lighten only your wallet. Effective treatments include electrolysis or electrocoagulation, along with intense pulsed-light treatment or laser therapy. If you are concerned, ask your GP to refer you to a skin specialist who can advise which is best for you.

Q I have an ongoing burning pain from a scar that is a result of a gall bladder operation 20 years ago. Numerous procedures and medications have yielded no success so any advice is welcome.

MOS from Cork, Ireland

A Chronic pain can be extremely difficult to treat. I suspect you still have some options left and suggest you ask to be referred to a pain-management clinic.

The first step is to ensure you have tried all the pain-relieving medication available. This does not just mean painkillers. Older treatments such as amitriptyline (originally designed as an antidepressant) and newer ones such as gabapentin can prove effective in treating pain. You may also benefit from having your scar injected with a local anaesthetic or steroid by a pain consultant, who is usually an anaesthetist.

Write, with your initials and home town, to drknow@sunday-times.co.uk All questions are answered by a practising doctor

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