Health: A Question of Health

I HAD a small operation to remove a mole and have been left with an ugly keloid scar which is much worse than the original mole. Can anything be done about this?

Keloid scars are caused by an overgrowth of tissue along the line of a scar caused by an operation or injury. The cause is not known, but keloids affect people with pigmented skin much more commonly than fair-skinned people. They are difficult to treat; if you try to remove a keloid scar surgically a new one will form as the skin heals. Specially designed pressure bandages will sometimes reduce the size of scars, and steroid injections into the scar tissue can also be effective in shrinking keloids.

I SUFFER from palpitations - atrial flutter and atrial fibrillation - which are mostly, but not completely, controlled by medication taken every day. I have heard about a technology that can cure this condition. Can you explain how it works?

These palpitations are usually triggered by some abnormal electrical activity in the heart. It is now possible to "map" the electrical activity within the heart and if the abnormal area can be identified it is sometimes possible to destroy it with a technique known as radiofrequency ablation. If this is successful, the condition is cured. It is most likely to work in younger patients who do not have other heart problems as well as palpitations. This treatment is available only in specialised cardiology centres.

I TAKE the contraceptive pill and I sometimes forget to start the packet of pills on the correct day. Does this increase my risk of getting pregnant?

Most definitely yes. With most contraceptive pills, you take one pill a day for 21 days and then have a seven-day break. You must start a new packet of pills on the day after this break. By the end of the seven-day break, the ovaries are beginning to wake up again and if you start your new packet of pills even a day late, there is a risk of pregnancy. Being without pills for more than seven days is much more risky than missing a pill in the middle of a packet.

MY TWO-YEAR-OLD has lost consciousness on several occasions and this has been diagnosed as breath-holding attacks by a paediatrician. Are these dangerous?

Typically, attacks occur when a small child is upset or has been hurt. He screams or cries and then suddenly holds his breath, turns blue, goes limp and falls to the ground unconscious. The child quickly starts breathing again and recovers completely within a minute or two. This can be terrifying, but fortunately it is not dangerous or harmful and children always grow out of it.

Send questions to A Question of Health, `The Independent', 1 Canada Square, Canary Wharf, London E14 5DL; fax 0171-293 2182; or e-mail to health@ independent.co.uk. Dr Kavalier cannot respond personally