I’ve had terrible acne on my back for weeks now. It’s uncomfortable against my clothes. What should I do?

The fact that the issue is new and painful may suggest that it is not acne but rather a different condition.

Back acne, often referred to as bacne, consists of red, pimple-like spots that may contain pus. It commonly arises when skin pores are blocked by oil.

The likelihood of bacne increases with excessive sweating, so it’s crucial to regularly shower after perspiring and wear loose, breathable clothes. Changing bed linens frequently also reduces bacne risk.

There are a number of over-the-counter treatments designed to relieve acne symptoms.

These include salicylic acid, which can help unclog pores, and benzoyl peroxide wash, which reduces inflammation.

If these methods don’t help, a GP can prescribe treatments. Options include retinoid creams, which prevent pore blockage, and isotretinoin, which can clear severe acne.

However, another condition that can affect the back in a similar way and come on suddenly is something called folliculitis.

Excess sweating raises the risk of bacne so it’s important that people regularly shower after sweating as well as wear loose, breathable clothing

Folliculitis occurs when back hair follicles become inflamed. Initially appearing as small pimples, it can progress to pustules and blisters, and is often sore and itchy.

Mild cases tend to clear up after a few days but, for some, the bumps can become infected with bacteria or with yeast.

Individuals with poor hygiene, weakened immunity, or skin conditions like acne or eczema are more susceptible. Combatting folliculitis involves regular skin washing. Products like Dermol or chlorhexidine body washes can remove excess skin bacteria.

Those experiencing painful back spots should consult their GP. If needed, an antibiotic or antifungal body wash may be prescribed to treat the infection. Shaving, waxing, tight clothing, and using heavy lotions or oils can exacerbate folliculitis for some individuals.

I recently had a bad bladder infection. I went to my chemist and I was told, because I’m over 65, they weren’t allowed to give me antibiotics. It doesn’t seem fair. What’s the reason for this?

Pharmacists are allowed to hand out certain prescription medicines for a set number of conditions – and there are specific criteria for which patients can get these drugs.

Under the Pharmacy First scheme, chemists can treat seven conditions including sore throats, earaches, shingles and bladder infections, known as urinary tract infections (UTIs).

The system, launched two years ago, is designed to reduce some of the workload on GPs.

However, because pharmacists do not have the same training as doctors, there are very strict limits on what they can do. For example, they can handle only earaches that affect children.

This is because ear infections are very common in children meaning ear pain is highly likely to be caused by this – while in adults the cause is less clear.

Likewise, pharmacists can provide antibiotics to treat UTIs but only to women between 16 and 64. This is due to UTIs being common in young women and straightforward to treat using a short course of tablets – but older women are at a greater risk of UTI complications, such as confusion or even sepsis.

There is also a chance at this age the symptoms could be ovarian cancer. So women over 65 with UTI symptoms should always see a doctor. If patients need to antibiotics outside normal hours, call 111, the NHS non-emergency phone number.

I had a surgery last week for an enlarged prostate. I haven’t been given any information on what happens next. What should I be doing to recover?

It can take up to six weeks to fully heal from an enlarged prostate surgery – but there are steps that patients can take to improve their recovery.

An enlarged prostate is a common condition for men in later life. The prostate, the organ underneath the bladder that helps create semen, never stops growing.

Overtime, it comes to put pressure on the bladder, leading to frequent urination and difficulty peeing.

The most common procedure is a transurethral resection of the prostate, a TURP.

This is an operation to remove part of the prostate via the penis. It’s done under general anaesthetic and is very safe.

But it is normal to experience some pain, swelling and even some blood in the urine in the days that follow. This should go away fairly quickly. Patients are told to drink plenty of water in the first few days, to help avoid an infection, and to avoid lifting heavy things or doing intense exercise for six weeks.

There are also exercises that patients can do to strengthen their bladder muscles, to avoid incontinence. The British Association of Urological Surgeons has a good leaflet describing pelvic floor exercises. It is also available in an app called Squeezy for Men.

Why ‘moobs’ are no laughing matter

Take That singer Gary Barlow said he followed an intense exercise routine to get rid of his ‘man boobs’

You might think it strange for a doctor to be writing about ‘man boobs’ – or gynaecomastia, to use the medical term. But in my surgery it comes up more often than you’d imagine.

For many men, the condition is deeply embarrassing. In 2017, Take That singer Gary Barlow revealed he’d followed an intense exercise routine to get rid of his ‘moobs’.

A rounded, breast-like chest can feel emasculating, and yet it’s something doctors have to take seriously.

Yes, sometimes it’s just down to weight gain, but it can also be caused by hormonal changes, alcohol, steroid misuse or as a side effect of common medicines. On rare occasions, it’s even a warning sign of cancer.

Have you or your partner had to deal with it? Write and let me know.

Fears over online consultations

The Government’s decision this week that GP surgeries should allow online consultations throughout the day has not been greeted with applause by doctors.

On the surface, it sounds like a win for patients – more flexibility, quicker access. But in reality, it may not be best for everyone. At my own NHS practice, we already run this system and it works because we have the clinical and admin staff to handle it safely.

However, not every surgery is in that position. Imagine a flood of online requests piling up faster than doctors can go through them. Urgent concerns – even cancer symptoms – risk being buried under trivial demands such as letters to cancel a gym membership.

Safe triage requires trained people on the ground, not just an open digital front door. Without that, this change won’t improve safety, it may actually put patients at greater risk.