Is illness staring you in the face? Symptoms you can spot in the mirror

By ANGELA EPSTEIN

Staring closely at yourself in the mirror may seem vain, but it could be good for your health.

Experts believe our faces reflect our state of wellbeing, and that problems often dismissed as trivial, such as bloodshot eyes, could be a sign of something more serious.
Here, with the help of leading medical practitioners, we look at the hidden health problems which may be revealed in the mirror.

• EYES

WHITE RINGS

Possible cause: High cholesterol

"A white ring bordering the coloured part of the eye can be a sign of fatty deposits caused by high cholesterol," says Dr Kevin Lewis, president of the Royal College of Optometrists.

"The condition can also produce small waxy white lumps on skin around the eye. This occurs when too much cholesterol in the blood causes a substance called plaque to form, which is dumped in areas of the body, such as the eye, where there is a particularly rich blood supply."

At the first sign of this, have your cholesterol level checked by your GP. Cutting saturated fats from your diet, regular exercise and keeping weight down can help.



BLOODSHOT EYES

Possible causes: Bacterial infection. Iritis/arthritis

Bactera from old eye make-up can lead to irritation or infection, so throw out cosmetics which are more than six months old.

"Bloodshot, sore eyes can also be a sign of iritis - inflammation of the iris (the coloured part of the eye)," says Dr Dawn Harper, a GP and author of a book on common diseases.

Iritis can be caused by a viral infection such as gastroenteritis, but in rarer cases can be triggered by auto-immune diseases such as arthritis, which need to be treated with medication. An optometrist will use a microscope to examine the surface of the eye and determine the cause of the inflammation.



PALE EYELIDS
Possible cause: Anaemia

"If the skin inside your lower lids looks pale rather than bright pink, it could mean you are anaemic and deficient in iron due to lack of red blood cells," says Dr Harper.

Iron is crucial for healthy production of red blood cells. On average, men need 8.7mg of iron a day, while women need 14.8mg as menstruation can lead to a shortage.

Good sources include red meat - animal sources are the most easily absorbed by the body - leafy green vegetables, wholegrain cereals and lentils. It's also worth increasing the amount of vitamin-C rich fruit and vegetables in your diet as vitamin C helps you absorb iron from food. Other symptoms of anaemia include brittle nails, headaches, breathlessness and tiredness.



TWITCHING EYE

Possible causes: Magnesium deficiency. Multiple sclerosis

Also known as myokymia, eye twitching is caused by random muscle contractions and may be triggered by lack of magnesium.

On average, men need 300mg of magnesium a day, while women require 270mg. Good sources include green leafy vegetables such as spinach.

"Myokymia can occur as a result of a number of serious nervous conditions including multiple sclerosis," says optometrist Dr Lewis.

Other symptoms of MS include numbness, weakness, tingling in the limbs and lack of co-ordination. If in any doubt, consult a GP.



DROOPING EYELID
Possible causes: Eye strain. Stress. Lung cancer. Stroke

Eye muscles can become strained due to poor lighting at work and over-use of computer screens. Stress can also affect the eyes, as it inhibits absorption of essential B vitamins that help keep eye muscles strong.

Eye exercises that increase the fresh blood supply to your eye may ease the strain and prevent drooping. Opticians recommend the "20/20" exercise: taking a break every 20 minutes and trying to look at something 20 feet away for roughly 20 seconds.

"In rare cases, a drooping eye can also be a sign of lung cancer," says Dr Harper. If the tumour is high enough in the chest it can press on a group of nerves that affect the eye. However, the disease has many more obvious symptoms such as coughing up blood, and unexplained weight loss. If the problem persists, contact your GP.

A drooping eyelid can also be the sign of a stroke. The Stroke Association advises using the Face, Arm, Speech Test (FAST) to help you recognise whether someone has had a stroke.

This stands for: F, Facial weakness: Can the person smile? Has their mouth or eye drooped? A, Arm weakness: Can the person raise both arms? S, Speech problems: Can the person speak clearly and understand what you say? T, Test all three signs.

If you are concerned about any of these signs you should seek medical attention immediately.




• SKIN

ITCHY SKIN
Possible cause: Eczema. Poor liver function

If your skin has become itchy, dry and flaky, and is also red and painful, this could be eczema. It can appear anywhere on the body, including the face, but is most common inside the elbows and wrists, and behind the knees.

Keep the skin moisturised; your GP may prescribe steroid creams or antibiotics for flare-ups or resulting infections.

In rare cases, itching (particularly on the hands and feet), can mean you are suffering from poor liver function, explains Dr Rob Hicks, a GP based in London.

This is known as cholestasis, and occurs when bile (a yellow liquid released from the gall bladder containing waste products) cannot flow freely into the digestive tract and instead accumulates in the blood, causing itching. A liver function test may be needed to diagnose the condition so that the right treatment can be prescribed.



COLOUR CHANGE
Possible causes: Too much beta-carotene. Jaundice. Liver problems

Eating excessive amounts of food containing beta-carotene - a form of vitamin A which gives fruit and vegetables their red, orange and yellow colour - an affect the skin colour, turning it orange, though this is rare.

A yellow tinge can also be a sign of jaundice and liver problems, and so should always be checked out immediately, says Dr Harper.

The colour is the result of a natural pigment called bilirubin being deposited in the skin, instead of being removed via the liver. Causes include hepatitis and liver disease.



SPOTTY COMPLEXION
Possible causes: Irritable bowel Syndrome. Polycystic Ovary Syndrome

The complexion is a good barometer of our digestive health, and problems such as irritable bowel syndrome can be reflected in the state of your skin.

Irritable bowel syndrome irritates the lining of the gut, causing diarrhoea or constipation, and pain. If you suspect a link, keep a food and drink diary for a few weeks to see whether any particular food irritates your digestive system and skin. Taking a probiotic supplement may help - these contain so-called good bacteria, which keep the gut healthy. Products containing lactobacillus acidophilus may both alleviate your digestive problems and give you a clearer skin.

Polycystic ovary syndrome is a hormonal problem which can cause acne in women. Other symptoms include menstruation and fertility problems, hair growth and weight gain. The problem can be diagnosed with a blood test.



SALLOW SKIN
Possible cause: Dehydration

Inadequate fluid intake leads to water loss from skin cells (the body uses the fluid to keep vital organs functioning). This results in dull, lifeless skin.

You can test for dehydration by pinching the skin on the back of the hand. If it does not immediately spring back into place, you are not drinking enough.

Fluid intake should be at least two litres a day - particularly in hot weather.




• HAIR

PREMATURE GREYNESS
Possible cause: Pernicious anaemia

Prematurely grey hair can be a sign of vitamin B12 deficiency (the vitamin is essential for hair growth and pigmentation), also known as pernicious anaemia.

"'When vitamin B12 is in short supply, red blood cells are produced in smaller numbers, are abnormally large and don't last as long as they should, causing anaemia to develop," says Dr Hicks.

"Other symptoms can include tiredness, weight loss and diarrhoea."


Vitamin B12 is found only in foods of animal origin, such as meat, fish, cheese, eggs and milk, so a strict vegetarian or vegan diet, without vitamin supplements, can lead to a deficiency.

The problem is diagnosed with a simple blood test and resolved with injections of vitamin B12 (it isn't absorbed properly if given by mouth).

Once the deficiency has been corrected, a maintenance dose is given every three months for life.



THIN, LIFELESS HAIR
Possible causes: Iron deficiency. Underactive thyroid

Thinning hair can be a sign of iron deficiency as the mineral is needed for healthy hair growth. Women are vulnerable when menstruating, and pre- and postmenopause.

Iron supplements may help, as will boosting your intake of iron-rich foods. Your GP can perform a simple blood test to check your iron levels.

Thinning hair on the head or eyebrows can also be a sign of an underactive thyroid gland, as the hormones it produces are needed for healthy hair growth. "The problem is diagnosed with a simple blood test and treated with a daily synthetic thyroid supplement to replace the missing hormone thyroxine," says Dr Hicks. Other symptoms include dry skin, fatigue and weight loss.




• MOUTH

BLEEDING GUMS
Possible causes: Gingivitis. Pregnancy. Leukaemia

"A build-up of plaque as a result of poor oral hygiene can cause bleeding gums, also known as gingivitis, and periodontal disease (infection of the bones that hold teeth in place)," says dentist Dr Phil Stemmer of the Teeth For Life clinic, London.

"Poor diet, stress, too much alcohol or spicy foods can lead to an overacidic environment in the mouth, which can also inflame gums," he says. Brushing twice a day and flossing daily should help, but you should see your dentist for a check-up, too.

Bleeding can also be a sign of pregnancy because hormonal changes make the gums softer and more likely to bleed.

In rare cases, bleeding gums can be an early sign of leukaemia, as the disease affects blood clotting. Other symptoms include weakness and fatigue, infections, weight loss, pain in the bones and excessive bruising.



ULCERS
Possible causes: Stress. Poor nutrition. Accidental damage. Cancer

Brushing your teeth too hard, minor burns from hot food and drinks, biting the inside of the mouth accidentally, or a tooth that rubs against the gums can all lead to mouth ulcers. They also happen at times of stress, as this can lead to a lowering of the immune system.

Lack of vitamin B12, iron and folate have also been connected to ulcers.

Ulcers can be treated with an antiseptic mouthwash and they usually heal within a week. "However, if they last for more than two weeks, you should see your dentist as, in rare cases, they may be an early indication of oral cancer," says Dr Stemmer.



INFLAMED LUMPS Possible cause: Pregnancy

Large benign bumps - often slightly overlapping the tooth - are common during pregnancy. Known as epuli, they are caused by oestrogen making the gums more sensitive and prone to inflammation - and will disappear after the birth.



SMALL, SHARP TEETH

Possible causes: Tooth grinding. Cancer

If your teeth appear smaller it could be as a result of grinding them - bruxism, as it is known, usually occurs at night when we are asleep. Some people grind their teeth when stressed; others do so because of a poor bite, which means their jaw is unable to relax into a comfortable position.


Over time, as well as producing sharp teeth, this can cause other health problems, such as muscle tension, headaches and jaw pain. See your dentist about wearing a mouth guard at night.


Dr Stemmer points out that it is vital to have a regular dental checkup, because sharp, broken fillings, crowns or teeth which rub on the mouth can cause tissue damage that may lead to pre-cancerous changes.



CRACKED LIPS
Possible causes: Anaemia. Diabetes

Dry, sore cracks at the side of the mouth are sometimes caused by anaemia due to iron deficiency. However, they may be a sign of diabetes, because the high level of blood glucose encourages the growth of candida, a yeast-like infection which attacks the thin dermis at the corners of the mouth. Other symptoms of diabetes include weight loss, thirst and frequent need to urinate.



PALE LIPS
Possible causes: Iron deficiency. Poor thyroid function. Heart problems


Pale pink lips are a common side-effect of iron deficiency and poor thyroid function (the thyroid gland plays a role in producing red blood cells).

Pale lips can also be a sign of heart conditions and lung problems, as these can affect oxygen levels in the blood. When this level drops significantly, the lips take on a bluish tone, instead of being a healthy deep pink, says Dr Hicks. If this develops suddenly, consult your doctor.



PATCHES ON TONGUE
Possible causes: Thrush, cancer

Creamy white patches on the tongue and gums can be a sign of oral thrush, says Dr Hicks. "Using an oral anti-fungal mouthwash or lozenges will clear this up quickly."

White patches that are not sore, cannot be scraped away and do not go away on their own are possibly an early-warning sign of cancer, as the patches can signify cell changes. These patches should be checked by a doctor so they can be dealt with before they become more serious.



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