I’ve had a hard white spot under my eye for two years and have no idea what it is – help!

FOLLOWING news of three deaths being linked to an NHS listeria outbreak, let me explain what the bug is and if you’re at risk.

Listeriosis is an infection caused by listeria, which usually contaminates chilled, ready-to-eat foods such as sandwiches, pate, deli meats, pre-packaged salads and soft cheese.

The latest outbreak, in 2024, was discovered after routine sampling of puddings such as mousses, ice-creams and yoghurts supplied to NHS hospitals and care homes, which have now been recalled.

Five hospital patients were found to be infected. Listeriosis can make some people seriously ill – particularly those with vulnerabilities, such as the over-65s, pregnant women or those with a condition that weakens their immune system.

Listeriosis can risk miscarriage or stillbirth, which is why women are told to avoid high-risk listeriosis foods, from smoked fish to brie, during pregnancy.

Symptoms can include a high temperature, aches and pains, chills, feeling or being sick, and diarrhoea. If you think you have listeriosis, see a GP urgently.

Here’s a selection of what readers asked me this week . . . 

A spot of bother

Q: DO you know what the hard white spot below my eye, in the photo I have sent you, might be?

And is it treatable? I have had it for around two years and it’s not that problematic, just unsightly. I’m 60 and take medications simvastatin, allopurinal and omeprazole.

A: Thank you for sending the photo to help me assess this skin lesion.

I see a smooth, pale yellow lump just below the inner corner of the left eye.

As doctors, we often make a differential diagnosis – this means we narrow down what the possible causes could be.

We tend to start by considering whether it could be anything potentially dangerous and in your case this is not a concern.

But any skin lesion that is growing or changing should be properly examined by a doctor or nurse.

We also consider if skin rashes or lesions could be a clue that there is an underlying disease going on.

So let me talk you through my differential diagnosis.

Xanthelasma are cholesterol deposits found around the eyes and appear as yellow plaques.

I note that you take a statin, which is a cholesterol-lowering drug, but your skin lesion appears more raised and cyst-like than the typical appearance of xanthelasma.

Next, I considered milia – also known as milk spots – which babies sometimes have on their face but adults can also get.

Milia are small, white or skin-coloured bumps that are firm and most commonly found around the eyes, cheeks, nose and forehead.

They contain keratin, a substance that is normally found in the skin, but are usually only around 1-2mm in diameter, your lesion appears to be larger than this.

The most likely potential diagnosis, is an epidermoid cyst, a benign and slow-growing domed bump, which is also filled with keratin.

They tend to be mobile, so you can move them around slightly on top of the underlying skin. These do not tend to cause problems unless they get infected.

All these lesions can be removed for cosmetic purposes, if that is your wish, but cosmetic procedures are not available on the NHS.

Struggling to shed pounds

Q: I’M a female in my seventies, 5ft 4in and 85kg. I can’t lose weight, despite eating sensibly and going for walks. What else can I do?

A: Thank you for writing about your dilemma, which I’m sure many people will be interested in. Obesity is a highly complex chronic condition that has more than 100 potential contributing causes – the most significant for many being genetics.

So if you’ve ever been told that it’s simply a matter of willpower, or just eating a little less and moving more, you’ve been told a lie.

Appetites vary from individual to individual – food preferences do, too – and some people are just more responsive to food cues.

Our metabolisms – how quickly we burn calories – vary from person to person.

And after menopause, changes to metabolism make it even more difficult for women to lose excess body fat.

So I’m going to propose a different way of thinking for you.

What if you were to shift your focus away from the scales and the weight, and make lifestyle changes that improve your health?

So when it comes to your diet, instead of cutting out the “less healthy”; food, focus on nourishing your body with what it needs and deserves – hydration; lots of fibre; proteins such as fish and chicken as well as plant-based ones like lentils, beans, chickpeas, tofu, tempeh, nuts and seeds; and colourful fruit and veg.

Do exercise for pleasure and because it makes you feel good.

Try being in nature, keeping fit with friends or aiming for the endorphin hit – whatever floats your boat.

But do it for that, not the number on the scales.

If you can incorporate some muscle-building exercise, then you may even gain weight from the lean mass.

But this is one of the best things you can do for your health, despite what you see on the scales, and can help shape your body.

I’d be wrong to say that obesity doesn’t matter, because it does have many health implications – but these changes protect you from the same health issues that obesity can cause.

Sometimes, a shift in mindset can help us achieve our health goals.

And let’s face it, if restrictive dieting worked long-term, there wouldn’t be so many people out there struggling to keep the excess weight off.