Are you plagued by greasy hair? Spots? A puffy face? Just by looking in the mirror, you can tell a lot about your state of health, says Dr Deborah McManners

As a GP and a naturopath, when I'm assessing a patient, complex lab-based tests come second to the assessment I can make with my own eyes and hands. If you know what to look for, you can tell a great deal about a person's reserves of health, lifestyle, likely family history and their predisposition to certain conditions, simply by listening to their story and examining their appearance in detail.

As a GP and a naturopath, when I'm assessing a patient, complex lab-based tests come second to the assessment I can make with my own eyes and hands. If you know what to look for, you can tell a great deal about a person's reserves of health, lifestyle, likely family history and their predisposition to certain conditions, simply by listening to their story and examining their appearance in detail.

The key to such an assessment is years of training and experience, and unfortunately that's something I can't get across here. However, I can give you direction for a preliminary self-assessment that you can do at home just by looking in the mirror. Remember that a self-assessment should only be a first step -- if you suspect you have any symptoms of a serious condition, you must always check with your doctor, and you shouldn't start or alter treatments without expert advice.

The evidence of your skin, hair, eyes and body is a guide to your physical health. The appearance of your features reflects what and how much you eat, drink and smoke, your physical and social environment including stress levels and sleep patterns and your physiological or 'real' (as opposed to your chronological) age. They can provide clues to any illness that might be affecting you, even before it becomes clinically apparent, and possibly even to diseases that may affect you in the future.

Is your hair greasy, dry, unmanageable or turning prematurely grey?

Dry or unmanageable hair could be a warning sign of a poorly functioning thyroid gland, or other hormonal disturbances, or a poor diet. Greasy hair may just be normal for you, but may also be a sign of hormonal imbalance, or, if you're a woman, of hormonal fluctuations during your menstrual cycle. Premature greying - for example, in your twenties - is sometimes hereditary, but can also be a sign of nutritional deficiency, such as protein or iron deficiency. A condition called pernicious anaemia, which causes failure of vitamin B12 absorption, may also be characterised by early greying.

Is your scalp itchy or flaky?

An itchy or flaky scalp may indicate eczema, either local, caused by direct contact with an irritant, or systemic (also known as atopic), where contact with an allergen triggers an allergic response all through the body. It can also be a sign of psoriasis or infestation with lice (typically in schoolchildren). Dandruff can be a warning sign of yeast infection or seborrhoeic dermatitis.

Is your face puffy or flaccid?

A puffy or flaccid face is usually a sign of either illness or overindulgence - too many late nights, too much drinking and smoking, and too little quality food. It may also be a sign of an underactive thyroid gland, and sometimes of kidney disorder, so you should discuss these possibilities with your doctor.

What's the skin like on your forehead, cheeks, or on either side of your nose?

Flaking and/or greasiness of the forehead, the sides of the nose and the cheeks, together with dandruff, can be a sign of seborrhoeic eczema - an oily, yeasty eczema. Sometimes, seborrhoeic eczema is linked to food intolerance.

Is your skin oily or dry?

Extreme dryness can indicate hormonal imbalance, for example, an underactive thyroid (thyroid dysfunction is surprisingly widespread). It may also indicate a lack of oils and foods rich in essential fatty acids in your diet. Some people do tend towards oilier skin, as do adolescents. However, if it has only recently appeared, it may indicate a hormone imbalance - maybe an increase in androgen (male type) hormones. This should be checked out by blood tests for hormone levels, especially if there are other symptoms, such as (for a woman) irregular periods or excess facial hair.

Do you suffer from excess hair?

Hirsutism - excessive facial or body hair - may simply reflect your constitutional type or heredity. But if it isn't a family trait, it could be a sign of a hormone problem such as polycystic ovarian syndrome (which, untreated, leaves some women subfertile and may put you at increased risk of heart disease and diabetes). There's also a chance that your increased hair growth could be due to an ovarian or adrenal tumour, so book in with a doctor for hormone-level tests straight away to find the cause before you even think about hair-removal treatments. If it's nothing serious but you find the hair difficult to deal with, be aware that electrolysis or laser treatment is available on the NHS in some parts of the UK.

Are you prematurely wrinkled?

Wrinkles and other signs of apparently premature ageing may show that your physiological age is outstripping your chronological age. If you're wrinkled beyond your years, you may well be overexposing yourself to harmful UV rays in sunlight, smoking, drinking too much, and failing to get enough vitamins, essential fatty acids and other micronutrients from your diet.

Do you have dark circles under your eyes?

Dark circles under the eyes are caused by seepage of fluid from the capillaries around the eyes - a kind of "mini-bruising". They can be linked to allergies, but are more commonly the result of insufficient/disrupted sleep, smoking and heavy drinking.

Are your eyes bloodshot or bulging?

Bulging eyes can be a sign of conditions such as an overactive thyroid gland and should be reported immediately. Bloodshot or reddened eyes can be the result of eye strain (staring at a screen or page for long periods without blinking enough dries out the eyes), lack of sleep, allergy or infection. Rheumatic disorders may also affect the eyes, causing inflammation and redness.

Do you get cold sores or cracks at the corners of your mouth?

Cold sores are caused by a variety of the herpes virus that many people carry. Most of the time it lies dormant, but if your immune system is weakened or overtaxed, the virus can reactivate and cause a cold sore. If you get a lot of them, it's a strong indicator that your reserves of health are overstretched and your immune system isn't working at full throttle. Cracks at the corner of the mouth are known as angular stomatitis, a condition that can be a warning sign of iron or vitamin B deficiency, especially in those not eating a nutritionally sound diet, the anaemic or the elderly.

How healthy are your gums?

Bleeding gums are usually a symptom of gingivitis - inflammation of the gums around the teeth due to a build-up of plaque and bacterial infection. But they can occasionally be a serious symptom (for example, of a blood disorder, or even scurvy, caused by vitamin C deficiency). See your dentist or doctor straight away for assessment. Retracted gums can be a sign of overbrushing, smoking, poor nutrition, or simply ageing.

What's the state of your tongue like?

A furry tongue is often a sign of poor oral hygiene (many people don't realise that you're supposed to brush your tongue as well as your teeth). A dry tongue can be a symptom of autoimmune problems. A sore, red tongue may indicate iron or vitamin B deficiency. White patches on a sore tongue may be a sign of a yeast infection. Any mouth or tongue problem that continues for several weeks must be seen by a doctor, as oral cancers are sadly very common and early diagnosis is essential.

From 'The Holistic Doctor' by Dr Deborah McManners, published by Piatkus at £12.99. To order a copy at £10.99, including p&p, call 01476541001

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