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I (32F) have been getting cold sores quite often lately, used to be only when I travel to cold countries, now it’s like every couple of months. I use acyclovir cream but it doesn’t seem to prevent it from coming back. Could it be due to stress or anything I can do to solve this?
Hi Shennie. Cold sores are usually caused by the herpes simplex virus type 1 (HSV-1), which stays dormant in your body once you’ve contracted it. When your immune system is weakened, for example due to stress, poor sleep, or even general fatigue, the virus can reactivate and flare up, causing recurrRead more
Hi Shennie. Cold sores are usually caused by the herpes simplex virus type 1 (HSV-1), which stays dormant in your body once you’ve contracted it. When your immune system is weakened, for example due to stress, poor sleep, or even general fatigue, the virus can reactivate and flare up, causing recurrent cold sores.
I’ve had patients who experience similar patterns, where it used to only happen during cold weather or travel, but starts recurring more often due to lifestyle stressors.
Topical acyclovir cream can help shorten each episode, but if you’re getting flare-ups this frequently, it might not be enough. You might benefit from oral antiviral medication, which can help reduce the severity and frequency of outbreaks. But you’ll need to see a doctor to get a proper assessment and prescription.
It’s worth visiting your GP to discuss treatment options and see what works best for you.
Regards,
Dr Say Wei Xian
General Practitioner
IG: Dr Say Wei Xian (General Practitioner)
The information provided on this forum is for educational purposes only and not intended as medical advice. Please consult a healthcare provider for any medical concerns, diagnosis or treatment.
See lessWhy does my toe nail look like that? Isit trapped blood inside? Has been like that for few months and the only trigger I can think of is wearing new heels that were too tight..
Hello! From the photo and your history, it does look like a subungual haematoma, which is basically dried blood trapped under the toenail, usually caused by trauma. In your case, it's most likely due to pressure from your tight heels. If it’s been there for months and not getting worse, the blood maRead more
Hello! From the photo and your history, it does look like a subungual haematoma, which is basically dried blood trapped under the toenail, usually caused by trauma. In your case, it’s most likely due to pressure from your tight heels.
If it’s been there for months and not getting worse, the blood may just grow out with the nail over time, nothing to worry about.
But do take note if there’s persistent pain, spreading of discolouration, nail changes like thickening or lifting. If any of these happen, it’s best to get it checked in case of something more serious.
I usually tell my patients to monitor it over a few months unless it’s painful or worsening. You could also see a GP if unsure to get it examined.
Regards,
Dr Say Wei Xian
General Practitioner
IG: Dr Say Wei Xian (General Practitioner)
The information provided on this forum is for educational purposes only and not intended as medical advice. Please consult a healthcare provider for any medical concerns, diagnosis or treatment.
See lessI’m trying to manage my PCOS with guidance from my OB, especially since my period has been delayed for quite some time. She prescribed a few medications, but one that caught my attention was YAZ. I noticed in the Consumer Medicine Information (CMI) summary that it may not be recommended for individuals with migraines, which I am diagnosed. I’m now unsure whether it’s safe for me to take, or if I should consult my OB again to explore alternative options. I might be overthinking this.
Hi, thank you for dropping your question. YAZ is a type of combined oral contraceptive pill that contains both oestrogen and progestin. It’s often prescribed for women with PCOS to help regulate their periods and manage symptoms like acne or excess facial hair. It’s a common choice for PCOS, so yourRead more
Hi, thank you for dropping your question.
YAZ is a type of combined oral contraceptive pill that contains both oestrogen and progestin. It’s often prescribed for women with PCOS to help regulate their periods and manage symptoms like acne or excess facial hair.
It’s a common choice for PCOS, so your OBGYN may have included it as part of a standard plan. But if you have a history of migraines, especially migraines with aura, it’s important to let your doctor know. Oestrogen-containing pills like YAZ have been linked to a slightly higher risk of stroke or blood clots in some people with this type of migraine.
Your OBGYN may not have been aware of your migraine history, so I’d suggest checking back in to discuss whether YAZ is still the best option for you. There are other alternatives your doctor can consider depending on your full medical history.
Regards,
Dr Say Wei Xian
General Practitioner
IG: Dr Say Wei Xian (General Practitioner)
The information provided on this forum is for educational purposes only and not intended as medical advice. Please consult a healthcare provider for any medical concerns, diagnosis or treatment.
See lessI accidentally touch a hot stove and got a blister on my hand now, should I cover it or let it air out? also should I apply vit E oil? I dont want scars D;
Hi there! Oh no, I'm sorry to hear about your burn. I know how painful and worrying those can be, especially when you're concerned about scarring. First things first, please don't pop that blister! I know it might be tempting, but the blister is actually your body's way of protecting the healing skiRead more
Hi there!
Oh no, I’m sorry to hear about your burn. I know how painful and worrying those can be, especially when you’re concerned about scarring.
First things first, please don’t pop that blister! I know it might be tempting, but the blister is actually your body’s way of protecting the healing skin underneath. Think of it as nature’s own bandage. Breaking it open just increases your risk of infection and potentially worse scarring. What I’d suggest is giving it a gentle clean with some mild soap and cool water, then covering it with a sterile non-stick dressing, you can find these at any pharmacy. If you’re just lounging at home and it’s not getting irritated, it’s fine to leave it uncovered for a bit to let it breathe.
I get asked about Vitamin E oil a lot! While many people swear by it, the research is honestly quite mixed, and some folks actually end up with skin irritation from it. My advice would be to wait until everything’s completely healed over, no open areas at all, before trying any scar treatments. In the meantime, something gentle like aloe vera gel or even just a basic moisturizer can help keep the area comfortable while it’s healing.
Do keep an eye out for any signs that things aren’t healing well such as increasing redness, swelling, warmth, throbbing pain, or any pus. If you notice any of these, do pop by a clinic to get it checked out. Oh, and when did you last have a tetanus shot? If it’s been more than 10 years, it might be worth checking in with your GP about that.
The good news is that most minor burns like this heal up really well with minimal scarring when looked after properly. Try not to stress too much about it, your body is quite good at healing itself! Take care, and I hope it settles down quickly for you.
Regards,
Dr Say Wei Xian
General Practitioner
IG: Dr Say Wei Xian (General Practitioner)
The information provided on this forum is for educational purposes only and not intended as medical advice. Please consult a healthcare provider for any medical concerns, diagnosis or treatment.
See lessMy RBC count is 5.11 in my CP blood test report. what is this and why its mark as red. is it dangerous sign. ?
Hello, this is something a lot of people ask when reviewing their blood test results. Firstly, let me explain what RBC count is. Your RBC count refers to the number of red blood cells in a given volume of blood, typically in one microliter (µL). These cells are responsible for carrying oxygen througRead more
Hello, this is something a lot of people ask when reviewing their blood test results.
Firstly, let me explain what RBC count is. Your RBC count refers to the number of red blood cells in a given volume of blood, typically in one microliter (µL). These cells are responsible for carrying oxygen throughout the body, so they’re quite essential for your overall health.
For context, the normal range is usually around 4.7-6.1 million cells/µL for adult men, and about 4.2 -5.4 million cells/µL for adult women. Your result of 5.11 falls within this range.
However, different labs may use slightly different reference ranges. So even if your result is considered normal, it might still be flagged in red if it sits near the upper or lower end of that lab’s cut-off. It doesn’t always mean something is wrong, but it may be highlighted for closer review.
A higher RBC count can sometimes be linked to things like dehydration, smoking or certain lung conditions. A lower count may point toward anaemia, which can result from iron or vitamin deficiencies, chronic illness, or blood loss.
That said, we usually don’t make conclusions based on one number alone. To get a clearer picture, it’s important to look at it together with other values in your blood test, such as haemoglobin, haematocrit, and MCV, as well as your overall health and any symptoms you might have.
So, if you’re unsure or just want peace of mind, I’d recommend going through the full report with your doctor.
Regards,
Dr Say
See lessHi, I want to ask if the HPV vaccine is for younger girls right? But I’m already married and in my 30s—still got point to take or not ah? Or too late already?
This is a very commonly asked question by my patients who are in their 30s or already sexually active. Yes, the HPV vaccine can still be beneficial. It helps protect against several strains of the human papillomavirus, especially the high-risk types linked to cervical cancer. Some vaccines cover upRead more
This is a very commonly asked question by my patients who are in their 30s or already sexually active.
Yes, the HPV vaccine can still be beneficial. It helps protect against several strains of the human papillomavirus, especially the high-risk types linked to cervical cancer. Some vaccines cover up to nine strains, including the most common cancer-causing ones.
Although it works best when given before any exposure to HPV, women who are already sexually active can still benefit—especially if they haven’t been exposed to all the strains the vaccine protects against, which is often the case.
For adults aged 15 and above, the full schedule usually consists of three doses over six months—typically given at 0, 1–2, and 6 months.
That said, the HPV vaccine doesn’t replace cervical screening. According to the current Malaysian guidelines, all sexually active women aged 30 to 65 should undergo HPV testing every 5 years, even after vaccination, as the vaccine doesn’t protect against all HPV types.
Getting vaccinated alongside routine screening gives the best protection against cervical cancer.
Regards,
Dr Say
IG: https://www.instagram.com/sayweixian/?hl=en
References:
See lessGuidelines for Cervical Cancer Screening in Malaysia, Second Edition (2023), Ministry of Health Malaysia. https://www2.moh.gov.my/moh/modules_resources/bookshelf/Guidelines_For_Cervical_Cancer_Screening_in_Malaysia_2023/Guidelines_For_Cervical_Cancer_Screening_in_Malaysia_2023.pdf
Hi, I recently went for a check-up and the doctor said my blood pressure a bit high. He asked me to monitor and might need to start medication soon. But to be honest, I’m quite scared to start, heard once you start BP meds, you cannot stop already. Is that true ah?
It’s a very common concern—many patients feel the same way when they hear they may need to start blood pressure medication. And just to reassure you, we don’t keep people on medication for no reason. Blood pressure medication isn’t something you take forever by default. It’s prescribed to manage a cRead more
It’s a very common concern—many patients feel the same way when they hear they may need to start blood pressure medication. And just to reassure you, we don’t keep people on medication for no reason.
Blood pressure medication isn’t something you take forever by default. It’s prescribed to manage a condition. If the root cause of your high blood pressure is addressed—like through diet, weight management, or regular exercise—there is a chance the medication can be reduced or even stopped. But this needs to be done properly. Stopping too early, before things are well controlled, can increase the risk of stroke, heart disease, or kidney problems.
There are many types of blood pressure medications, and they’re not all the same. If you’re experiencing side effects, it’s important to bring it up—there are often alternatives that can be better suited.
Home monitoring is also very helpful, especially when first starting medication or adjusting doses. Some people experience white coat hypertension, where blood pressure readings are higher in the clinic than at home—so home readings give a more accurate picture.
Also, just because your BP reading looks fine for a day doesn’t mean the issue has resolved. The medication could be what’s keeping it controlled. Skipping or stopping it on your own could cause your blood pressure to spike unexpectedly.
And it’s totally understandable to be concerned about long-term effects on the kidneys or liver. That’s why regular follow-ups are important—your healthcare provider will know which blood tests to run and what to keep an eye on based on the medication you’re on.
If you have concerns, do bring them up at your next visit. It’s always worth having that conversation so expectations can be properly managed.
Regards,
Dr Say.
Reference:
See lessClinical Practice Guidelines – Management of Hypertension, 5th Edition (2018), Ministry of Health Malaysia.
Hi, so I woke up with a UTI today and it’s really annoying but I don’t have time to go to the doctor today :(( Will UTI go away on it’s own? Can I just wait awhile and be okay?
I know dealing with a UTI can be really uncomfortable, especially when you’re busy, but it’s important to start treatment as soon as possible. The bacteria multiply quickly and even waiting a few hours can make things feel much worse. You might notice symptoms like burning sensation when you pee, feRead more
I know dealing with a UTI can be really uncomfortable, especially when you’re busy, but it’s important to start treatment as soon as possible. The bacteria multiply quickly and even waiting a few hours can make things feel much worse. You might notice symptoms like burning sensation when you pee, feeling like you need to go all the time (even if hardly anything comes out), or that your bladder doesn’t feel completely empty after you go. Worsening of these symptoms usually means that the infection is spreading and becoming more severe.
While some mild infections might clear up on their own, there’s no guarantee, and waiting too long can let the infection spread to your kidneys. That can lead to more serious problems like fever, chills, and a deep, aching pain in your lower back, which can be much harder to treat and make you feel really unwell. Hence, it’s best to start treatment as soon as possible.
Personally, I really recommend that you see a doctor as soon as possible so you can get started on antibiotics. In the meantime, drink plenty of water to help flush out the bacteria. If you’re feeling uncomfortable, taking some ibuprofen or paracetamol can help ease the pain. You might also find Phenazopyridine (e.g., Pyridium, Azo, Uristat) helpful. These are over-the-counter medication that can relieve the burning sensation when you urinate. Just keep in mind that they only help with symptoms and doesn’t actually treat the infection, so antibiotics are still necessary.
If you start feeling worse, develop fever, chills, or pain in your back, or if your symptoms don’t improve within a day, I really urge you see your general practitioner straight away. I know it’s frustrating to have to deal with this when you’re busy, but the sooner you start antibiotics, the quicker you’ll feel better and avoid complications.
Dr Say
See lessI’ve been smoking for years and trying to quit, but it’s really hard la. I keep hearing about nicotine replacement inhalers/ gum/ patch – like, do they really work? Isn’t it still nicotine, so can still get addicted, right? How is it supposed to help?
Quitting smoking isn’t easy, but it helps to understand where you are right now. I usually explain it using the 6 Stages of Change Model: Precontemplation – Not thinking about quitting yet. Contemplation – Starting to think about quitting. Preparation – Actively planning to quit. Action – Actively wRead more
Quitting smoking isn’t easy, but it helps to understand where you are right now. I usually explain it using the 6 Stages of Change Model:
From what you’ve shared, it sounds like you’re probably at stage 2 (contemplation) or maybe even stage 3 (preparation), which is fantastic. Thinking about quitting or getting ready to take action is such an important step, and you should be proud of that.
Let me explain how nicotine replacement therapy (NRT) works in a simple way. When you smoke, you’re not just getting nicotine – you’re also inhaling other harmful chemicals, like tar and carbon monoxide, which do most of the damage to your health. With NRT, you still get a small, controlled amount of nicotine, but without all those harmful toxins. It’s a safer way to manage withdrawal symptoms and cravings while you work on breaking the habit.
What’s great about NRT is that it’s very flexible, and we can control the dose. For example, if you use a patch, you’ll start with a higher dose to manage the cravings and then gradually reduce it over time. The same goes for gum, lozenges, or inhalers – you use them when you need them and slowly cut back as your cravings get better. This gradual approach makes quitting much more manageable, especially compared to going cold turkey.
There are also a few types of NRT:
From my experience with other patients, a lot of them find the inhaler most helpful because it mimics the act of smoking, which can be one of the hardest parts to give up.
I know some patients also worry if an inhaler is like vaping. It’s actually very different. With NRT inhalers, you’re only getting a controlled dose of nicotine – there’s no harmful chemicals, no burning, and no smoke. It’s purely a tool to help you quit, not something designed to replace one addiction with another.
In Malaysia, you can get NRT products like patches, gum, and inhalers at pharmacies such as Guardian, Watsons, or Caring Pharmacy. Just ask the pharmacist, and they’ll guide you on how to use them properly. You can also visit a smoking cessation clinic or any general clinics if you’d like more support.
The fact that you’re considering quitting is already a huge step. With the right tools and support, you can definitely do this.
Dr Say.
References:
- Centers for Disease Control and Prevention (CDC) – Benefits of Nicotine Replacement Therapy
- World Health Organization (WHO) – Tobacco Facts and Smoking Cessation
- Ministry of Health Malaysia – Resources for Smoking Cessation Clinics and Quitline (KKM MyHealth)
See lesswinter season started and i am having pain in my knee. what could be the cause and what medicine should i take. ?
Knee pain during the winter season is very common, especially amongst the older population. This can result from several factors, including the cold weather causing joint stiffness and discomfort, particularly in individuals with arthritis or previous joint injuries. Reduced physical activity duringRead more
Knee pain during the winter season is very common, especially amongst the older population. This can result from several factors, including the cold weather causing joint stiffness and discomfort, particularly in individuals with arthritis or previous joint injuries. Reduced physical activity during colder months can also lead to muscle stiffness and exacerbate joint pain. If you have a history of arthritis, symptoms may worsen in winter due to changes in joint fluid and increased stiffness.
To manage the pain, keep the knee warm using thermal wraps or heating pads, and maintain regular low-impact exercises to improve joint mobility. Over-the-counter pain relievers such as ibuprofen or acetaminophen can help with pain, while topical creams containing menthol or capsaicin may provide localised relief.
If the pain persists or worsens, please do consult a doctor for further evaluation and proper treatment options. They may recommend imaging studies such as X-rays if indicated, physical therapy, or other forms of interventions.
Dr. Say
Medical Officer
Disclaimer: The information provided on this forum is for educational purposes only and not intended as medical advice. Please consult a healthcare provider for any medical concerns, diagnosis or treatment.
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