Q. My husband frequently has a nightcap before going to bed. He says scotch relaxes him and helps him fall asleep. The only trouble is that he frequently wakes up in the middle of the night and then has a hard time getting back to sleep. That wakes me up, and it ruins my sleep as well.

I suspect the nightcap is to blame, but he disagrees. He says he just has to get up to urinate. Can you settle this argument, please?

A. This question is more complicated than it seems. Conventional wisdom is that alcohol before bed helps people fall asleep but disrupts sleep in the second half of the night. There’s surprisingly little research on this issue, however.

The best study we could find examined sleep in 20 healthy people, half of whom were insomniacs. A modest dose of alcohol before bed did not seem to have a negative impact on sleep later in the night (Neuropsychopharmacology, March 1999). On the other hand, it didn’t make people fall asleep faster either.

Many men do have to get up at night to urinate because of an enlarged prostate. His doctor may be able to assess this and prescribe a drug to ease this symptom if it is waking him.


Q. I developed a skin condition on my lower leg for which my dermatologist recommended skin cream with 20 percent urea (OTC). The area was near some spider veins, and during the course of treatment, the spider veins faded where some of the urea cream got on them.

I began to cover the entire spider-vein area with the urea cream and now they are almost completely gone. Have you heard of using urea cream to treat spider veins?

The change was really dramatic. I assume it was due to the action of the urea on these superficial veins.

A. Yours is the first report we’ve received about urea-containing cream making spider veins (telangiectasia) fade. There is good evidence that topical urea can strengthen the skin’s barrier function and boost its resistance to microbes (Journal of Investigative Dermatology, June 2012). That may be why it is often helpful for conditions such as eczema.

Although we don’t know why or how urea-containing cream could make small red or blue veins on the legs become less visible, the cream is readily available as a moisturizer.


Q. I had tried all the remedies for body odor described on your website. Oddly, I had only one smelly armpit. Antiperspirant worked fine on the other pit.

My primary care doctor conferred with a dermatologist, who recommended using a topical erythromycin gel twice daily for a month. He suggested this is most likely due to a corynebacterium infection.

A. We’re surprised the dermatologist was willing to make such a diagnosis without seeing you. It is plausible, however, as the skin-dwelling bacteria known as corynebacteria can colonize the armpit and cause odor or even colored sweat (yellow, red or black). The usual treatment seems to be shaving, washing with antibacterial cleanser and applying benzoyl peroxide. Topical erythromycin also is reported to work against this infection.