Sunday, October 11, 2015

Teens and Acne Treatment

I'm starting to get pimples! What can I do to get rid of them?

The bad news—There's no cure for acne. The good news—It usually clears up as you get older. In the meantime, there are a few things you can do to help keep those zits under control.

Types of treatments

Benzoyl peroxide

Benzoyl peroxide wash, lotion, or gel—the most effective acne treatment you can get without a prescription. It helps kill bacteria in the skin, unplug oil ducts, and heal pimples. There are a lot of different brands and different strengths (2.25% up to 10%). The gel may dry out your skin and make it redder than the wash or lotion, so try the wash or lotion first.
How to use benzoyl peroxide

Start slowly—only once a day with a 5% wash or lotion. After a week, try using it twice a day (morning and night) if your skin isn’t too red or isn’t peeling.
Don’t just dab it on top of your pimples. Apply a thin layer to the entire area where pimples may occur. Avoid the skin around your eyes.
If your acne isn’t any better after 4 to 6 weeks, try a 10% lotion or gel. Use it once a day at first and then try twice a day if it doesn’t irritate your skin.

Stronger treatments

Retinoid. If benzoyl peroxide doesn’t get your zits under control, your doctor may prescribe a retinoid to be used on the skin (like Retin A, Differin, and other brand names). This comes in a cream or gel and helps unplug oil ducts. It must be used exactly as directed. Try to stay out of the sun (including tanning salons) when taking this medicine. Retinoids can cause your skin to peel and turn red.
Antibiotics, in cream, lotion, solution, or gel form, may be used for “inflammatory” acne (when you have red bumps or pus bumps). Antibiotics in pill form may be used if the treatments used on the skin don’t help.
Isotretinoin (brand names are Accutane, Amnesteem, Sotret, and Claravis) is a very strong medicine taken as a pill. It’s only used for severe acne that hasn’t responded adequately to other treatments. Because it’s such a powerful drug, it must never be taken just before or during pregnancy. There is a danger of severe or even fatal deformities to unborn babies. Patients who take this medicine must be carefully supervised by a doctor knowledgeable about its usage, such as a pediatric dermatologist or other expert in treating acne. Isotretinoin should be used cautiously (and only with careful monitoring by a dermatologist and psychiatrist) in patients with a history of depression. Don’t be surprised
if your doctor requires a negative pregnancy test, some blood tests, and a signed consent form before prescribing isotretinoin.

Remember

The following are things to keep in mind no matter what treatment you use:

Be patient. Give each treatment enough time to work. It may take 3 to 6 weeks or longer before you see a change and 12 weeks for maximum improvement.
Be faithful. Follow your program every day. Don't stop and start each time your skin changes. Not using it regularly is the most common reason why treatments fail.
Follow directions. Not using it correctly can result in treatment failure or troublesome side effects.
Only use your medicine. Doctors prescribe medicine specifically for particular patients. What's good for a friend may not be good for you.
Don't overdo it. Too much scrubbing makes skin worse. Too much benzoyl peroxide or topical retinoid creams can make your face red and scaly. Too much oral antibiotic may cause side effects.
Don't worry about what other people think. It's no fun having acne, and some people may say hurtful things about it. Try not to let it bother you. Most teens get some acne at some point. Also remember that acne is temporary, and there are a lot of treatment options to keep it under control.

Last Updated: 8/20/2015

Source: Acne - How to Treat and Control It (Copyright © 2010 American Academy of Pediatrics, Updated 12/2013)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Mental Health Tips for Teens Graduating from High School

Graduating from high school is a time of excitement and adventure for many young people, but also a time filled with uncertainty. In addition, the end of high school means transitions to college, into jobs, into the military, or out of the foster care system. All of these situations bring up things to think about regarding general well-being, health concerns and diagnoses, and medications.
Your child’s pediatrician can be a wonderful source of advice on helping your teen to transition successfully.

Advice for Parents/Guardians of Teens and Young Adults

Is your child headed to college? Know what to do to support your teen emotionally as he ventures out into the world and away from home base.

Make sure that your teen has medical coverage after high school and teach your teen how to access and use it. Many teens and young adults are covered under their parents’ health insurance through age 25.
If your teen is going to college, check into the health and mental health support services on campus, and make sure he is familiar with them.
In addition to making sure that the graduating patient has all of the vaccines and other preventive health care recommended for this stage of life, pediatricians also can help families to ensure they are preparing the way for their young adult’s continuing mental and emotional health.
If your teen has mental health needs, develop a plan of care in advance of your teen moving away from home. For college, this can take several weeks or months to develop.
Does your child have a mental health diagnosis, such as ADHD, depression, eating disorder, etc? Be sure to ask the health center staff what kind of medical information they will need related to your teen, and how to set up prescription refills if needed.
With your teen, communicate with college or university staff about their accommodations for teens with ADHD and other diagnoses. In addition, consider contacting the college’s Disabilities Office, Academic Advising Office, or Student Affairs Office to determine what accommodations are available for ADHD and other diagnoses.
Once your teen is settled into the college routine, keep in close contact and try to get frequent readings about how he is doing academically and socially. This is especially important during the first month or so while teens are still trying to settle in and may not have made friends yet.
Do you have a child in foster care who is “graduating” out of the system? Depending on state laws, children in foster care are covered under Medicaid until age 18 or 21 and may need to transition to a different provider. Some may need to transition even earlier to an adult or Transitional Aged Youth mental health provider. Young adults transitioning out of the foster care system need help in identifying caring adults-- related or not-- from whom they can seek advice, support, and reassurance.
Is your teen going straight to work rather than college? Even though she may be remaining at home for a time, her life will change dramatically from when she was in the structured environment of high school, having daily contact with friends. Be sure to give her extra space as a young adult, but realize that she may need help navigating adult responsibilities like bill paying, taking on her own health care, etc. She may be missing her high school life and friends who have moved on. Encourage her to keep up her friendships and to form new ones through work or other interesting activities.
Alcohol, drugs and sexual activity may become more accessible at this time. Be clear about your expectations regarding drug and alcohol use are even though your child may not be living at home. Be sure your teen knows where to go—whether on campus or locally-- for reproductive health care. Continue to have conversations about peer pressure, good decisions, and consequences.
Once your teen turns 18, you’ll no longer have legal access to his academic or health records. After he moves on from high school to college or work, have frequent, one-on-one conversations with your teen as a means of staying in touch.
It’s normal for young people starting at college or moving to a new place to have days when they feel sad, homesick, or a bit lost. If these feelings persist or interfere with their ability to work, they should seek help and know that it is normal to do so. Watch for warning signs and be prepared to act.

Advice for the Young Adult

Graduating from high school is such an exciting time. For some, this may mean transitioning to a full time job. For others, it may mean heading off to college. Whatever this next stage in life brings, it’s important to be in charge of your own health. Here are some tips for you to consider.

Participate in activities to promote your overall health. Eating right, getting enough sleep (at least 8-9 hours), and being active will keep you feeling energized and can reduce stress.
Talk with your pediatrician about when to start seeing an adult doctor. Many young adults see their pediatricians until they turn 21. Your pediatrician can provide you with guidance about choosing an adult health provider.
If you have a health care problem, know the facts. When going to a new doctor or clinic, you will need to provide information about your diagnosis and how you treat it.
If you are taking medication to treat a health care problem, know the name of the medication, how is it taken, side effects, and if you cannot have certain foods or drinks while taking the medication. Also know how and where you will go to refill prescriptions.
If you will no longer be living at home, know where you will go if you are having a health problem. What hospitals or clinics are close by? Is there a student health center? Talk with your parents about how your family’s health insurance works, and be sure you have a card from the health plan.

Tips for the College Student

Be sure you are familiar with the local or campus health center and counseling center (hours of operation, services offered, fees, location) and what to do if the Center is closed (nights and weekends). Make sure you have your insurance card and know how to use it (For example, some insurance companies may only allow certain labs or may require pre-authorization for referrals.)
If you have a chronic health condition, make sure roommates or someone close to you know about your health condition, signs of problems, and what to do in an emergency situation. Consider having your treating physician send a report with your current status and treatment report to the Health Center. If your problem is particularly complex or challenging, consider talking with or meeting with a health center staff member before the academic year starts.
Studies have shown that the majority of students on campus don’t use drugs and either don’t drink or do so in so moderation. So you don’t need to do either one to fit in. Drinking excessively can open you up to significant health risks (accidents, fights, date rape/sexual assault).
Find out what resources are available to support you. Often there are support groups and student services available to help address the transition to work or college. And don’t forget about your family…they want to hear how you are doing!
It’s normal for someone starting at college or moving to a new place to have days when they feel sad, homesick, or a bit lost. If these feelings last for more than a week or so or are interfering with your ability to work or enjoy your college experience, seek help. The health center or counseling center is the best place to start.

Warning Signs for Depression or Mental Health Concerns

Changes in sleep patterns
Unexpected weeping or excessive moodiness
Eating habits that result in noticeable weight loss or gain
Expressions of hopelessness or worthlessness
Paranoia and excessive secrecy
Self-mutilation, or mention of hurting himself or herself
Obsessive body-image concerns
Excessive isolatio
Abandonment of friends, social groups, and favorite pastimes
Unexpected and dramatic decline in academic performance
Drinking excessively or using other drugs to feel better or help with sleep

Last Updated: 8/20/2015

Source: American Academy of Pediatrics (Copyright © 2013)

A Teenager’s Nutritional Needs

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Calories

A surge in appetite around the age of ten in girls and twelve in boys foreshadows the growth spurt of puberty. How much of a surge? Let’s just say that Mom and Dad might want to oil the hinges on the refrigerator door and start stockpiling a small cache of their own favorite snacks underneath the bed.
“Adolescents seem like they’re hungry all the time,” says Mary Story, “especially boys.” Calories are the measurement used to express the energy delivered by food. The body demands more calories during early adolescence than at any other time of life. On average, boys require about two thousand eight hundred calories per day; and girls, two thousand two hundred calories per day. Typically, the ravenous hunger starts to wane once a child has stopped growing, though not always, says the dietitian. “Kids who are big and tall or who participate in physical activity will still need increased amounts of energy into late adolescence.” During middle and late adolescence, girls eat roughly 25 percent fewer calories per day than boys do; consequently, they are more likely to be deficient in vitamins and minerals.

Nutrients

The nutrients protein, carbohydrates and fats in food serve as the body’s energy sources. Each gram of protein and carbohydrate supplies four calories, or units of energy, whereas fat contributes more than twice as much: nine calories per gram.

Protein

Of the three nutrients, we’re least concerned about protein. Not because it isn’t important—50 percent of our body weight is made up of protein—but because “adolescents in the United States get twice as much protein as they need,” Story explains. The densest sources of protein include teenage favorites such as beef, chicken, turkey, pork, fish, eggs and cheese.

Carbohydrates

Carbohydrates, found in starches and sugars, get converted into the body’s main fuel: the simple sugar glucose. Not all carbs are created equal, however. In planning meals, we want to push complex-carbohydrate foods and go easy on simple carbohydrates. Complex carbs provide sustained energy; that’s why you often see marathon runners and other athletes downing big bowls of pasta before competing. As a bonus, many starches deliver fiber and assorted nutrients too. They are truly foods of substance: filling yet low in fat. Most nutritionists recommend that complex carbohydrates make up 50 to 60 percent of a teenager’s caloric intake. Simple carbs, on the other hand, seduce us with their sweet taste and a brief burst of energy but have little else to offer and should be minimized in the diet.

Dietary Fat

Nutrition experts recommend that fat make up no more than 30 percent of the diet. While Americans have trimmed their fat consumption in recent years, as a nation we’re still about 4 percentage points above the suggested level.
Let’s give dietary fat its due. Fat supplies energy and assists the body in absorbing the fat-soluble vitamins: A, D, E and K. But these benefits must be considered next to its many adverse effects on health. A teenager who indulges in a fat-heavy diet is going to put on weight, even if he’s active. It would take a workout befitting an Olympic athlete to burn off excess fat calories day after day.
Fatty foods contain cholesterol, a waxy substance that can clog an artery and eventually cause it to harden. The danger of atherosclerosis is that the blockage will affect one of the blood vessels leading to the heart or the brain, setting off a heart attack or a stroke. Although these life-threatening events usually don’t strike until later in adult life, the time to start practicing prevention is now, by reducing the amount of fat in your family’s diet. Researchers studying the eating habits of approximately two hundred California high school students were dismayed to find that more than one-third had abnormally high levels of blood cholesterol. Ultrasound scans of their carotid arteries revealed evidence of atherosclerosis already. The carotids, a pair of large vessels located in the neck, serve the brain. One of the doctors involved in the study commented that some of the teenagers’ arteries resembled those normally seen in a person twice their age. Fortunately, at this early stage, the condition is still reversible.

The Three Types of Fat

Dietary fat contains varying proportions of monounsaturated fat, polyunsaturated fat and saturated fat. The last type—found in meat and dairy products like beef, pork, lamb, butter, cheese, cream, egg yolks, coconut oil and palm oil—is the most cholesterolladen of the three. You want to limit your family’s intake of saturated fat to no more than 10 percent of your total daily calories.
The other 20 percent of daily calories from dietary fat should come equally from the two unsaturated kinds of fat, both of which are contained mainly in plant oils. Corn oil, safflower oil, sunflower oil, soybean oil, cottonseed oil and sesame-seed oil are predominantly polyunsaturated. So are the oils in fish and almonds. Foods high in monounsaturated fat, the healthiest kind, include olives and olive oil; peanuts, peanut oil and peanut butter; cashews; walnuts and walnut oils; and canola oil. You’ll want to avoid the partially hydrogenated oils in most margarines and vegetable shortenings.
If your family eats a lot of packaged and processed foods, you should make a habit of reading the “nutrition facts” food labels. You may be surprised to see how much fat, not to mention sugar and salt (sodium), is in the foods you eat every day. And almost all packaged goods that contain fat are likely to have partially hydrogenated fat, because it has a longer shelf life.

Vitamins and Minerals

A well-rounded diet based on the USDA guidelines should deliver sufficient amounts of all the essential vitamins and minerals. Adolescents tend to most often fall short of their daily quotas of calcium, iron and zinc. Unless blood tests and a pediatrician’s evaluation reveal a specific deficiency, it’s preferable to obtain nutrients from food instead of from dietary supplements, because unlike supplements vegetables, fruits and grains contain phytochemicals—natural substances that are believed to help safeguard us from disease.

Last Updated: 8/20/2015

How Teens Can Stay Fit

What can I do to get more fit?

Any type of regular, physical activity can improve your fitness and your health. The most important thing is that you keep moving!
Exercise should be a regular part of your day, like brushing your teeth, eating, and sleeping. It can be in gym class, joining a sports team, or working out on your own. Keep the following tips in mind:

Stay positive and have fun. A good mental attitude is important. Find an activity that you think is fun. You are more likely to keep with it if you choose something you like. A lot of people find it's more fun to exercise with someone else, so see if you can find a friend or family member to be active with you.
Take it one step at a time. Small changes can add up to better fitness. For example, walk or ride your bike to school or to a friend's house instead of getting a ride. Get on or off the bus several blocks away and walk the rest of the way. Use the stairs instead of taking the elevator or escalator.
Get your heart pumping. Whatever you choose, make sure it includes aerobic activity that makes you breathe harder and increases your heart rate. This is the best type of exercise because it increases your fitness level and makes your heart and lungs work better. It also burns off body fat. Examples of aerobic activities are basketball, running, or swimming.
Don't forget to warm up with some easy exercises or mild stretching before you do any physical activity. This warms your muscles up and may help protect against injury. Stretching makes your muscles and joints more flexible too. It is also important to stretch out after you exercise to cool down your muscles.

Your goal should be to do some type of exercise every day. It is best to do some kind of aerobic activity without stopping for at least 20 to 30 minutes each time. Do the activity as often as possible, but don't exercise to the point of pain.

A Healthy Lifestyle

In addition to exercise, making just a few other changes in your life can help keep you healthy, such as

Watch less TV or spend less time playing computer or video games. (Use this time to exercise instead!) Or exercise while watching TV (for example, sit on the floor and do sit-ups and stretches; use hand weights; or use a stationary bike, treadmill, or stair climber).
Eat 3 healthy meals a day, including at least 4 servings of fruits, 5 servings of vegetables, and 4 servings of dairy products.
Make sure you drink plenty of fluids before, during, and after any exercise (water is best but flavored sports drinks can be used if they do not contain a lot of sugar). This will help replace what you lose when you sweat.
Stop drinking or drink fewer regular soft drinks.
Eat less junk food and fast food. (They're often full of fat, cholesterol, salt, and sugar.)
Get 9 to 10 hours of sleep every night.
Don't smoke cigarettes, drink alcohol, or do drugs

Last Updated: 8/20/2015

Source: Get Fit, Stay Healthy (Copyright © 2006 American Academy of Pediatrics, Updated 3/2006)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.