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Your Child

Antibiotics Often Prescribed When Not Needed

2.00 to read

By now, most parents understand that antibiotics are not effective for viral infections, only for illnesses caused by bacteria.

However, that hasn’t deterred many physicians from over-prescribing antibiotics for children with ear and throat infections.

More than 11 million antibiotic prescriptions written each year for children and teens may be unnecessary, according to researchers from University of Washington and Seattle Children's Hospital. This excess antibiotic use not only fails to eradicate children's viral illnesses, researchers said, but also supports the dangerous evolution of bacteria toward antibiotic resistance.

"I think it's well-known that we prescribers overprescribe antibiotics, and our intent was to put a number on how often we're doing that," said study author Dr. Matthew Kronman, an assistant professor of infectious diseases at Seattle Children's Hospital.

"But as we found out, there's really been no change in this [situation] over the last decade," added Kronman. "And we don't have easily available tools in the real-world setting to discriminate between infections caused by bacteria or viruses."

 Doctors have limited resources when it comes to differentiating between bacterial or viral infections. Physicians can use the rapid step test to determine if the streptococcus bacteria is the cause of a child’s sore throat, but that is about it for immediate diagnostic tools.

Most colds are virus related and one of the first symptoms will be a sore or scratchy throat. It will typically go away after the first day or so and other cold symptoms will continue. Strep throat is often more severe and persistent.

A virus often causes ear infection as well. Many doctors treat ear infections as though they are bacterial to be on the safe side and avoid serious middle ear infections.

To determine antibiotic prescribing rates, Kronman and his colleagues analyzed a group of English-language studies published between 2000 and 2011 and data on children 18 and younger who were examined in outpatient clinics.

Based on the prevalence of bacteria in ear and throat infections and the introduction of a pneumococcal vaccine that prevents many bacterial infections, the researchers estimated that about 27 percent of U.S. children with infections of the ear, sinus area, throat or upper respiratory tract had illnesses caused by bacteria.

But antibiotics were prescribed for nearly 57 percent of doctors' visits for these infections, the study found.

Kronan hopes that the study’s results will encourage the development of more diagnostic tools and will spur doctors to think more critically about prescribing antibiotics unless clearly needed.

Previous research has shown that parents often pressure their doctor to prescribe an antibiotic to treat their child’s ear or sore throat symptoms. However, when parents are given other suggestions on how to alleviate the symptoms they have been much more receptive than when their doctor just flat out says he won’t prescribe antibiotics.

Many physicians and researchers are concerned that the amount of antibiotics being prescribed these days is setting us all up for future problems when dealing with bacterial infections. Bacteria are adaptable and mutate over time becoming less responsive to antibiotics. When possible, it’s much healthier in the long run to treat your child’s symptoms with simpler therapies. Ask your physican ways you can make your little one more comfortable until the symptoms pass. 

The study was published online in the journal Pediatrics.

Source: Maureen Salamon, http://consumer.healthday.com/infectious-disease-information-21/antibiotics-news-30/antibiotics-prescribed-twice-as-often-as-needed-in-children-study-says-691686.html

Your Teen

More Teens Fall Victim to Dating Violence

2:00

The teenage years are supposed to be filled with laughter, fun and testing the boundaries of parental control. It’s also a time when many boys and girls will start dating. For some teens, the beginning of couple relationships is about as far away from fun as it could possibly be.

Some teenagers may think that teasing and name-calling are somehow linked with a fondness for someone, and that might have been true when they were six or seven years old. However, by the time a young girl or boy reaches their teenage years, that kind of behavior can take on a much different tone. What was once an awkward attempt at gaining someone’s attention can turn into physical and sexual abuse.

According to a new study from the Centers for Disease Control and Prevention (CDC) that is happening more than you might think.

Twenty-one percent of high school girls have been physically or sexually assaulted by someone they dated -- a figure twice as high as previously estimated.

Ten percent of high school boys also reported being physically or sexually assaulted by someone they had dated.

The authors of the new report noted that the CDC has changed the way it phrases its questions about teen dating violence, leading more students to report assaults.

Sadly, teens that have experienced dating violence are at risk for other serious problems as well. Research has shown that they are more than twice as likely to consider suicide. They are also more likely to get into fights, carry a weapon, use alcohol, marijuana or cocaine and to have sex with multiple partners. Not the kind of life any parent would want for their teenager or the one that they would truly want for themselves.  

Researchers don't know if any of these events causes the others. While it's possible that dating violence could cause thoughts of suicide, it's also possible that children who are depressed are more likely than others to fall into abusive relationships, says Adiaha Spinks-Franklin, a developmental and behavioral pediatrician at Texas Children's Hospital in Houston who was not involved in the study.

Assaults by romantic partners often aren't isolated events. Many teens reported being assaulted multiple times, according to the study, based on the CDC's Youth Behavior Risk Surveillance System using questionnaires answered by more than 13,000 high school students.

"If there is violence once, there is likely to be violence again," Spinks-Franklin says. "It has to be taken very seriously."

Spinks-Franklin says she has seen violence even among relationships between 10- and 11-year-olds.

"If a parent is concerned that a child is in an unhealthy relationship, they need to address it, but do it in a way that doesn't make the child shut down," she says. "They need to feel safe telling a parent."

Teens often hide the abuse from their parents, Spinks-Franklin says. Teens may not be able to confide in friends, either, because abusers sometimes isolate their victims from loved ones. Teens are sometimes more willing to talk to doctors, especially if their parents are not in the room.

Some schools have taken the lead in promoting awareness of and education on teen dating violence. Pediatricians can also discuss this important topic with their patients and parents. If time is limited, brochures in the waiting room can offer information and open the door for questions.

"This study makes it even more important for parents to ask lots of questions and get to know their teen's friends and significant others, and not ignore anything that makes them uncomfortable," says McCarthy, a pediatrician at Boston Children's Hospital. "They also shouldn't ignore any changes in their teen's behavior."

Dating violence may never be eliminated one hundred percent, but can be considerably lessoned when teens, families, organizations, and communities work together to implement effective prevention strategies.

One of the best strategies for prevention is for parents and teens to be able to communicate about serious topics without judgmental attitudes or closed-minded opinions. Your teen wants your help even if he or she doesn’t know how to ask. They'll appreciate you being there before and when they need you.

The new study was published in JAMA Pediatrics.

Sources: Liz Szabo, http://www.usatoday.com/story/news/2015/03/02/teen-dating-violence-study/24127121/

http://www.cdc.gov/violenceprevention/intimatepartnerviolence/teen_dating_violence.html

Your Child

Trying to Guilt Kids into Exercising Doesn’t Work

1:45

 

Experts often discuss how kids aren't getting the proper amount of exercise they need to be healthy. But, trying to guilt children into exercising often results in the opposite desired effect according to a new study.

Researchers from the University of Georgia found that middle school students were less likely to be physically active if they didn't feel in control of their exercise choices or if they felt pressured by adults to get more exercise.

Kids who felt that whether they exercised or not was their own choice were much more likely to choose to exercise, the researchers said.

"Can we put these children in situations where they come to value and enjoy the act of being physically active?" lead author Rod Dishman, a professor of kinesiology, said in a university news release.

Dishman and his colleagues said they are looking for ways to help more children identify themselves as someone who likes to exercise.

"Just like there are kids who are drawn to music and art, there are kids who are drawn to physical activity. But what you want is to draw those kids who otherwise might not be drawn to an activity," Dishman said.

So how do you get your child to exercise? Make it about fun, not exercise says Dishman..

“The best thing is to do it because it's fun. It's the kids who say they are intrinsically motivated who are more active than the kids who aren't," Dishman concluded.

Children's activity levels typically fall 50 percent between fifth and sixth grades, the authors noted in the September issue of the journal Medicine & Science in Sports & Exercise.

Using guilt as a motivator seldom achieves the desired result, no matter whether it’s exercising or any other choice. Playing the guilt card with kids only makes them resent what you are trying to get them to do and more often than not, they will do the opposite.

Building a lifetime of healthy choices never began with a guilt trip. Being creative and adding an element of fun and challenge will achieve more than coercion through guilt. 

Children need to identify themselves as someone who wants to exercise instead of someone forced to exercise. The best results have been achieved when families make exercise a part of their daily routine and treat it like anything else they enjoy doing together.

Source: Robert Preidt, http://www.webmd.com/children/news/20150923/want-your-kids-to-exercise-skip-the-guilt

 

Your Baby

Does Your Unborn Baby Hear You?

2.00 to read

More than twenty years ago I remember reading that fetuses can learn to recognize their mothers and father’s voices and then respond to those voices as newborns. I thought… well maybe… but it seemed to me that voices from outside of the womb would sound muffled from inside. Of course, I don’t remember my in utero experience so I don’t really know how words sound.

Over the years though, scientists have continued to examine how and what babies learn before they are born.

A recent study by researchers at the University of Helsinki in Finland have determined that fetuses not only hear and recognize voices but they can become familiar with different words and different pitches used when saying those words.

The study involved 33 moms-to-be, and examined their babies after birth. While pregnant, 17 mothers listened at a loud volume to a CD with (2), four-minute sequences of the made-up words “tatata” or “tatota.” The words were said with several different pitches. The moms-to-be listened to the recordings beginning at 29 weeks of pregnancy -about 7 months along- until birth. They heard them around 50 to 71 times.

Following birth, researchers tested the babies for normal hearing and then performed an electroencephalograph (EEG) brain scan to see if the newborns would respond to the made-up words and different pitches. And sure enough, the brain scans showed increased activity from the babies who had been listening to the CD in utero when the words were played to them after birth. Not only did they respond to the words, but also seemed to recognize the different pitches used when they heard them.  

The babies born to the mothers who had not listened to the CDs while pregnant showed little reaction to the words or pitches.

 “We have known that fetuses can learn certain sounds from their environment during pregnancy,” Eino Partanen, a doctoral student and lead author on the paper, said via email.

“We can now very easily assess the effects of fetal learning on a very detailed level—like in our study, [we] look at the learning effects to very small changes in the middle of a word.”

Some experts believe the finding shows that not only can a third-trimester fetus hear and recognize voices; he or she can also detect subtle changes and process complex information.

“Interestingly, this prenatal exposure also helped the newborns to detect changes which they were not exposed to: the infants who have received additional prenatal stimulation could also detect loudness changes in pseudo words but the unexposed infants could not,” Partanen says.

“However, both groups did have responses to vowel changes (which are very common in Finnish, and which newborns have been many time previously been shown to be capable of).”

You may be wondering why is it even important that scientists know if fetuses can recognize voices or words.  Partanen says because sounds heard in utero may shape the developing human brain in ways that affect speech and language development after birth.

“The better we know how the fetus’ brain works, the more we’ll know about early development of language,” Partanen says. “If we know better how language develops very early, we may one day be able to develop very early interventions [for babies with abnormal development].” 

An abstract for the Finnish study is published on the Proceedings of the National Academy of Sciences website.

Does talking and singing to your baby before it’s born actually stimulate his or her brain activity and increase language learning? Some experts say definitely yes, others say it has no impact. But really, most moms and dads enjoy baby bump bonding whether it’s productive or not. And who knows, maybe your pre-born hears you loud and clear. 

Source: Meghan Holohan, http://www.nbcnews.com/health/unborn-babies-are-hearing-you-loud-clear-8C11005474

Your Teen

Helping Teens Cut Down on Sugary Drinks

2.00 to read

Want to help your teen shed his or her addiction to high-sugar drinks? A new study says that when adolescents are shown the calorie content, and how long they will have to vigorously exercise to burn off those calories, many teens decide to make a different choice as to what they drink.

The study was published in the American Journal of Public Health.

"Most consumers underestimate the number of calories in a can of soda, and they often do not realize that such calories can add up quickly," lead researcher Sara Bleich said in a press release about the study.

Researchers set up in a convenience store and used 3 methods to see if they could discourage teens from choosing drinks packed with sugar. In the first method they posted a sign that noted there are 250 calories in a typical bottle. The second sign noted that the bottle contains about 10% of an average teen’s daily-recommended calorie intake. The third sign told them that they would have to jog for about 50 minutes to burn off the calories.

The results were that all three methods discouraged teens from buying the sugary drinks by approximately 40%, but the third method had the biggest impact. When teens knew how much they would have to jog to burn off the calories, 50% chose water or diet soda instead of the high-sugar drinks.

The size of soda drinks has changed over the years. Most can drinks are 12 ounces, but bottled drinks are usually 20 ounces, with some being as large as 1 liter (34 oz.)

Super sized fountain drinks and “Gulp” drinks can be anywhere from 28 oz. to 55 oz. The 7-11 Double Gulp has 186 grams of sugar (almost a cup of sugar) and 744 calories! How does 3 hours of jogging to burn off those calories sound?  Liquid candy is what some public health officials have labeled these soft drinks.

The Center for Science in the Public Interest (CSPI) looked at teens and high sugar drinks. CSPI’s analyses of 13- to 18-year-olds found that five percent of male soft-drink drinkers down about five or more cans a day and five percent of female drinkers consume more than three cans a day. That’s 80 percent more than 20 years ago. And, because kids are drinking more sweetened beverages than milk, they are getting too little calcium for growing teeth and bones, reports the CSPI. That's especially important for growing girls, who are at highest risk of osteoporosis.

For kids without a weight problem, one sweetened beverage per day -- as part of a well-balanced diet -- is fine, says Sarah Krieger, RD, LD, MPH, a spokeswoman for the American Dietetic Association. "If children are maintaining a healthy weight, eating a healthy diet, and are active, one soda is OK."

The American Beverage Association agrees. "No single food or beverage is a unique contributor to obesity," says Tracey Halliday, a spokeswoman for the association. "Obesity is a serious and complex problem that is best addressed by living a balanced lifestyle -- consuming a variety of foods and beverages in moderation and getting regular physical activity. Quite simply, all calories count, regardless of the source."

If your child has a tendency to gain weight, however, it's best to keep these beverages out of the house. "Keep it for parties, since for most young kids that's about once a week," says Krieger, who is also lead instructor for children's weight management classes at All Children's Hospital in St. Petersburg, Fla.

Also, limit other sweet drinks -- including 100% fruit juice. "Yes it's healthy, but it can have as many calories as a soda. One serving a day is OK, but that's all," she says.

There have been a lot of articles on teens and obesity. Some say too many. But the reason there is so much attention paid to obesity and children is not because of how children look- but because of the damage obesity can cause to a young person’s health. One third of all kids between the ages of 2 (yes 2) and 19 are overweight or obese.  Young kids and teens are developing health problems that used to affect only adults, like high blood pressure, high cholesterol, and Type2 diabetes.

Helping your child or teen wean themselves off high-sugar drinks is a good start to improving their diet and health.

In 2012, the Food and Drug Administration is expected to require chain restaurants and retail food establishments - companies whose primary business is selling food - with 20 or more locations to post calorie counts on their menus. The rule would also require calorie counts on vending machines. The calorie information would have to be "displayed clearly and prominently" and be listed per item or per serving,

The goal is to help people realize how many calories they are consuming so they can make better food and drink choices. It’s a good start towards a healthier lifestyle.

Sources:

http://thechart.blogs.cnn.com/2011/12/15/teenagers-buy-fewer-sugary-drin...

http:// children.webmd.com/features/children-and-sweetened-drinks-whats-a-parent-to-do

Your Child

Another Study Finds No Vaccine –Autism Connection

2:00

A new study, using insurance records for nearly 96,000 U.S. children, found no link between the measles - mumps – rubella (MMR) vaccine and autism – even among children who are at an increased genetic risk.

Experts are hoping that this study, along with several other studies on the risks of autism and the MMR vaccine, will reassure parents that the vaccine is safe.

While the original 1998 study associating the vaccine with autism has been found fraudulent, many parents continue to worry that the vaccine could be a trigger for autism; particularly parents that already have a child with autism.

"Research has shown that parents of kids with autism spectrum disorders are more likely to delay vaccinating their younger children," said Dr. Bryan King, an autism researcher at the University of Washington, in Seattle.

"Basically, they wait until the developmental dust has settled, and it looks like their child will be unaffected (by autism)," said King, who wrote an editorial published with the study.

Health officials are concerned that children who do not receive the MMR vaccine are putting other children at risk for serious diseases. They point to the recent measles outbreaks as one example. So far this year, 162 people have been sickened across 16 states and Washington D.C. according to the U.S. Centers for Disease Control and Prevention (CDC).

Scientists are working hard to find out why there has been an increase in autism over the last decade.  It's known that genes make certain children more vulnerable to autism -- that's why kids with an affected older sibling are at higher-than-average risk. But environmental factors also have to play a role, experts believe.

Based on years of research, the MMR vaccine is not that trigger, according to health experts. "Every study that's looked at this, through every strategy they've used, has found no signal," King said.

According to King, it's natural for parents with a child who has autism to want to reduce their younger kids' risk.

"Everyone believes there have to be environmental factors contributing to the exponential rise we've seen in ASDs," he said. "But we don't understand what those factors are yet."

Researchers are finding clues, though. And more and more, they suspect that prenatal brain development is the critical period, King said.

The new findings are based on insurance records for nearly 96,000 U.S. children with an older brother or sister; 2 percent had an older sibling with an autism spectrum disorder.

Of the children with an affected sibling, 7 percent had an autism spectrum disorder themselves, compared to just under 1 percent of other kids. There was no evidence, though, that the MMR vaccination raised the risk of autism in either group of children, Jain said.

Among kids with an affected sibling, those who'd received one MMR dose by age 2 were actually one-quarter less likely to be diagnosed with an autism spectrum disorder, the study found. The odds were even lower among those who'd received two doses by age 5.

The study did not reveal any evidence that the MMR vaccine offered any protective influence over autism, only that it was not associated with an increase of risk for autism.

More studies are in the works to find the source of autism. Environmental factors are playing a key role in many of those studies as well as genetic links.

It’s understandable that parents would worry about vaccinations of any kind having a negative effect on their child, but more and more studies confirm that the MMR vaccine is one that parents can eliminate from their list of concerns.

This study was reported in the April 21 issue of the Journal of the American Medical Association.

Source: Amy Norton, http://consumer.healthday.com/cognitive-health-information-26/autism-news-51/another-study-finds-no-vaccine-autism-link-698635.html

Your Child

High Cholesterol Putting Kids at Risk for Heart Attack

2:00

Abnormally high cholesterol levels are putting American children at higher risk for a heart attack or stroke later in life. One in five kids has high cholesterol according to a review of 2011-2014 federal health data compiled by researchers at the U.S. Centers for Disease Control and Prevention (CDC).

Overall, slightly more than 13 percent of kids had unhealthily low levels of HDL ("good") cholesterol -- the kind that actually might help clear out arteries. The CDC says just over 8 percent had too-high levels of other forms of cholesterol that are bad for arteries, and more than 7 percent had unhealthily high levels of "total" cholesterol.

Obesity was seen as a major contributing factor, the CDC said. For example, more than 43 percent of children who were obese had some form of abnormal cholesterol reading, compared to less than 14 percent of normal-weight children.

Not surprisingly, rates of abnormal cholesterol readings rose as kids aged. For example, while slightly more than 6 percent of children aged 6 to 8 had high levels of bad cholesterol, that number nearly doubled -- to 12 percent -- by the time kids were 16 to 19 years of age, the CDC said.

Knowing how obesity can impact the heart, cardiologists were not shocked by the findings.

"When one looks at the data it is clear that the obesity epidemic is responsible for a substantial portion of these abnormal cholesterol values," said Dr. Michael Pettei, who co-directs preventive cardiology at Cohen Children's Medical Center in New Hyde Park, N.Y. "Approximately one-third of U.S. children and adolescents are either overweight or obese.

"Clearly, the American Academy of Pediatrics' (AAP) recommendations to screen all children for cholesterol status, and to take measures to prevent and manage obesity, are more appropriate than ever," he said.

Dr. Kevin Marzo, chief of cardiology at Winthrop-University Hospital in Mineola, N.Y., agreed.

"Abnormal cholesterol is a key modifiable risk factor for developing cardiovascular disease, including heart attack and stroke, in adulthood," he said. "This study confirms that preventive strategies must start in childhood, including healthy eating habits, regular exercise, and maintaining ideal body weight."

The AAP recommends that all children begin having their cholesterol checked between the ages of 9 and 11.

An acceptable total cholesterol level for a child is below 170 with LDL below 110. A borderline reading in total cholesterol is 170-199 with LDL between 110-129.  And a high classification in total cholesterol is above 200 with LDL above 130.

There may be other reasons a child can have high cholesterol such as diabetes, liver disease, kidney disease or an underactive thyroid. If an initial test shows high cholesterol, your pediatrician will check your child’s blood again at least 2 weeks later to confirm the results. If it is still high, the doctor will also determine if your child has an underlying condition.

Some children can also have high cholesterol that is passed down through families.  It’s called familial hypercholesterolemia and is an inherited condition that causes high levels of LDL cholesterol levels beginning at birth, and heart attacks at an early age. Any child with a family history of high cholesterol should begin having his or her levels in infancy.

The findings were published Dec. 10 as a Data Brief from the CDC's National Center for Health Statistics.

Sources: E.J. Mundell, http://consumer.healthday.com/vitamins-and-nutrition-information-27/high-cholesterol-health-news-359/one-in-five-u-s-kids-over-age-5-have-unhealthy-cholesterol-cdc-706032.html

https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Cholesterol-Levels-in-Children-and-Adolescents.aspx

Your Teen

New Guidelines for Treating Acne

2.30 to read

I recently ran into a friend I hadn’t seen in about 5 years. We were catching up on each other’s lives when her teenage son joined us. The last time I saw “John” he was about 11 years old and full of pre-teen energy and curiosity. This time however, he was quiet and kept his head down when he said hello. When he finally looked up, I saw why he had been avoiding full-face eye contact. “John” had a pretty severe case of acne. Not a few pimples, but entire areas on his face that were red and dotted with large pustules and cysts.  It looked painful.

Typically, acne isn’t a serious medical condition. It comes and goes throughout life and is more of an annoyance than anything else. For some though, acne can cause emotional distress and lead to scarring of the skin and psyche.

Fortunately, there are many over-the-counter (OTC) medications that when combined with a consistent face cleaning routine, keep breakouts to a minimum.

But for some people, teens in particular, acne can progress to the point where OTC medications don’t control the problem. Pediatricians are often called upon to help teens come up with a plan of treatment. 

There is a range of medications that can clear up even severe cases of acne, according to the American Academy of Pediatrics (AAP). Writing in the May issue of its journal Pediatrics, the group throws its support behind new guidelines from the American Acne and Rosacea Society that detail how to treat acne in children and teens of all ages.

That "all ages" part is important because acne is becoming more and more common in pre-teens, too, said Dr. Lawrence Eichenfield, the lead author of the AAP report. One study of 9- and 10-year-old girls found that more than three-quarters had pimples.

A possible reason for why kids are experiencing breakouts at a younger age is that, on an average, boys and girls are starting puberty earlier than in past generations says Eichenfield.

According to the AAP, milder cases of acne can be managed with OTC soaps, washes, lotions or gels containing benzoyl peroxide.  Another common ingredient used to battle acne is salicylic acid. Department stores now have sections of aisles filled with these types of products making them easy to find.

But what if the OTC medications do not help clear up your teen’s acne? The AAP recommends going to the next step of trying a topical retinoid. Retin-A, Avita and Differin are the most commonly prescribed treatments. They are vitamin A derivatives and work by speeding up skin cell turnover, which helps unclog pores.

The main side effects of all the topical treatments are skin irritation and dryness, the AAP said.

If the acne is considered moderate to severe and other treatments have failed to work, the next step may be oral antibiotics. When pores become clogged with oil and skin cells, bacteria can grow in the pore and cause inflammation. Antibiotics help by killing bacteria and soothing inflammation.

But, Eichenfield said, "it's important to use antibiotics appropriately."

Antibiotics can have their own set of problems and should be used with caution. The overuse of antibiotics has made some acne causing bacteria more resistant. Other side effects can be stomach upset, dizziness and, in girls - yeast infections.

When all else fails and acne is severe, the prescription drug isotretinoin may be an option. Brand names include Roaccutane (formerly known as Accutane) and Claravis.

The drug is very effective, but it can cause birth defects, so girls and women have to use birth control and get regular pregnancy tests if they go on the medication. Isotretinoin also has been linked to inflammatory bowel disease, depression and suicidal thoughts in some users, although it's not clear the drug is to blame, the AAP said. (Severe acne itself can cause depression and suicidal thoughts, for example.) Other side effects can include sun-sensitivity, dry eyes, mouth, lips nose and skin as well as itching, nosebleeds and muscle aches.

Why do we get acne?

Acne occurs when hair follicles become plugged with oil secretions, dead skin cells and sometimes bacteria. The most common areas on the body where acne erupts are the face, neck, chest, back and shoulders. It takes time for acne lesions to heal and quite often another breakout will appear as one is finally clearing up.

Hormones and certain medications can play a role in triggering acne. Whether diet is a factor is still up for debate. "The idea that food plays a role became relegated to myth," Eichenfield said. But recently, he added, some researchers have been revisiting the issue. There is some evidence that a sugary diet may promote acne, for example. But for now, it's not clear whether any diet changes will actually help keep kids' skin clear, Eichenfield said.

Stress may not cause acne but it can aggravate it.

Keeping skin pores open and unclogged is the key ingredient to preventing acne. While it may seems that scrubbing your face, using astringents and drying masks would help do that, they aren’t generally recommended. Too much washing and scrubbing can irritate the skin.

It's best to wash your face gently twice a day, with a soap-free pH-balanced cleanser, the AAP said. Facial toners -- which commonly come in pre-packaged acne regimens -- can help clear away oil. But the group suggested going easy on toners, since they can irritate the skin.

One myth that seems to never go away is that tanning and more time in the sun is good for acne. A sunburned face may look better to you because your whole face is red instead of just certain areas. Too much sun can actually make acne worse for some people. It also ages your skin and can cause skin cancer. Certain medications (including some for acne treatment) can make your skin very sensitive to the sun’s rays. Always use a “face-friendly” sunscreen that doesn’t clog the pores.

I really felt bad for my friend’s son when I saw how miserable he was. To me he’s still handsome and has a bright and interesting future ahead of him. I’m not so sure that he thinks that, at least not until his acne is under control.

The bottom line, Eichenfield says, is that many treatment options are available. "There's no reason that children have to live with acne that is severe and troubling to them.”

Sources: Amy Norton, http://www.webmd.com/skin-problems-and-treatments/acne/news/20130506/pediatricians-endorse-new-acne-treatment-guidelines

http://www.mayoclinic.com/health/acne/DS00169

 

Daily Dose

Teens & Headaches Go Together

I just read an interesting study about teenagers with headaches. About one to two percent of adolescents have chronic daily headaches, defined as greater than 15 headache days per month for greater than three months.

Once school begins, teens stress levels increase with each week of school, and with that come more complaints of chronic headaches. It is not unusual for me to see several teens a week who complain that they have headaches every day. Despite these persistent headaches, the majority of adolescents continue to participate in their school activities, sleep well once they fall asleep and spend their weekends doing whatever it is that teens all do. I see very few teens who look like they are in “severe” pain, although they state that their head is “killing” them while they chatter away about where it hurts, and how often it hurts etc. It is quite reassuring to watch their faces and expressions as they go into detail about their headaches. In these cases it is important to obtain a good history to rule out any underlying pathology, as well as to inquire about family history of migraines. In this study the authors followed adolescents ages 12 – 14 years who met criteria for chronic daily headaches. They followed the group after both one and two years, and then again after eight years. The results showed that after one year 40 percent of adolescents still complained of chronic headaches. After two years, only 25 percent reported headaches. After eight years, only 12 percent reported chronic headaches. Most participants reported substantial or some improvement in headache intensity and frequency during the eight-year follow-up. The most significant predictor for ongoing problems with headaches was onset of chronic headaches before the age of 13 years. For the most part 75 percent of adolescents with chronic daily headaches improved over the eight-year period, which is quite reassuring. This study just seemed to confirm that teens and headaches go together. If a good history and physical exam is performed and there seem to be no underlying problems that contribute to their headaches, it is best to discuss the natural history of chronic headaches. I think it is important to spend time with adolescents to explore ways to alleviate stress as a trigger for chronic daily headaches. Basic changes in lifestyle such as healthy eating, regular exercise, and a good night’s sleep will often help reduce headaches. Relaxation techniques and cognitive behavioral therapy may also be utilized. At least we know that the headaches reduce with time, maybe just a maturational process, like many things! That’s your daily dose, we’ll chat again tomorrow.

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