CHAPTER 11: Skin Problems

Contents

CHAPTER 11: Skin Problems

About 1 of every 20 adolescents are bothered "often or always" by skin problems. You can usually control the two most common problems, eczema (x-zema) and acne, with simple treatments. However, treatment often takes weeks before any real improvement is noticed. Many persons get into trouble because they don't treat the problem every day. Over treatment of the skin to get a "quick cure" can also make the problem worse.

Neither eczema nor acne can be spread to others. Both will heal without permanent scars.

Eczema

When a skin problem causes itching, wet and scaling patches on the face, neck, hands or where the elbows and knees bend, it is probably eczema. The skin may be very dry and the person who has eczema may also be bothered by hay fever and asthma. Some children and adolescents have eczema caused by a skin reaction to things like dust, pet fur, or perfumes. For many others, the cause is not as obvious. Usually, eczema responds very well to 1% hydrocortisone (steroid) cream and avoidance of things that obviously bother the skin. Placing dust free covers on bedding will help.

Hydrocortisone (which can be purchased without a prescription) is best if used at least twice a day. If the skin is usually very dry, mixing the hydrocortisone with Vaseline can help. Many persons find that putting the cream on damp skin (after a shower) works very well.

Acne

Most adolescents get acne. For many it is mild and only a minor nuisance. For others, it is severe, takes many forms and covers the face, chest, and back. Acne reaches its peak for most persons by age eighteen.

Adolescents get acne because of the sexual hormones. The hormones causes clogging of the oil ducts that are located on the face, upper chest, and upper back. The clogged ducts trap oil and produce white heads, or they can trap dark skin cells and produce blackheads.

Blackheads are not produced by dirt on the skin. As the clogging gets worse, the ducts break and the acne begins to look red. It may fill with pus if bacteria grow in the damaged skin. Deep infections causes lumps that sometimes have to be drained.

What Worsens Acne

Pinching or popping pimples can cause the oil ducts to be more red and infected.
Harsh scrubbing or strong detergent type soaps dry out the skin too much and produce more clogging of the oil ducts.
Things that irritate the skin like chin straps and headbands also produce more clogged oil ducts.
Some cosmetics and makeup can pro duce clogged oil ducts and increase the acne.
Some medications including some brands of birth control pills can increase acne.
Menstruation may aggravate acne.
For some persons certain foods, like chocolate, make acne worse. This is not true for most people.

Treatment of Acne

Although there is no single cure for acne, the several treatments can keep acne under excellent control.

Start with benzyl peroxide lotion or gel that can be bought over the counter at all pharmacies. Start with the 5% strength once a day and then twice a day. Increase to 10% twice a day if it does not make your skin too red and itchy. Check the labels at the store to make sure you're getting the strength that you want. Spread a thin film on the entire area of your body that has had some acne not just on the individual pimples themselves. If there is only small or no improvement after four to six weeks, then discuss your acne with your physician, since it is time for stronger therapy.
The next cream or gel that is often added to the benzyl peroxide is Retin A, also called Tretinoin. This medication works in a similar way as benzyl peroxide but is stronger. Be careful with Retin A if you like to sit in the sun, since it can cause increased redness in some persons. A related medication is called adalapene.
If your acne shows signs of having bacterial infection -- is red, inflamed, or pustular -- then an antibiotic is usually added or used instead of one of the creams. The antibiotic can be mixed into a lotion or cream itself or given as a pill. Tetracycline, clindamycin, and erythromycin are the antibiotics commonly used and can be very effective. Benzyl peroxide combined with an antibiotic is another helpful mixture (benzomycin).
If you are one of the few who still are having significant problems even after trying all of the above, then another visit to a doctor is in order. A new medication, called Accutane (isotretinoin) is now being used for severe cystic acne and can be very useful. But it must be used under a doctor's supervision. It can never be used during pregnancy.

Insect Bites

Many serious diseases can be spread by the bites of insects. A strong defense is the best approach. Always learn about dangerous insects in the environment in which you live and travel. Follow recommended approaches to avoid being bitten.

The strongest chemical repellents for most flying insects are DEET (10-35%) or Piocardin (20%). Young children should not use high percentage DEET.

Skin-So-Soft and citronella last about 30 minutes. Soybean oil products may also be effective.

The Joys of Summer

The amount of skin wrinkling and skin cancers doctors find in older age can be reduced if kids protect themselves from the sun by:

Not being in the sun from 10am-2pm
Wearing wide brimmed hats and protecting as much skin as possible from the sun
Protecting the skin and wearing at least UVA/UVB SPF15 sun block. This will reduce some skin damage and some moles. HOWEVER, THIS MAY NOT PREVENT MELANOMA SKIN CANCER.

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.

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