Teenage Acne: As a Parent, What You Need to Know – Part II
In my last post I discussed the pathophysiology of acne and how a pimple is formed. From the initial plugging of the duct going from the small gland in the skin to the outside to the colonization of the thick material stuck in the duct with bacteria. The growth of bacteria and the eventual formation of a pimple was the final common pathway to the process.
All of the forms of treatment are aimed at relieving one of the above factors. The simplest form of treatment is the use of keratolytic agents which cause the top layers of skin to peal faster than they ordinarily do. You must remember that our skin is constantly pealing and replacing itself. In an effort to prevent plugging of the ducts an effort is made to try to keep the skin pealing frequently.
The two most common keratolytic agents are benzoyl peroxide, and retinoic acid. When used too rapidly these can cause flushing and irritation of the skin, so we usually start using it less frequently than we use it eventually. The other process involves bacteria getting into the pores from the skin (we all have bacteria on our skin) and growing to produce a painful pimple. For this there are a variety of antibiotics that can be used both topically (placed right on the skin) or systemically (taken by mouth). The problem is that the process of formation of a pimple takes quite a long time, and the stimulus for teenage acne (hormones) does not stop while treatment begins. So, it is usually a prolonged process to clear the acne (months versus weeks or days).
There are all types of combinations of medications to use for acne and if one does not work it is reasonable to change products. A few of these are found over the counter such as proactive, but most are prescription medications.
Of course, regular soap and water washes help also and avoidance of picking or squeezing the pimple is very important because it can change simple acne in the skin to a much larger cyst or abscess under the skin that can then scar the skin.
Most kids get some degree of acne at one point or another, but keep reminding your children that there are ways to deal with acne, because is can be an emotionally upsetting time for adolescents.
…And Then There’s the Joy
Given the project I’ve been working on, it has meant that over the years most of the news stories I’ve captured have been the sad stories of the children involved in ambulance crashes. This blog gives me the opportunity to share all kinds of pediatric patient stories. Today, I am grateful to be able to share something incredibly uplifting…
(by Roni Caryn Rabin: NYT 5/13/09 http://www.nytimes.com/2009/05/14/health/14scorpion.html?_r=1&ref=us )
10 year-old Michael Moerdler-Green was stung by a scorpion during a recent family trip to Phoenix. At the emergency room, doctors offered his parents a choice of treatments: heavy sedation to help calm his symptoms or an experimental scorpion venom made in Mexico, but not yet approved for use in the US by the FDA. His father, Dr Moerdler-Green, chose the antivenom. His son was able to leave the hospital ONE HOUR AFTER RECEIVING THE MEDICATION.
No other antivenom specifically for scorpion stings is available in the US. A study published yesterday in the New England Journal of Medicine documents a small clinical trial of young children stung by bark scorpions – most given the drug recovered from most of their symptoms within 2 hours. Dr Leslie Boyer, director of a venom research institute at the University of Arizona College of Medicine in Tucson said wider use of the antivenom could make treatment much easier in rural areas and small towns in the state that do not have PICU’s and usually have to helicopter children to hospitals for care.
I would like to thank everyone for sharing this with me today. I am grateful to have your company when the news I have is sad or scary and my hope is to raise awareness about some child safety issue. I am thrilled that the only message I have to pass on today is one of hope…and life. Welcome to the joy.
