Adolescent Health

Acne is one of the most common problems in adolescent teens affecting nearly seventeen million people in the United States. Acne is nothing but a disorder involving sebaceous glands and hair follicles. Acne results from the clogging of sebaceous glands leading to the formation of pimples and cysts. The condition usually begins with the onset of puberty. Going by the facts, as teens attain puberty the androgens also called male sex hormones are produced in high number leading to sebaceous glands becoming over active which results in sebum being produced in high proportions.

Sebum, which is nothing but oil is produced by sebaceous glands which travel to the skin surface through hair follicles. But, skin cells block the follicles which results in oil also being blocked. When these hair follicles are blocked it results in the development of skin bacteria known as Propionibacterium Acnes within the follicles which in turn results in swelling of the skin called Acne. If the hair follicles are partially blocked it results in blackheads. If the follicles are completely blocked they result in whiteheads. But if these plugged follicles are not treated they ultimately burst causing the oil, bacteria and skin cells to spill all over the skin resulting in irritation and formation of pimples. Acne can be shallow as well as deep in various individuals depending on the nature of skin and amount of oil produced.

There can be various causes why Acne forms. Apart from rising hormone levels due to puberty it can also be attributed to certain other factors like intake of drugs which contain lithium, barbiturates and corticosteroids. Acne can also be caused due to excess grease and oil in the scalp, due to cooking oil and use of some cosmetics can actually alleviate the acne problem. Acne problem many times is inherited also. Acne problem is worsened if the pimples are squeezed or scrubbed too hard.

Acne can form at any place of the body but they most commonly form in the areas where there sebaceous glands are present in high proportions like face, chest, shoulders, neck and upper back. The symptoms may differ from person to person but commonly seen symptoms are: formation of blackheads, whiteheads, lesions filled with pus and which are very painful and lastly nodules. One may get confused sometimes as symptoms of acne may be like some other skin condition and it is always advised to consult a doctor in this scenario.

There are lots of treatments available today to treat acne. The primary goal of the treatment is to reduce scars and better appearance. There are various treatments and the doctor decides which specific treatment you need based on: the extent of acne problem, age, medical history, overall health, tolerance to specific medications and procedures, expectations and last but not the least what patients prefer.

Treatment of acne is classified into topical and systemic drug therapies which are given based on extent of severity. In some instances the combination of both the methods might be the way to go for acne treatment. Topical medication is nothing but creams, gels, lotions, solutions etc. prescribed to patients for acne treatment. Some of the examples of topical medication are: Benzoyl Peroxide which kills the Propionibacterium Acnes bacteria, antibiotics helps in stopping or slowing down the growth of the bacteria and also reduces inflammation, Tretinoin helps in stopping the formation of new acne lesions and Adapalene reduces formation of comedo.

Systemic drug therapies involve prescription of systemic antibiotics primarily for the treatment of acne problem which is moderate to severe in nature. The examples of antibiotics prescribed are Doxycycline, erythromycin and tetracycline. In some cases an oral drug called Isotretinoin is prescribed for teenagers with severe acne problem which shrinks down the sebaceous glands that produce oil. The results are pretty good and almost ninety percent of the adolescents have success with this oral drug. But the drug has some serious side-affects and thus it is very important that one consults a doctor before use.

Smoking is the cause of many diseases and kills about four hundred and forty two thousand people every year in the United States. In spite of anti smoking campaigns and billboard warnings, more and more people are joining the bandwagon of smokers every year. Out of the total number of new smokers, ninety percent are children and adolescents, replacing smokers who have quit or died early due to a disease caused by smoking. Smoking is the top cause of preventable and premature deaths, followed by obesity.

Smoking not only increases the risk of lung disease, but also increases the risk of contracting lung cancer, oral cancer, emphysema, stroke and heart disease. Certain statistics by the American Lung Associations show alarming results. Over five thousand adolescents smoke their very first cigarette every day, out of which over two thousand turn into regular smokers. Presently there are nearly five million adolescents smokers. Twenty percent of the twelfth graders smoke cigarettes regularly.

Smoking has many harmful affects on the health of a human being. It damages the cardiovascular system, causes high blood pressure, increases heart rate, increases the risk of ischemic stroke, increases the risk of formation of blood clot formation, and decreases the oxygen amount which reaches the tissues in the body, reduces coronary blood flow & cardiac output, and damages the blood vessels. Smoking not only affects physical health, but mental health too. It causes psychological distress and depression.

Smoking not only affects the person who smokes but also other people who surround him/her. According to the American Heart Association, nearly thirty five thousand passive smokers die of smoke inhaled from a lit pipe, cigar or cigarette. People who do not smoke directly and inhale smoke from a cigarette smoke by his/her neighbor is known as passive smoker, secondary smoker or indirect smoker. Among the passive smokers, women, children and infants are at a higher risk. Infants and children who are exposed to smoke develop asthma, frequent ear infections and may even experience infant death syndrome. The symptoms experienced by secondary smokers are coughing, excess mucus formation in the airways, chest discomfort, chest pain, and lung irritation. They even feel irritation of throat, nose and eyes. If the passive smokers experiences chest pain, it can be an indication of a heart disease. Sometimes the symptoms of secondary smoking can coincide with the symptoms of other medical conditions. Hence, it is recommended to contact the doctor immediately after the surfacing of the symptoms.

In active smokers, smoking, apart from building up high cholesterol in blood, increases the risk of cardiovascular disease, obesity, high blood pressure, physical inactivity and diabetes. So smoking cessation will not only reduce the risk of coronary heart disease, which is top of the list, but also decreases the risk by fifty percent of heart attacks and deaths caused by it. But quitting smoking undertakes lots of physical and mental efforts. The person should be made mentally relaxed and stress free. In case of adolescents, they can be asked to exercise regularly and sleep adequately. The American Lung Association and The American Academy of Otolaryngology have developed certain tips which can be of great help to the smokers who are thinking of quitting. The smokers must first be made to understand the reason for quitting. Stress only makes even more difficult to quit smoking, so a stress free period should be chosen to quit. Family and friends’ encouragement and support are extremely necessary to persuade the smoker to quit. If the support isn’t sufficient, smokers can join a smoking cessation program or a support group to attain their goals. A balanced diet is a must, along with lots of rest.

Sometimes taking nicotine replacement products, such as nicotine chewing gum, nicotine inhalers, and nicotine patch, are a great help to smokers who want to quit. By using these products the smokers can satisfy their nicotine craving. The good thing is that these nicotine replacement products can deduct the poisonous gases and tars emitted by the cigarettes. But nursing and pregnant women should consult a doctor before trying nicotine replacement products. For such people non-nicotine alternative is available in the market.

Also known as mononucleosis or mono Pfeiffer's disease or glandular fever, infectious mononucleosis can be identified by inflamed lymph glands and constant fatigue. The disease is named so as the amount of mononuclear leukocytes which belong to white cells increase in number. The cause of the disease is EBV (Epstein - Barr virus) or in some cases cytomegalovirus. Both these viruses belong to the family of herpes simplex. According to statistic majority of the adults in the United States are exposed to the virus Epstein – Barr, a very widespread virus. Although the virus does not show any visible affects in children but it does in adolescents which can lead to infectious mononucleosis in nearly fifty percent of cases of exposure to the virus.

The other virus called cytomegalovirus which also belongs to the family of herpes simplex causes the cells to become enlarged. According to statistics, about eighty percent of adolescents infected with this virus generally don’t see any further symptoms. Although EBV has potential to develop infectious mononucleosis in adolescents the virus could make throat and blood cells its home for the lifetime. The virus has the capability to bounce back and reactive from time to time but the consolation is that it would reactivate without symptoms.

The condition usually lasts for 1-2 months. The symptoms may vary from one adolescent to other but may include inflamed lymph glands in areas such as groin, neck and armpits, fever, continuous fatigue, enlarged spleen, sore throat as a result of tonsillitis that can make things difficult to swallow and last but not the least minor liver damage that can lead to short-term jaundice. Some adolescents may also experience symptoms such as abdominal pain, petechial hemorrhage, muscle ache, headache, depression, loss of appetite, skin rash, weakness, dizziness, enlarged prostrate, dry cough, swelled genitals and puffy and swollen eyes. Some parents are puzzled by the symptoms of mononucleosis as it may be similar to other medical conditions. It is safe to consult a doctor in such cases.

The viruses are usually transmitted to other people through saliva (the reason why it is also called kissing disease), blood, sharing drinks and sharing utensils. The symptoms usually lasts for 4-6 weeks and do not cross 4 months. The disease is diagnosable but requires a though medical history of the adolescent. The diagnosis also involves physical examination of the adolescent and is based on symptoms reported to the physician. The diagnosis is further supported by laboratory test like blood test, antibody test and test to count white blood cells.

A rest of about a month is generally advised and normal activities can be resumed after acute symptoms disappear. Also care should be taken to avoid physical activities which are heavy in nature and also activities or sports involving physical contacts should also be avoided. Care must also be taken to avoid eating sweet things in excess for few months.

To understand what is anemia one should begin with breathing. The oxygen that is inhaled simply doesn’t stop in lungs. It circulates though out the body and fuels the brains also. Oxygen travels to all parts of the body though bloodstream and to be precise in the RBCs I.e. red blood cells. Now, these RBCs are produced in the bone marrow of the body and they serve as boats carrying oxygen in the bloodstream. RBCs have something called hemoglobin, a protein which holds oxygen. To make adequate hemoglobin body requires iron in plenty. The iron is supplied by the foods that we take along with other nutrients. When these RBCs are fewer in number than what is needed anemia occurs in the body. There can be 3 primary reasons: RBCs are lost due to some reason, the production of RBCs is slower than what is needed and lastly the body is destroying the RBCs. Different types of anemia are linked to at least one of these causes.

The bone marrow replaces small amounts of blood is lost due to some reason without making a person anemic. But in cases where considerable amount of blood flows in small amount of time as a result of an injury due to a serious example for instance, it may not be possible for bone marrow to replace RBCs so quickly resulting in anemia. Also, losing small amounts of blood over long periods of time may also lead to anemia. Example of this situation can be seen in girls who get heavy periods attributed mainly to deficiency of iron in the diet.

Anemia due to iron deficiency is the most common kind of anemia in the United States. It occurs mainly due to lack of iron in a person’s diet. A teen with iron deficiency would have lower hemoglobin production and consequently lower RBCs. When the production of RBCs is low the person is regarded as anemic. The signs of anemia are paleness and tiredness. There can be other reasons as to why enough RBCs are not produced in the body. Folic acid and Vitamin B-12 are also essential to produce RBCs. Getting these in adequate quantities is this important too. There can be a problem with bone marrow’s working too resulting in anemia.

Hemolytic anemia occurs when a person has RBCs whose lifespan is shorter. The bone marrow may not be able to produce new blood cells if the blood cells die too early. This can result due to many reasons including person having disorders like sphenocytosis or sickle cell anemia. In some cases the immune system of the body may itself destroy the RBCs. In some cases certain antibodies can form in the blood as a result of reaction to certain drugs or infections and may attack the RBCs.

Teens get anemia as they grow rapidly the amount of iron intake may not be enough to keep up with the pace of the growth as it needs more nutrients in this process. In the case of girls they need more iron after puberty and are at risk due to heavy blood loss during menstrual periods. In some cases pregnancies also leads to anemia. Also, teens who diet excessively to lose weight may also be at risk of having iron deficiency. Meat eaters especially red meat eaters are at less risk compared to vegetarians as meat has rich iron in it.

Sprains and strains are among the majority of the injuries caused while playing sports. Sports injuries can be caused by small trauma which involves ligaments, muscles and tendons including bruises, sprains and strains. The body part which is most commonly involved in spraining or straining is the ankle. The 3 ligaments that are involved during ankle sprain or strain include anterior talofubular ligament, posterior talofibular ligament and calcaneofibular ligament.

An injury caused to the soft tissue as a result of a direct force like fall, kick and blow is called a contusion or a bruise. A sprain is nothing but a ligament injury which is wrenched or twisted. Sprains usually affect knees, wrists and ankles. On the other hand a strain is an injury caused to a tendon or muscle which usually results from force, stretching and overuse.

Sprains/Strains are usually diagnosed by a physician after a physical examination. The physician asks for thorough medical history of the adolescent and asks various questions that lead to the cause of the injury. Various diagnostic procedures are also available which also helps in evaluating the problem. X-ray is one of the oldest and common diagnostic tests done to know the extent and exact location of the injury. An x-ray uses electromagnetic waves to get photos of internal tissues, organs and bones onto a film. MRI scan is one of the recently evolved diagnostic procedures which also help in evaluating a physical injury. This procedure actually called Magnetic Resonance Imaging makes use of bug magnets, computer and radio frequencies to get detailed pictures of structures and organs inside the body. Another diagnostic procedure called Computed Tomography Scan or CT scan is also used to evaluate the extent and location of injury. This procedure uses a blend of computers and x-rays to get cross sectional pictures in horizontal and vertical alignment. It shows thorough pictures of any part of the body like muscles, bones, fat and organs. They provide more information than conventional x-rays.

There are various symptoms of strain and sprain depending on each teen’s physical condition and they may vary accordingly. One of the symptoms includes pain in and around the area injury. There could also be a swelling around the injured area. Some teens also experience difficulty when they use or move the area of the body that is injured. Some teenagers also undergo bruises or redness in the area that is injured. Many times the symptoms of sprains and strains may look similar to other medical conditions and a doctor’s advice is the best option in this scenario.

Depending on various factors the treatment of sprains and strains will be prescribed by the teenager’s physician that include teenager’s age, overall health of the teenager, and medical history of the adolescent. To what extent the teen is injured is also a factor in determining the nature of treatment. A teenager’s level of tolerance to certain medications, therapies and procedures is also taken into consideration before opting for a particular method of treatment. The treatment also depends of what expectations one has and also preference and opinion.

Various options available for treatment include things like restriction of the activity after the injury, application of cast/splint on the injured spot, crutches or wheelchair, physical therapy which involves stretching exercises to give strength to the muscles, tendons and ligaments that are injured and last but not the least is the surgery which is opted for in worst case scenario.

In the long-term scenario bruises, sprains and strains heal pretty quickly in kids and teenagers but it is important that the adolescent sticks to the restrictions imposed during the treatment and healing process like restriction of activity and regularly attending physical therapy sessions if any. It is noted that majority of the sports related injuries results either due to traumatic injury or excessive use of muscles and joints. But, they can be avoided and prevented with right training, by wearing right protective gears and by using right equipment for training.

Adolescent pregnancy in ninety nine percent of the cases is unwanted and is the major consequence of adolescent sexual activity, other than STDs. This issue has affected youth, families, educators, health care professionals, and government official. A study on the high school adolescents has concluded that forty eight percent of the males and forty five percent of the females are sexually active. One fourth of the high school students had sexual contact by fifteen years of age. The average age of boys is sixteen and a girl is seventeen, who have had intercourse. Ninety percent of adolescents, in the age range of fifteen to nineteen, say their pregnancy is unintended.

Seventy four percent of females above fourteen years and sixty percent of females below fifteen years have reported to have involuntary sex. Fifty percent of the adolescent pregnancies are within the time period of six months after the initial sexual intercourse. More than nine hundred thousand teenagers are reported to have become pregnant every year in the United States. Fifty one percent of the adolescent pregnancies result in live birth, thirty five percent result in induced abortion and fourteen percent result in stillbirths or miscarriages. Four out of ten adolescent females get pregnant, before they turn twenty, at least once. Twenty five percent of adolescent deliveries aren’t the mother’s first child. When a teenager gives birth to her first child, she increases the risk of begetting another child. One third of the adolescent parents are themselves result of adolescent pregnancies.

There are many reasons why adolescents choose to become sexually active at an early stage in life. The reasons can be early pubertal development, poverty, sexual abuse in childhood, lack of parent’s attention, lack of career goals, family and cultural patterns of early sex, substance abuse, dropping out from school and poor school performance. Factors which discourage an adolescent to become sexually active are stable family environment, parental supervision, good family income, regular prayers, connectedness with parents and living with complete family and both the parents. The factors which are responsible for the consistent use of contraceptive among adolescents are academic success, anticipation for successful future, and involvement in a stable relationship.

There are many medical risks associated with adolescent pregnancies. Adolescents who are less than seventeen years are at a greater risk of developing medical complications, when compared to adult females. The risk is even more in teenagers below seventeen. The weight of the child, given birth by an adolescent, is very low in these pregnancies. It is usually below 2.5 kilogram. The rate of neonatal birth is also three times greater in adolescents, when compared to adults. Other problems caused by adolescent pregnancies are prematurity of the child, birth of underweight child, poor maternal weight gain, poor nutritional status, anemia, STDs and hypertension induced due to pregnancy.

Although there is an increase in the use of contraceptive methods by adolescents during their first sexual contact, only sixty three percent of the high school students have said to use condom while having sex previously. Adolescents, who use prescription contraceptives, delay their doctor’s visit until the time they become sexually active for over a year.

According to a research, youngsters who have participated in sex education programs which gave them knowledge about contraception methods, abstinence, sexually transmitted diseases and youngsters who involved in discussions in order to get a clear picture, used contraceptives and condoms effectively without any increase in sexual activity. The Center for Disease Control & Prevention has said that the solution for unwanted adolescent pregnancies and STDs are barrier contraceptive use and abstinence.

Adolescence is the time when there is sudden transformation in the body and many questions arises in the minds of the adolescents. Firstly they are not able to cope with the changes and secondly the changes bring along problems with them. The most challenging problems are related to menses, in girls. Menstrual conditions are many that may require physician’s attention or any other healthcare professional’s attention. The most common of the menstrual disorders are premenstrual syndrome, dysmenorrheal and amenorrhea.

Before the onset of the menses, females face many uncomfortable symptoms which last for a short period, stretching from few hours to few days. But some of them can be very intense and can disturb the normal functioning of the person. These symptoms are grouped as premenstrual syndrome. In usual cases, the symptoms come to a halt when the menses begin, but for some they may last even after the menstrual periods are over. Eighty five percent of the females experience some of the symptoms of premenstrual syndrome at one time or the other. Nearly forty percent experience the symptoms so intensely that their daily chores are affected by it and ten percent are disabled by it.

There are many premenstrual syndrome symptoms which can be broadly classified as neurologic & vascular symptoms, psychological symptoms, gastrointestinal symptoms, fluid retention, eye problems and respiratory problems. The cause of premenstrual syndrome are fluctuations in the levels of progesterone & estrogen, hypoglycemia, hyperprolactinemia, psychogenic factors, changes in carbohydrate metabolism, excessive aldosterone, progesterone allergy and water retention by kidneys. The good thing is that premenstrual syndrome can be prevented by exercising regularly, eating balanced diet and sleeping adequately.

Dysmenorrhea is feeling intense menstrual pain and cramps. Depending on the severity, dysmenorrhea is stated as primary dysmenorrhea or secondary dysmenorrhea. Primary dysmenorrhea symptoms are felt from the onset of the menstrual periods and are felt life-long. Because of abnormal uterine contractions due to chemical imbalance, severe menstrual cramping is experienced. Secondary dysmenorrhea starts in the later stages. The causes are different for primary and secondary dysmenorrhea. Secondary dysmenorrhea can be blamed on medical conditions such as endometriosis, uterine fibroids, pelvic inflammatory disease, tumors, infections, and abnormal pregnancy.

Dysmenorrhea symptoms are lower abdomen cramping & pain, lower back pain, nausea, diarrhea, vomiting, fatigue, fainting, weakness and headaches. Females who are overweight, smoke, and have started to menstruate before turning eleven are at a higher risk of developing dysmenorrheal. Females who drink alcohol during menstrual period experience prolonged pain. After studying the health conditions, age, cause of dysmenorrhea, and extent of condition of the individual, corresponding treatment will be recommended. Regular exercise, abdominal massage, hot bath, vitamin supplements, and dietary modifications can help overcome dysmenorrhea.

Amenorrhea is the condition in which the female skips her menses for more than three consecutive menstrual cycles. Amenorrhea is also classified as primary amenorrhea and secondary amenorrhea. Primary amenorrhea develops from the onset of menstrual periods. In this condition, the adolescent might not get periods when she enters puberty. Secondary amenorrhea is a condition where periods become irregular after a period of time and not from the start.

There are many causes of amenorrhea such as ovulation abnormality, eating disorders, birth defects, anatomical abnormalities, malnourishment, anorexia, bulimia, pregnancy, over exercising, thyroid disorder, obesity and other medical conditions. Out of these ovulation abnormalities are a common cause for absent or irregular periods. It is a must that an adolescent start getting menses at least by the age of sixteen. If not, anatomical abnormality, birth defect and other medical conditions are the cause. Adolescents who participate in sports actively and are athletic have a lower body fat content because of which they have absent menses. Even because of malnourishment, the body is incapable of sustaining pregnancy. So in turn the body itself shuts down the reproductive system and menses. Extra fat cells in the body interfere with ovulation and that is the reason why obese female have irregular menses. Amenorrhea is treated by dietary modifications, ovulation inhibitors and hormone treatment.