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Your Teen

Teenage Girls May Take Longer to Recover From Concussions

2:00

Teenage boys and girls can both suffer a concussion during sports activities; however, female athletes may take more than twice as long to fully recover, according to a new study.

Researchers examined data on 110 male and 102 female athletes, ranging in age from 11 to 18 years, who sustained their first concussion while participating in sports. 

To assess the duration of symptoms, the researchers examined patient records for young athletes treated for concussions at one medical practice in New Jersey from 2011 to 2013. The athletes were 15 years old on average.

Half of the girls reported still having symptoms at least 28 days after sustaining a concussion, while half of the boys no longer had symptoms after 11 days, the study found.

Boys were more likely to receive their injuries while participating in football, soccer, wrestling, lacrosse and ice hockey. Most of the girls’ injuries were from soccer, basketball, softball, field hockey or cheerleading.

Overall, 75 percent of the boys recovered from their concussions within three weeks, compared to just 42 percent of girls.

Researchers acknowledge that the study was a small group and focused on a single medical practice.

It’s also possible that some of the difference in recovery time for boys and girls was due to pre-existing medical conditions, notes one injury prevention director.

According to Dr. Mark Halstead, director of the Sports Concussion Clinic at St. Louis Children’s Hospital, females that who participate in similar sports as males have a higher rate of concussion.

“Boys and girls likely have different recovery courses, but we have to treat each concussion individually,” Halstead, who wasn’t involved in the study, said by email to Reuters Health. . “Adult coaches need to create an environment and culture for their players that stresses that a concussion is an important injury to not downplay and encourage the reporting of symptoms.”

Experts agree that the most important take-away from the study is that it is extremely important for adolescents who sustain a concussion to seek proper care and follow through with recommended treatment and rest following an injury.

A teenager, like an adult, may lose consciousness after getting a concussion, but the majority of people do not pass out after a head injury.

Watch for these symptoms if your teen has suffered a head injury:

·      Dizziness

·      A headache that lasts more than a few minutes

·      Trouble with vision, balance or coordination

·      Nausea or vomiting

·      Difficulty concentrating, thinking or making decisions

·      Trouble speaking, slurring or making sense

·      Confusion, sleepiness, emotional for no reason

·      Seizures

If your child experiences a head injury, make sure that a doctor examines him or her. If any of these symptoms persists, seek immediate medical attention. Concussions should always be taken seriously.

Story source: Lisa Rapaport; http://www.reuters.com/article/us-health-girls-concussion-sport/after-concussion-teen-girls-may-take-longer-to-heal-than-boys-idUSKBN1CH2SS

http://kidshealth.org/en/teens/concussions.html

 

 

Your Teen

Stop Yelling at Your Teenager!

2.30 to read

I’m going to go out on a limb and say that anyone who has a child has yelled at him or her at one time or another. As parents, we’ve all lost our patience when we believe our child is misbehaving. If ever there is a time when parents and kids are standing at the crossroad of “Listen to me” and “I don’t need to”, it’s during the teenage years.

Tempers often ignite with harsh words being said.  

While you may be trying to make an important point, aggressive yelling and screaming only pushes your child away and may be doing much more harm than good according to a new study.

An analysis involving nearly 1,000 two-parent families and their adolescent children suggests that such harsh verbal lashings not only don't cut back on misbehavior, they actually promote it.

The end result: an uptick in the kind of adolescent rage, stubbornness and irritation that escalates rather than stops or prevents disobedience and conflict.

"Most parents who yell at their adolescent children wouldn't dream of physically punishing their teens," noted study author Ming-Te Wang, an assistant professor with the department of psychology at the University of Pittsburgh School of Education. "Yet, their use of harsh verbal discipline -- defined as shouting, cursing or using insults -- is just as detrimental to the long-term well-being of adolescents," he said.

"Our findings offer insight into why some parents feel that no matter how loud they shout, their teenagers do not listen," Wang added. "Indeed, not only does harsh verbal discipline appear to be ineffective at addressing behavior problems in youth, it actually appears to increase such behaviors."

Wang and his co-author, Sarah Kenny of the University of Michigan, report their findings in the current issue of the journal Child Development.

The researchers were particularly interested in kids between 13 and 14 years old so they focused on 976 primarily middle-class families in Pennsylvania with young adolescent offspring, all of whom were already participating in a long-term study exploring family interaction and adolescent development. A little more than half the families were white, while 40 percent were black.

The teen participants were asked to disclose recent behavioral issues such as in-school disturbances, stealing, fighting, damaging property or lying to their parents.

Their parents were asked how often they used harsh verbal discipline such as yelling, screaming, swearing or cursing at their child. Most importantly, if they called their child names like “dumb” or “lazy.”

The teens were also asked to what degree they felt “warmth” in their relationship with their parents. Researchers inquired about the amount of parental love, emotional support, affection and care the kids felt like they received from their parents. Both teens and parental depression were tracked.

The study points out that the children who were on the receiving end of the harsh verbal attacks experienced an increase in anger and a drop in inhibitions. Those two reactions prompted an intensification of the very things that parents were hoping to stop – such as lying, cheating, stealing or fighting.

"Parents who wish to modify their teenage children's behavior would do better by communicating with them on an equal level," Wang said, "and explaining their rationale and worries to them. Parenting programs are in a good position to offer parents insight into how behaviors they may feel the need to resort to, such as shouting or yelling, are ineffective and or harmful, and to offer alternatives to such behaviors."

Parents get frustrated with their children and vice versa. None of us behave perfectly all the time. Raising your voice because you are frustrated is one thing, name calling and screaming is quite another.

Imagine if you were at work and your boss screamed at you, called you names and cursed at you because he or she didn’t like how you did something. That may have actually happened to you – remember how you felt, or think about how you would feel. Humiliated, angry and sad are the most common reactions people have.  

Children are trying to find their way in life; parents are their guides. The next time you feel you’re on the verge of screaming or saying hurtful things to your child - walk away. Give yourself time to cool down and find a better way to communicate.

People say kids are resilient and get over things quickly. Many are able to bounce back when bad things happen, but that saying is too often used to excuse bad behavior on a parent’s part. If you’ve crossed the line with your child, say you’re sorry and come up with better ways to handle your frustration and anger.

Words and tone matter and the best teaching method is by example. You can help your child learn what love, patience, tolerance, compassion and respect are by being an example of those very qualities.

Source: Alan Moses, http://consumer.healthday.com/kids-health-information-23/misc-kid-s-health-news-435/yelling-at-insulting-teens-can-backfire-on-parents-study-679863.html

Daily Dose

Tattoos

1:30 to read

Some of my adolescent patients (who are over 18 years) have come in for check ups and shown me their latest “fashion statement”, a tattoo or an occasional tongue piercing.  While years ago it was teenage girls with pierced belly buttons, that fad has declined (at least in my patient population), and societal acceptance of tattoos and other body piercings is more common. While I do see tattoos, tongue piercings and eyebrow piercings within my practice… it seems that I also notice them far more frequently on the parents of the new babies I am seeing.

 

While tattoos and body piercings may be a form of self-expression for a teen, it is also important to remember that there may be risks involved.  A recent article in Pediatrics reviewed risks and consequences of the ever growing “body modification” trend.

 

In several surveys somewhere between 20%-38% of youths 18-24 years old have a tattoo or body piercing (other than ear lobe) and the perception of the association between having a tattoo or body piercing and engaging in high risk behavior is changing.  

 

But, when a teen asks me about tattoos or body piercings I do remind them that there are risks involved, including infection. While most teens worry about a skin infection I also remind them of the risks of HIV, hepatitis B and C and even tetanus…so you want to make sure you have an up to date tetanus vaccine before thinking about a tattoo or piercing. You also want to make sure that there are good antiseptic processes and sanitary practices in place when choosing a tattoo parlor and always use a professional tattoo artist.  

 

I also tell them that tattoos should be viewed as being “permanent”, and I would consider where I had the tattoo placed, and would it be possible to cover it if necessary for employment opportunities?  In the not too distant past I remember our office requiring any employee with a visible tattoo to have it covered with long sleeves but while those days are over, at least in my  office, other employers may have rules about tattoos or body piercings. Because tattoos are supposed to be permanent I also remind teens that trying to remove an ill placed or “out of style” tattoo is difficult, expensive and may only be partially effective. 

 

If any piercing or tattoo begins to look infected or has skin changes the adolescent should definitely seek treatment with a physician. Better still….maybe use a henna “non-permanent tattoo” and limit piercings to the ear.

 

 

 

 

 

 

 

 

Your Teen

Are Today’s Teens Avoiding Adulthood?

2:30

Are today’s teens riding a slow boat to maturity? Compared to teens in the 1980s and 90s, this generation of teenagers are not in any hurry to grow-up, according to a new study.

In some ways, that’s a good thing. High school kids today are less likely to drink alcohol or have sex, compared to their counterparts a couple of decades ago.

However, they are also less likely to go on dates, have a part-time job or learn to drive – all conventional steps to adulthood.

Are these changes in development good or bad?  Actually, they are both, researchers said.  It depends on how you look at it.

Jean Twenge, a professor of Psychology at San Diego State University, said there are “trade offs’ to each path.

"The upside of slower development is that teens aren't growing up before they are ready," she said. "But the downside is, they go to college and into the workplace without as much experience with independence."

Being unprepared for work or college is definitely a problem for many of today’s adolescents, according to one specialist in teen mental health.

"I think if you ask any college professor, they'll tell you students these days are woefully unprepared in basic life skills," said Yamalis Diaz.

Diaz, who was not involved in the study, is a clinical assistant professor of child and adolescent psychiatry at NYU Langone Medical Center, in New York City.

Today's students may be sharp academically, Diaz said -- but they often have trouble with basics like planning, time management and problem solving.

The findings, published online in the journal Child Development, are based on nationally representative surveys done between 1976 and 2016. Together, they involved over 8 million U.S. kids aged 13 to 19.

On the upside, many of today’s teens aren’t attracted to activities that can be destructive such as drinking alcohol, drug and tobacco use and having sex at an early age. Those are important changes that bode well for young adults and make parents happy.

So why the change in attitude and priorities? It’s complicated. Technology has altered how many people, particularly teens, communicate. Many are spending less time in face-to- face conversations, choosing to text or post on social media.

Parenting styles have also seen a transformation. The “helicopter” or “hovering” parental style has gained in popularity. Some parents are involved so heavily in their kids’ lives that they make all the decisions for them and try to keep their kids from experiencing any type of failure.

In recent years, Diaz said, parents have become much more "child-centric," compared with the days when parents would send their kids outside with instructions to be back by dinner.

And while that is well-intended, Diaz said, kids today may have few chances to deal with relationships, work through their own problems -- and otherwise "stand on their own two feet."

"On one hand," Diaz said, "today's parents should be commended for sending their kids the right messages about what's appropriate for their age."

But, she added, "sometimes parents want to keep doing everything for their kids."

Diaz suggests that parents give kids the space they need to develop necessary skills, like problem-solving, time management and the ability to hold down a part-time job. She also advised parents to create some "no phone" time every day at home -- and to encourage their kids to do the same when they're with their friends.

Story source: Amy Norton, https://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/are-today-s-teens-putting-the-brakes-on-adulthood-726634.html

Your Teen

More Teens Getting Tattoos and Piercings

2:00

To many a parent’s chagrin, tattoos and piercings have skyrocketed in popularity among teenagers. While mom and dad may not want to have a serious discussion about the pros and cons of getting a tattoo or body part pierced with their adolescent, the American Academy of Pediatrics (AAP) says pediatricians should be taking to their patients about the health risks and providing safety guidelines.

The AAP released its first report this week regarding tattooing and piercing for adolescents and young adults. The report discusses health risk issues from tattoos and piercings as well providing guidelines to talk to about important safety measures.

"Let's face it, kids are getting tattoos or piercings now," said Dr. Jay Greenspan, chairman of pediatrics at Nemours/A.I. Dupont Hospital for Children. "We know it's mainstream and we want the medical community to be a part of it."

It's unclear how many American teenagers have tattoos and piercings. The report cited a Pew Research Center study that said about 38 percent of young people ages 18 to 29 have at least one tattoo.

In some states, it’s illegal for someone to tattoo or body pierce a minor without the parent’s written consent. But we’re talking about teens here, and where there is a will; there is often a way found around any constraints.  That’s why Greenspan believes that an honest discussion is necessary.

Ten years ago, there was an association between tattoos and alcohol, drug use, violence, sexual activity, eating disorders and even suicide. But that's not the case anymore, the report said.

Today’s teens are more likely to associate tattoos and body piercings with celebrities and sports figures than with the seedier side of life.

Seventy-two percent of teens that have tattoos have them in places that can be covered, the report said. High-ear cartilage is one of the most common visible piercings, followed by navel, tongue and nipple and genital. 

While the rate of tattoo complications is unclear, the AAP believes it's likely low. Common tattoo complications can be inflammation, infections and neoplasms. Preexisting conditions like psoriasis, systemic lupus and sarcoidosis can lead to reactions.

Data on body piercing complications is also minimal. What is known is that teenagers who have a higher risk of infection, particularly those who are diabetic or taking blood thinning medication, may have a greater risk of complications when getting a piercing. 

For piercings, stainless steel posts and studs are recommended to avoid skin reactions. Cheaper products typically have lower quality materials that can lead to a reaction.

So, what do you do if your teen wants a tattoo on their arm or stud placed in their eyebrow? Once you’ve talked it through and if you decide that you’re ok with it, make sure to find a reputable parlor (there are many) and consult with your doctor beforehand to learn how to care for and what to expect during the healing process. Tattoos and body piercings may have become a trend that won’t go away, but they still involve needles and require that certain precautions be taken.

Story source: Meredith Newman, https://www.usatoday.com/story/news/nation-now/2017/09/20/young-people-tattoos-and-piercings-report/686360001/

 

Your Teen

Early Puberty and Bone Health

1.50 to read

The normal rate of bone mass decline in adulthood is about 1 to 2 percent each year. This means that a 10 to 20 percent increase in bone density resulting from a naturally early puberty could provide an additional 10 to 20 years of protection against normal age-related decline in bone strength, according to the researchers.A new study suggest the earlier your child starts puberty, the lower the risk he or she will have osteoporosis later in life.

The research was based on 78 girls and 84 boys, who were studied from the time they began puberty until they reached sexual maturity. The investigators found that adult bone mineral density was influenced by age at puberty onset, with greater bone mass linked to early puberty and less bone mass associated with later puberty. However, bone strength did not seem to be affected by how long puberty lasted. "Puberty has a significant role in bone development," study leader Dr. Vicente Gilsanz, director of clinical imaging at the Saban Research Institute of Children's Hospital Los Angeles, said in a hospital news release. "During this time, bones lengthen and increase in density. At the end of puberty the epiphyseal plates close, terminating the ability of the bones to lengthen. When this occurs, the teenager has reached their maximum adult height and peak bone mass," Gilsanz explained. Reduced bone mineral density leads to osteoporosis, which affects 55 percent of Americans aged 50 and older. The normal rate of bone mass decline in adulthood is about 1 to 2 percent each year. This means that a 10 to 20 percent increase in bone density resulting from a naturally early puberty could provide an additional 10 to 20 years of protection against normal age-related decline in bone strength, according to the researchers. The study was published in the January issue of the Journal of Pediatrics. Pediatricians have long understood the role of pediatric bone development in osteoporosis prevention. The tween and teen years are critical for bone development because most bone mass accumulates during this time. In the years of peak skeletal growth, teenagers accumulate more than 25 percent of adult bone. By the time teens finish their growth spurts around age 17, 90 percent of their adult bone mass is established. Following the teen years, bones continue to increase in density until a person is about age 30. The need for calcium in the diet. Calcium is critical to building bone mass to support physical activity throughout life and to reduce the risk of bone fractures, especially those due to osteoporosis. The onset of osteoporosis later in life is influenced by two important factors: •   Peak bone mass attained in the first two to three decades of life •   The rate at which bone is lost in the later years Although the effects of low calcium consumption may not be visible in childhood, lack of adequate calcium intake puts young people at increased risk for osteoporosis later in life. Other foods, including dark green, leafy vegetables such as kale, are also healthy dietary sources of calcium. But, it takes 11 to 14 servings of kale to get the same amount of calcium in 3 or 4 8-ounce glasses of milk. In addition to calcium, milk provides other essential nutrients that are important for optimal bone health and development, including: •       Vitamins D, A, and B12 •       Potassium •       Magnesium •       Phosphorous •       Riboflavin •       Protein The role of physical activity in bone development. Weight-bearing physical activity helps to determine the strength, shape, and mass of bone. Activities such as running, dancing, and climbing stairs, as well as those that increase strength, such as weight lifting, can help bone development. For children and teenagers, some of the best weight-bearing activities include team sports, such as basketball, volleyball, soccer, and softball. Studies show that absence of physical activity results in a loss of bone mass, especially during long periods of immobilization or inactivity.

Your Teen

10 Reasons Teens Act The Way They Do

2:30

Anyone in the midst of raising a teen knows that the adolescent years can be some of the most difficult to get through and understand.

As a parent or guardian of a teenager that wants to be more independent, but also needs supervision and guidance, the times can be challenging indeed.

If that’s the position you find yourself in, you may be asking – what’s going on in that youngster’s brain? Actually, there’s a lot happening!

There are several scientific reasons an adolescent brain can be similar to a toddler’s: After infancy, the brain's most dramatic growth spurt occurs in adolescence. Here’s 10 things you may not know about your teen’s brain.

10. Critical period of development. Adolescence is generally considered to be the years between 11 and 19. It’s easy to see the outward changes that occur in boys and girls during this time, but inside, their brains are working on overdrive.

"The brain continues to change throughout life, but there are huge leaps in development during adolescence," said Sara Johnson, an assistant professor at the Johns Hopkins Bloomberg School of Public Health.

Parents should understand that no matter how tall their son has sprouted or how grown-up their daughter dresses, "they are still in a developmental period that will affect the rest of their life," Johnson told LiveScience

9. The growing brain. Scientists used to believe the greatest leap in neuronal connections occurred in infancy, but brain imaging studies show that a second burst of neuronal sprouting happens right before puberty, peaking at about age 11 for girls and 12 for boys.

The adolescent's experiences shape this new grey matter, mostly following a "use it or lose it" strategy, Johnson said. The structural reorganization is thought to continue until the age of 25, and smaller changes continue throughout life.

8. New Thinking Skills. This increase in brain matter allows the teenager to become more interconnected and gain processing power, Johnson notes.

If given time and access to information, adolescents start to have the computational and decision-making skills of an adult. However, their decisions may be more emotional than objective because their brains rely more on the limbic system (the emotional seat of the brain) than the more rational prefrontal cortex.

"This duality of adolescent competence can be very confusing for parents," Johnson said, meaning that sometimes teens do things, like punching a wall or driving too fast, when, if asked, they clearly know better.

Sound familiar?

7.  Teen tantrums. While teens are acquiring amazing new skills during this time, they aren’t that good at using them yet, especially when it comes to social behavior and abstract thought.

That’s when parents can become the proverbial guinea pig. Many kids this age view conflict as a type of self-expression and may have trouble focusing on an abstract idea or understanding another's point of view.

Particularly in today’s heavy media influenced world, teens are dealing with a huge amount of social, emotional and cognitive flux says Sheryl Feinstein, author of Inside the Teenage Brain: Parenting a Work in Progress (Rowman and Littlefield, 2009.)

That’s when they need a more stable adult brain (parents) to help them stay calm and find the better path.

6. Intense emotions. Remember the limbic system mentioned earlier (the more emotional part of the brain)? It’s accelerated development, along with hormonal changes, may give rise to newly intense experiences of rage, fear, aggression (including towards oneself), excitement and sexual attraction.

Over the course of adolescence, the limbic system comes under greater control of the prefrontal cortex, the area just behind the forehead, which is associated with planning, impulse control and higher order thought.

As teens grow older, additional areas in the brain start to help it process emotions and gain equilibrium in decision-making and interpreting others. But until that time, teens can often misread parents and teachers Feinstein said.

5. Peer pressure. As teens become better at abstract thinking, their social anxiety begins to increase.  Ever wonder why your teen seems obsessed with what others are thinking and doing?

Abstract reasoning makes it possible to consider yourself from the eyes of another. Teens may use this new skill to ruminate about what others are thinking of them. In particular, peer approval has been shown to be highly rewarding to the teen brain, Johnson said, which may be why teens are more likely to take risks when other teens are around.

Friends also provide teens with opportunities to learn skills such as negotiating, compromise and group planning. "They are practicing adult social skills in a safe setting and they are really not good at it at first," Feinstein said. So even if all they do is sit around with their friends, teens are hard at work acquiring important life skills.

4. Measuring risk.  "The brakes come online somewhat later than the accelerator of the brain," said Johnson, referring to the development of the prefrontal cortex and the limbic system respectively.

At the same time, "teens need higher doses of risk to feel the same amount of rush adults do," Johnson said. Not a very comforting thought for parents.

This is a time when teens are vulnerable to engaging in risky behaviors, such as trying drugs, sex, getting into fights or jumping into unsafe water.

So what can a parent do during this risky time? "Continue to parent your child." Johnson said. Like all children, "teens have specific developmental vulnerabilities and they need parents to limit their behavior," she said.

It’s when being a parent to your child instead of trying to be their “friend” is more difficult but much more important for their physical and emotional safety.

3. Yes, parents are still important. According to Feinstein, a survey of teenagers revealed that 84 percent think highly of their mothers and 89 percent think highly of their fathers. And more than three-quarters of teenagers enjoy spending time with their parents; 79 percent enjoy hanging out with Mom and 76 percent like chilling with Dad. That’s not 100%, but it’s probably more than you thought.

One of the tasks of adolescence is separating from the family and establishing some autonomy, Feinstein said, but that does not mean a teen no longer needs parents – even if they say otherwise.

"They still need some structure and are looking to their parents to provide that structure," she said. "The parent that decides to treat a 16 or 17 year old as an adult is behaving unfairly and setting them up for failure." 

Listening to your teen and being a good role model, especially when dealing with stress and the other difficulties life can present, can help your teen figure out their own coping strategies.

2. Sleep. Ah, yes, sleep. Although teens need 9 to 10 hours of sleep a night, their bodies are telling them a different story. Part of the problem is a shift in circadian rhythms during adolescence: It makes sense to teen bodies to get up later and stay up later, Johnson said.

But due to early bussing and class schedules, many teens rack up sleep debt and "become increasingly cognitively impaired across the week," Johnson said. Sleep-deprivation only exacerbates moodiness and cloudy decision-making. And sleep is thought to aid the critical reorganization of the teen brain.

"There is a disconnect between teen’s bodies and our schedules," Johnson said.

Shutting down the electronics an hour before bedtime has been shown to help teens as well as adults get to sleep quicker and sleep better. No computer, TV, video games or cell phones.

1.The “I am the Center of the Universe” syndrome. You may have noticed that your teen’s hormones are causing quite a bit of havoc. Experts say that’s to be expected. But you may still wonder- what the heck is going on with my kid?

The hormone changes at puberty have huge affects on the brain, one of which is to spur the production of more receptors for oxytocin, according to a 2008 issue of the journal Developmental Review.

The increased sensitivity caused by oxytocin has a powerful impact on the area of the brain controlling one’s emotions. Teens develop a feeling of self-consciousness and may truly believe that everyone is watching him or her. These feelings peek around age 15.

While this may make a teen seem self-centered (and in their defense, they do have a lot going on), the changes in the teen brain may also spur some of the more idealistic efforts tackled by young people throughout history.

"It is the first time they are seeing themselves in the world," Johnson said, meaning their greater autonomy has opened their eyes to what lies beyond their families and schools. They are asking themselves, she continued, for perhaps the first time: What kind of person do I want to be and what type of place do I want the world to be?

Until their brains develop enough to handle shades of grey, their answers to these questions can be quite one-sided, Feinstein said, but the parents' job is to help them explore the questions, rather than give them answers.

And there you have it. Teen’s brains are exploding with new data, confusing signals and dueling desires. It’s a tough time in one’s development- but rest assured, what you teach them by example and compassion as well as how you gingerly help guide them will last a life-time. Even when you do the best you can, there are no guarantees that they will turn out the way you’re hoping they will – they are after all- individuals with a will and a mind of their own. But now you know a little more about why your teen acts the way they do.

Story Source: Robin Nixon, http://www.livescience.com/13850-10-facts-parent-teen-brain.html

Your Teen

Parenting Style And Teen Drinking

2.00 to read

Researchers at Brigham Young University have found that teenagers who grow up with parents who are either too strict or too indulgent tend to binge drink more than their peers. A new study suggests that your child could become a binge drinker depending on your parenting style. For teenagers, friends play a big role in the decision to take that first drink. And by the 12th grade, more than 65 percent of teens have at least experimented with alcohol. But what parents do during the high school years can also influence whether teens go on to binge drink or abuse alcohol. Researchers at Brigham Young University have found that teenagers who grow up with parents who are either too strict or too indulgent tend to binge drink more than their peers. "While parents didn't have much of an effect on whether their teens tried alcohol, they can have a significant impact on the more dangerous type of drinking," says Stephen Bahr, a professor of sociology at BYU, and the author of the study that was published in the Journal of Studies on Alcohol and Drugs. As part of the survey of 5,000 teenagers, Bahr and his colleagues asked 7th- to 12th-grade students a series of questions about their alcohol use. "We asked how many had taken five or more drinks in a row in the past two weeks," says Bahr. That's the typical definition of binge drinking. They also asked the kids about their parents: What kinds of rules did they have? Did their parents know where they were on weekends? Did their parents check up on their whereabouts and set curfews? How much oversight and monitoring was typical? The teens who were being raised by so-called indulgent parents who tend to give their children lots of praise and warmth — but offer little in the way of consequences or monitoring of bad behavior — were among the biggest abusers of alcohol. "They were about three times more likely to participate in heavy drinking," says Bahr. The same was true for kids whose parents were so strict that no decision was left to the teenager's own judgment. "Kids in that environment tend not to internalize the values and understand why they shouldn't drink," says Bahr. They were more than twice as likely to binge drink. Striking The Right Balance The parenting style that led to the lowest levels of problem drinking borrowed something from each of the extremes. From the strict parents: accountability and consequences for bad behavior. From the indulgent parents: warmth and support Bahr says these parents tend to be more balanced. "They recognize their kids when they do good things and praise them, but they offer direction and correction when they get off a little bit," he says. Lots of factors contribute to teenagers' experimentation with alcohol and drugs. Genes play a significant role, as do peer relationships. And the teenage years can be adversarial. "Parents get really frustrated with teenagers," says Aimee Stern, who has written “Delaying That First Drink: A Parents’ Guide.”  “I have two of them — and you can't tell them anything they don't already know." That's why it's important to start talking to kids about alcohol when they're young — as early as fourth grade, recommends Stern. Her free book, published by the American Association for the Advancement of Science, is intended as a teaching tool for parents and contains plenty of evidence-based information on drinking and addiction. It explains the science of alcohol, both in terms of what it does to the body and the developing brain. The guide can be used as a companion to a series of Science Inside Alcohol lessons developed by AAAS or as a stand-alone tool that parents can use in talking with their children. More information about Aimee Stern’s free book “Delaying That First Drink: A Parent’s Guide”  is at http://www.aaas.org/news/releases/2010/0927alcohol_book.shtml.

Daily Dose

Teens, Sun and Acne

Teens using acne medication need to take extra care of their skin during the sunny months.With the sun beating down on many us, this seems like the beginning of  a long, hot summer. I am already seeing kids with sunburned shoulders and noses, and this brings to mind all of my teenage patients who are using products, both OTC and prescription, for treatment of their acne.

Although I discuss sun protection with teens throughout the year, summer is an especially important time to re-iterate the risk of sunburn and sun damage, especially for those who are using acne products. While I was growing up (many moons ago), we all thought that baking our faces in the sun helped with pimples and acne. In fact, you may see some improvement in a teens “pimply” skin after they have been in the sun, but at what cost? According to the American Academy of Dermatology, 80% of lifetime sun exposure occurs before the age of 18.  Blistering sunburns before the age of twelve (think about those peeling noses) and freckles before age 12 are both signs that too much sun exposure has happened. Many teens use over the counter products containing glycolics, lactic acids and salicylic acid products.  These products promote exfoliation (peeling) of the skin which results in more sun sensitivity. Teens are also often prescribed a group of drugs called retinoids that are applied topically to control acne.  The most common names are Retin-A, Differin (a retinoid analog), Tretinoin (generic), Renova, Tazorac, and combination products like Ziana, and Epiduo. These products cause exfoliation of the top layer of the skin which initially causes increased sun sensitivity, but after about the first 30 days of using these products you actually get thickening of the skin and therefore will have minimal to no increase in sun sensitivity as long as you are not getting red, dry or irritated from these products. I typically do not begin a teen on a retinoid product during the summer months if they are planning significant sun exposure. Procedures such as micro-dermabrasion and peels will also cause increased sensitivity early on. Due to the above statements it  is important that teens using topical ( as well as oral) acne products apply a daily facial sunscreen.   Products such as Oil of Olay Complete 15 or Complete Defense 30, or Neutrogena Dry Touch #30 are both inexpensive and well tolerated. When buying a facial sunscreen you want to make sure that the product says “non-comedogenic, non-greasy, non-irritating and broad-spectrum (UVA/UVB) coverage. For sun exposure at the pool/beach/sporting activities etc. I would use a higher sunscreen product like Neutrogena Dry Touch 55. You want to apply these to the face 30 minutes prior to sun exposure.  Make sure that you are using more than enough sunscreen on the face, squirt out enough that it looks like you have too much and just keep rubbing it on until it disappears. We are all guilty of applying too little sunscreen when using these products. Rule of thumb is a shot glass full of sunscreen can cover the whole body, but also needs to be reapplied every 2 hours. Lastly, hats and sun protective clothing definitely have a place in preventing sun damage to teens faces. These are especially useful for teens who may be lifeguarding, working on outdoor projects, or spending long hours with continuous sun exposure. Do not allow your teens to tan in a tanning booth either as this is even WORSE than tanning outdoors. If you do get a facial sunburn try mixing 1 part vinegar to 4-6 parts water to make a solution. Chill the solution and use a well soaked washcloth to apply to affected areas. Ibuprofen is also more effective for pain relief and inflammation than acetaminophen. Frequent moisturization as well as the use of a OTC topical steroid cream may also ease the symptoms, but the skin damage has already been done. With good sun protection, and a little planning a head, most teens can continue to use their acne treatment products. That's your daily dose for today.  We'll chat again tomorrow. Send your question or comment to Dr. Sue now!

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