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Ask the DocDr. Davis Smith is an internist practicing in Connecticut and at Trinity College in Hartford. He specializes in the care of adolescents and GLBTQ patients. |
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Q: What is the best way to treat chest and back acne?
-Jon, Elmhurst College
A: Jon,
Every day, your skin sheds dead skin cells, and these can mix with sebum and plug your hair follicles. Sebum is a normal secretion and is what makes hair waxy or oily if it isn’t washed regularly. The number of sebaceous glands and their productivity increases with adolescence, in response to hormonal shifts.
Acne develops when the glands beneath the plug continue to produce their normal amounts of sebum, but because it can’t get out, it accumulates beneath the surface. Glands that are not plugged continue to produce sebum as well, and this promotes bacterial overgrowth. When the sebum that has collected under the surface gets infected by these bacteria, the cells of the hair follicle get even more inflamed and can rupture. This causes a pimple. Acne is the medical name for these inflamed pustules.
Medications to prevent and treat acne act using one of two mechanisms:
Some do one or the other, while others do both. For more extensive and inflammatory cases of acne, combining two antibiotics, or an antibiotic and an anti-plugging agent, tends to be more effective than using just one. Medications can be applied as a lotion, cream, or gel.
Medications to treat acne are readily available over the counter, meaning without a prescription. These can be very effective for limited, mild cases. The best known of these is benzoyl peroxide, a topical antibiotic, which comes in several strengths, usually ranging from 2 to 10 percent.
Salicylic acid is also available over the counter in strengths ranging from 0.5 to 2 percent. This medication is a chemical exfoliant; it helps remove dead cells from the surface of skin, and can help unplug follicles and reduce inflammation. You may find it to be more effective in combination with benzoyl peroxide than on its own.
In a small study, tea tree oil, a naturally occurring substance that works both as an antibiotic and to control inflammation, was found to be about equally effective as applications of a 5 percent benzoyl peroxide product, but the tea tree oil took longer to begin helping.
Some people need the help of prescription medications to manage their acne. Topical antibiotics-such as benzoyl peroxide (in strengths not available without a prescription), clindamycin, and erythromycin-treat bacterial infections in plugged hair follicles. Sometimes clindamycin and erythromycin are packaged together for extra efficacy.
Oral antibiotics, such as tetracycline and trimethoprim-sulfamethoxazole (among others), also treat infection. They are useful for acne that covers a larger area or is difficult to reach and cover with a topical treatment, such as on the back or chest.
Lastly, there are also medications to control follicular plugging, such as topical and oral retinoids. The more inflamed and widespread your acne, the more likely this type of treatment will be necessary, at least initially. Severe cases may require the oral retinoid isotretinoin, which many people know by its brand name, Accutane®. Accutane® itself is not produced anymore, but other manufacturers make the same drug.
There are many potential side effects of treatment, with dryness and irritation among the most common. Acne care needs to be individualized, and because of the lifecycle of hair follicles, it may take up to eight weeks to start seeing the benefits. This can be very frustrating. Stick with your regimen for at least that length of time before trying something new.
If the usual approaches are unsuccessful, a dermatologist may be able to offer additional options, such as light or laser therapy. Campus health center practitioners specialize in the health of young adults and are typically expert in the management of acne.
The following resources have additional information:
American Academy of Dermatology, Acne
Up to Date, Acne (Beyond the Basics)
National Institutes of Health, MedlinePlus, Acne
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Ask the ProfessorAmy Baldwin, M.A., is the chair of college studies at Pulaski Technical College in Arkansas. |
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Q: How can I make better use of my study time?
-Erin, Aquinas College
A: Erin,
Ah, to get through college without having to study…Well, it isn’t going to happen, but there are ways to make the time spent studying more useful and maybe even enjoyable.
Here are my top five tips:
Strategies suited to different classes or for help taming your inner procrastinator.
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Ask the CounselorPeter Welch, M.A., is a wellness educator and counselor at the University of New Hampshire. |
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Q: How happy should a person be?
-Susanna, Binghamton University, The State University of New York
A: Susanna,
What a wonderful and compelling question. Happiness is a topic that has been extensively researched, and from this the field of positive psychology has evolved.
Here are a few things about happiness that we now know:
Sometimes it seems like happiness is a commodity or a lofty goal marked by constant smiling and no bumps in the road. But real happiness is more like feeling content or satisfied: Living a meaningful and purposeful life. Our choices, thoughts, and deeds can all influence our personal level of satisfaction.
To maximize your experience of happiness, try these tips:
As the Dalai Lama says, “If you want others to be happy, practice compassion. If you want to be happy, practice compassion.”
Keep in mind that living a satisfied life requires that we experience a full range of emotions-including sadness, anger, frustration, and confusion-in addition to pleasure, playfulness, and joy. Without the contrast between these feelings, we wouldn’t fully know happiness. As it’s said, without darkness, there is no light.
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Ask the TrainerFrankie Romeo is a certified personal trainer, small group training coach, and student at Virginia Polytechnic Institute and State University. |
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Q: How can I avoid shin splints?
-Emily, Rollins College
A: Emily,
The tibia, typically referred to as the shin, is the weight-bearing bone in your lower leg. Repetitive impact on the tibia can result in inflammation and injury, particularly of the muscles and connective tissue around the shin and toes, and these are often called “shin splints.” They’re common in many athletes, runners, and sometimes others who are new to physical activity.
Here are three suggestions to help you avoid injury to your shins:
More about preventing shin splints.
By Theresa Ketterling
Grocery shelves are packed with “nutrition bars” these days. They typically contain:
These bars differ from granola or snack bars in that they have much higher quantities of protein and calories, and often claim to include various vitamins and minerals.
Meal-replacement bars are commonly advertised as weight-loss aids. Eating one every once in a while won’t hurt, but they don’t replace balanced meals, and diarrhea is a common side effect of eating too many. Plus, they tend to be expensive and taste a bit like cardboard.
Here are some affordable and portable alternatives:
By Theresa Ketterling
The idea behind the Paleo diet is this: Our bodies weren’t designed to digest the large quantity of grains, dairy, salt, and sugar that are typical these days. Instead, the staples of a Paleo plate are meat, fish, vegetables, fruit, and nuts-all foods which were available to our Stone Age ancestors. That period ended about 10,000 years ago, but proponents of Paleo-style eating say it prevents health concerns like diabetes and heart disease.
Katharine Milton, a physical anthropology professor at University of California Berkeley, suggests eating more fruits and vegetables, rather than increasing your protein intake. A healthy meal might consist of meat or fish and steamed or raw veggies. Eggs are a popular choice, with minimal inclusion of breads and pasta.
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National Cancer Prevention Month
Random Acts of Kindness Week 10-16
National Eating Disorders Week 23-March 1
