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Back to the November Issue

November 2012 Health Bulletins

Ask The Doc
Get Out The Vote
Drooping in Your Soup?
Flu Shots
Feel Good About Your Body
Submit Your Photos
Health and Wellness Events

Ask the Doc

Dr. Davis Smith answers questions submitted by our readers.

Q: What is the best way to treat chest and back acne? - Jon J., Elmhurst College

A: 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 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 infl amed and can rupture. This causes a pimple. Acne is the medical name for these infl amed pustules.

Medications to prevent and treat acne act using one of two mechanisms:

1. Preventing follicles from plugging;
2. Controlling bacterial growth and infection (an antibiotic).

Some do one or the other, while others do both. For more extensive and infl ammatory cases of acne, combining two antibiotics, or an antibiotic and an anti-plugging agent, tends to be more eff ective 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 eff ective 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 infl ammation. You may fi nd it to be more eff ective 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 infl ammation, was found to be about equally eff ective 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 diffi cult 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 infl amed 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 eff ects 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 benefi ts. 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 off er additional options, such as light or laser therapy. Campus health center practitioners 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

Get Out The Vote

November 6th is Election Day. This year, there’s the presidency, plus many state and local positions - and ballot initiatives - up for vote. Elections are an important time to get involved with your community, no matter whether you’re voting or not. You can discuss the issues with peers, volunteer for a campaign, or support voter registration efforts. Are there elections on your campus for leadership positions? Now’s a great time to think about the concept of citizenship, and what it means to you.

Drooping in Your Soup?

Feel tired after a big meal? Some believe this is because of the amino acid tryptophan, found in turkey, milk, peanut butter, and soy products, among other foods.

But you don’t get enough tryptophan through food to make you drowsy. You’re probably drooping because of post-prandial somnolence, caused by nervous system changes during digestion. So, warm milk is more soothing than truly sleep inducing, and that big meal has simply filled your stomach. If you are very tired before or after a meal, have your blood sugar checked.

Flu Shots

Flu is short for seasonal influenza, a virus that causes a cough, sore throat, runny or stuffy nose, body and headaches, fatigue, and possibly a fever/chills and stomach distress. The symptoms can affect you for 1-2 weeks.

Flu is spread when an infected person coughs, sneezes, or talks - starting one day before symptoms develop, and for up to 5-7 days after. On college campuses, where people live and attend classes in close proximity, the virus is transmitted easily.

The Centers for Disease Control and Prevention recommend the flu vaccine for everyone over six months old, especially if you're pregnant or have an illness or chronic health condition. Check with your health care provider about vaccine availability; many schools and pharmacies offer free or low-cost flu clinics. For more about the flu, and vaccine availability, CLICK HERE.

Whether sick or not, wash your hands frequently and practice “safe sneezing.” Cough or sneeze into your elbow, rather than your hands.

What makes you feel good about your body?

Focusing on what you appreciate about your body can help you develop a healthy body image. What inspires your body-confidence?

Doing What I Love
An hour of exercise a day involving an activity I love is unbeatable! On a recent trip to Europe, I worked out on the beaches of Barcelona, around the Eiffel Tower, and even ran with the bulls in Pamplona, Spain during a huge annual festival held there.
-Colby C.,University of Kansas

Water Sports!
Water sports! As a two-time cancer survivor, I carry scars and physical reminders of my battles, but getting out on the water before dawn to paddleboard, scull, outrigger, or dragon boat shapes my body and my mind.
-Heather S.,Tompkins Cortland Community College

Ultimate Frisbee
Playing Ultimate has gotten me into the best shape of my life. I quickly realized that I needed to gain endurance and quit smoking to remain competitive in this sport! I am in the best shape of my life, and I don't even realize I am working out when I am playing.
-Adam S.,College of Wooster

Eating Right and Exercising
Eating right and doing stretches helps make me feel good about my body. It reminds me that I should be thankful that I can do all the things I do every day without any pain or problems.
-Rainbow S., Pasadena City College

Being Active
Using it to hike, dance, swim, canoe, and kayak. I feel good about my body when I take care of it and it takes care of me.
-Michele O., Memorial University

Swing Dancing
Swing Dancing. It makes me want to keep my body moving.
-Grace Y., University of California, Irvine

Being Unique
I look at the people around me because unlike magazines and television, they accurately portray real human beings. Without a perfect standard to compare myself to, accepting how I am physically unique becomes much easier.
-Quinlynn S., Rochester Community and Technical College

Running
Running makes me feel strong and in tune with my body. The continual motion of one strong leg after another treading across the ground reminds me of how strong my legs have become. I celebrate what my body can do by running almost every day.
-Alex W., UCLA