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Teens, Vaccines and Other Adolescent Health Matters

Wednesday, April 24, 2013 - Campus News - Contact Theresa Green, (405) 833-9824

A teenagers' world can be fraught with challenges, both physical and emotional; and helping your teen stay healthy starts with knowledge.

"Parents often look to their pediatricians for advice to help keep their children healthy when they are young, but as children become teens, those visits to the doctor's office can become less frequent. Yet, they are still just as important," said Dr. Philip Rettig, an adolescent medicine specialist with OU Children's Physicians.

Annual Health Checks
Rettig pointed out that there are many health issues that can crop up in the teen years, everything from acne to high blood pressure, from concerns about normal puberty to new emotional and behavioral issues, from athletic injuries to menstrual disorders. That's why continued, regular visits to the doctor's office can be so beneficial.

Rettig pointed out that as youth mature and assert more independence, they are sometimes more reluctant to share health concerns with parents. So having a physician in whom they can confide is helpful.

Adolescence also is a good time to help teens begin to take more control of their health. For instance, you can encourage them to start scheduling their own doctors' appointments and to ask their own questions at those visits. It's also important to help them learn to take their medications as directed.

Rettig said that just as in earlier childhood, vaccinations are important in the teen years.  Having all the vaccines required to enter school is no longer equal to being "up to date" for preteens and teens. Several new vaccines which provide safe and effective protection  against infections that are significant threats to teens are now recommended starting at ages 11 to 12 years

However, recent research by Dr. Paul Darden, a colleague at OU Medicine, looked at why many teens are still not getting the recommended vaccinations.

"Since 2005, three new vaccines recommended for adolescents have been licensed and approved for use but we are not achieving our national goals," said study author Dr. Paul Darden of the Department of Pediatrics, OU College of Medicine. 
?The three vaccines are Tdap (tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine), a vaccine for meningitis - MCV4 (quadrivalent meningococcal conjugate vaccine), and the vaccine for HPV (human papilloma virus).

A third or more of teens have not received the Tdap or MCV4 vaccines. About two thirds have not been vaccinated against HPV, which has also been recommended for adolescent boys for the past two years. Researchers found the low rate of HPV immunization particularly concerning.

"HPV is a vaccine that prevents cervical cancer, a serious health condition in women. So it's worrisome that adolescents are not getting the HPV vaccine," Rettig said.

Currently, in Oklahoma, only the Tdap vaccination is required for all seventh and eighth grade students as of the fall of 2012.  The meningitis and HPV vaccines, though recommended, are not mandatory.

Darden and his colleagues believe the study points to the importance of better educating families, teens and health care providers about the safety and effectiveness of vaccines.

Acne is a frustrating reality in the teen years for most. In fact, eight in every ten teens experiences some degree of acne.

"Acne is not caused by eating chocolate or fried foods," Rettig said. "It's actually caused by increased levels of certain hormones and so is a common occurrence in adolescence."

When those levels increase fat glands in the skin are stimulated and begin producing more sebum, an oily secretion that lubricates and protects the skin. With acne, sebum combines with dead skin cells and other debris, blocking follicles in the skin and causing blackheads and pimples.

The good news is there are a growing number of treatments, both over-the-counter and prescription, available to help teens with acne issues. Your health care provider can help you find the right treatment for you.

Menstrual Disorders
Up to two-thirds of teen-age girls will consult a physician during their teen years with a concern about their periods: not yet having them, having them infrequently, having them excessively, or having severe cramps or other menstrual symptoms.  Consultation with a physician familiar with normal adolescent development and these issues will help the adolescent female and her parent(s) deal with the frequent "normal" variations,  and treat and diagnose the uncommon medical problems that can lead to these symptoms.

Substance Abuse
It is during the teen years when many first experiment with illicit drugs or alcohol. That's why the American Academy of Pediatrics now recommends that pediatricians provide both substance abuse education and screening during routine clinical care.

Sadly one-fourth of those who use illicit drugs between the ages of 12 and 17 will develop dependency. It's still unclear why some teens can flirt with alcohol or drug use and then just stop, while others become addicted.

What is known is that family history increases a child's risk.  Other risk factors include:
- Untreated psychological conditions such as depression or anxiety
- Thrill-seeking behavior
- An eating disorder
- Associating with known drug users
- Lack of parental supervision
- Physical or verbal abuse in the home

The greater the number of risk factors, the greater the risk for alcohol or substance abuse.  If you have concerns, talk to your teen, but come to the conversation well informed.  The U.S. Department of Education recommends that parents know the following facts:
- The different types of drugs and their street names
- What each drug and any associated paraphernalia look like
- The physical and behavioral signs of drug abuse
- How to get your child help if you suspect a substance abuse problem

To have questions about your teen's health answered, Dr. Rettig will be available for a live chat on Friday, April 26th at noon at

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