Some young teens avoid the commonly accepted routines of personal care: regular showers, twice-a-day teeth brushing, clean socks and underwear. Although your child's body is maturing (she menstruates, she sweats, and her skin is oilier), she may decide that she doesn't want to shower more than twice a week. In fact, twice a week is the average for early teens. Some shower less often, particularly boys.
What are parents to do? As with most everything else during this phase of your child's life, accept that she can make more decisions on her own, and negotiate, don't demand. It's her changing body, after all. Offer to pick up a favourite shampoo. Stock up on deodorizing insoles, and when the TV room takes on the odour of smelly feet, suggest that your teen use them.
The aversion to soap and water is of relatively short duration in a teen's life. By the time they're fourteen or so, most girls would no more go out of the house with greasy hair than they would go to school with a bag over their head. Boys may avoid soap and water a little longer, but by about age sixteen, they no longer fight the daily shower. Share the following information with them.
Sweat glands are activated during puberty, producing a substance that interacts with bacteria to cause body odour. Body odour occurs mostly in the underarms, around the genitals, and in the feet. Physical exertion and psychological stress can cause sweating. Lots of teenagers get clammy hands or break out in a sweat when they're nervous. Deodorants (designed to mask odour) and antiperspirants (designed to mask odour and prevent wetness) can help, although they're not a replacement for regular bathing, as some teens seem to think. Letting the body cool down after a hot shower before applying deodorant or antiperspirant will make either more effective.
Most teenage boys start showing facial hair between the ages of fourteen and sixteen. The first growth is usually on the outer edges of the upper lip. Moustaches fill in toward the centre. Soft hair on the upper cheeks and just below the centre of the lower lip appears next. Sideburns may also grow at this time. Chin hair grows in last. With your teen's maturation, his facial hair grows thicker and darker.
Some young men show the full extent of their potential beard by the time they're eighteen. Others don't develop their full facial beard until ten years after puberty. A young man's first razor is an important rite of passage that acknowledges his transition to a new stage of maturity. Some teens have to shave every day; others rarely need to pick up a razor. Both are normal.
For girls, shaving is also a rite of passage. Girls often begin shaving their legs and underarms as soon as the hair grows in during puberty. Since shaving does not affect the rate of hair growth or how thick it becomes, you might just respect your daughter's choice.
When they take on responsibility for remembering to brush and floss their teeth, teens can sometimes get lax about dental hygiene which can lead to bad breath and cavities. Between the ages of thirteen and sixteen, a teen's teeth are particularly prone to cavities.
You may have to continue to remind your teen to brush and floss his teeth, but beware too much nagging can be counterproductive. But one measure you can take is to keep making regular appointments for him; your dentist and dental hygienist can reinforce the advantages of regular daily brushing and flossing as a means of avoiding other treatments on either teeth or gums in later years.
The hormonal changes of puberty increase production from the oil glands in the skin of the face, scalp, neck, chest, and back, which means that many teens develop acne. The glands of the hair follicles in the skin produce an oily substance (sebum) that combines with dead cells and tiny hair remnants to plug the follicle. Under the skin surface, the plug forms a bump, a whitehead. If the plug opens to the skin surface, it darkens to form a blackhead. If the wall of the plugged follicle ruptures, the area becomes a red and swollen bump. If the follicle wall breaks near the skin surface, it may become a pimple. If the follicle wall breaks beneath the skin, cysts can form, which may cause scarring.
Acne tends to run in families, and occurs most commonly between the ages of fourteen and seventeen. For some teens, it may last for a year or two. For others, acne persists throughout their teenage years. Acne is common in both genders, but boys may suffer more severely because they have more skin oils. Girls often find that their acne flares at certain points in their menstrual cycle because of hormone activity. Although some people believe that chocolate, greasy snacks, and salty foods can aggravate acne, there is no scientific evidence to support the belief. However, if you notice that certain foods aggravate your teen's acne, then eliminating them might help.
There are no foolproof cures for acne, but every case can be treated and improved. lt's important to seek medical help early to avoid scarring. If your teen has acne, consult your family doctor, who may refer you to a dermatologist. Topical treatments are effective for a lot of teens, as are systemic antibiotics for others. For milder cases, washing all the areas affected by acne no more than twice a day with a special soap can help. Washing too often can irritate the skin, causing more outbreaks. Girls with acne should avoid perfumed and oil- or alcohol-based makeup and facial lotions.
There are different treatments available that bring improvement within a few weeks or months. Be prepared to stay with a treatment for at least two months before deciding it doesn't work. Acne treatments are meant to prevent future outbreaks rather than clear up the pimples that have already occurred.
Benzoyl peroxide is available as a cream, gel, lotion, or soap, and can be bought without a prescription, but your doctor should recommend the most suitable strength and frequency for your teen's type of acne.
Antibiotics: Your doctor may prescribe an oral antibiotic, or one available in cream (least drying), lotion (less drying), or gel (most drying) form. For them to be effective, your teen must follow closely the directions for use.
Tretinoin (Retin-A, Stieva-A) is applied to the skin once daily. With this treatment, the skin may appear to get worse before it gets better, usually in several weeks. The teen must avoid the sun or use a strong sunscreen during treatment.
Isotretinoin (Accutane) is usually prescribed to treat severe cases of acne, particularly cystic acne. Although this treatment is very effective, a young woman should know that if she becomes pregnant while under treatment, the drug can cause a miscarriage or birth defects.
Tattoos and body piercing
A glance around most high-school cafeterias will confirm that tattooing and body piercing are popular features of teen culture. If your teen wants to undergo one of these procedures, ensure that the decision she makes is an informed one because all body piercing and tattoos involve some risk to health and require regular maintenance.
Your teen must consider whether or not she'll be able to deal with any lifestyle changes that may result. During the healing time for a bellybutton piercing, for example, she may not be able to sleep in certain positions or wear certain clothes. If she chooses to have lip or tongue piercing, she may find it painful to eat or speak until it's healed. A piercing could also affect her participation in her favourite sports: Some kinds of piercing will be snagged during contact sports; during the healing period, she won't be able to remove a bellybutton ring to go swimming. If she gets an eyebrow ring or a visible tattoo, will it affect her chances of getting a job?
You might suggest that your teen first try a removable tattoo or a clipon ring for nose, lip, or bellybutton. These are less expensive, pose few health risks, and are widely available in many fashion accessory stores. If your teen decides to proceed, make sure that he chooses a reputable tattoo or piercing parlour. If he is under eighteen, most parlours will refuse to serve him without your written permission or without speaking to you in person.
You or your teen should make sure that the technician is qualified and that the parlour is clean. Inquire about safety procedures: All needles, forceps, and similar equipment should come from a sealed, sterile package and not be re-used. Inquire about the kind of jewellery to be inserted in the opening; to reduce infection, all body jewellery for new piercing should be 316L or LVM surgical stainless steel, solid gold (14K or higher), niobium, or titanium. The technician should also provide written instructions about any after-care required to avoid infections. The healing time for most piercing ranges from several weeks to a year or longer.
Solo health care
Your children are ready to take charge of their own health care when they're mature enough to ask questions of all health-care providers and to comprehend and deal in a responsible fashion with the information provided. In order to build a trusting relationship with your adolescent, the doctor will usually make a point to mention that their discussions will remain confidential.
In most Canadian provinces and territories, children as young as twelve can choose not to have their parents accompany them either when they go to their doctor or when they go into the doctor's examining room. They may also consent to a treatment if doctors believe them capable of understanding the implications of the treatment. In Quebec, the age is fourteen years and older, and parents have to be informed if the youth is admitted to hospital for more than twelve hours.
At the Children's & Women's Health Centre of British Columbia in Vancouver, health-care professionals say that children aged twelve and older are capable of deciding whether they want to pursue a recommended treatment. This policy grew out of the efforts of health professionals to deal with sexually transmitted diseases (STDs). If the matter is debatable, the case may go to the hospital's Ethics Committee.
Parents should have begun talking with their children at an early age about all aspects of bodily health so that nothing develops into a taboo subject between them. Single parents need to inform themselves about the health concerns of their opposite-sex child. Most kids want to talk to their parents about personal health issues that concern them; they just don't want to get a lecture. When it seems to you that your children are mature enough to handle a visit to the family doctor on their own, discuss with them whether they would like you to accompany them or to remain in the waiting room. Let them know that you respect their privacy, and that you'll understand if they want their discussion with the doctor to be private. You may still talk separately with the doctor about your own concerns after the examination.
A teenage girl by age eighteen or earlier if sexually active should include a Pap smear in her annual physical. This is a short and simple test to detect possible cancerous cells in the cervix. Because cells undergo a series of changes before they become cancerous, the analysis of the Pap smear will reveal any precancer cell changes. To ensure greater accuracy of test results, a woman should not douche, should not use birth control creams or feminine deodorants for 48 hours before the appointment, and should not have sexual intercourse for 24 hours before her physical.
Ensure your daughter understands how her doctor will obtain the sample of cervical cells for the test. She will insert the instrument called a speculum into her vagina to open it wide enough to touch the cervix with the tip of a cotton swab, transfer the sample to a glass slide, and send it to a laboratory to be analyzed for abnormalities.
Although Pap smears are not 100 per cent accurate, the procedure has greatly reduced the number of deaths from cervical cancer detected too late for treatment. When the Pap test results are positive, it means that abnormal cells are present 95 per cent of the time. If the results are positive, your doctor will want to discuss the implications of the cell changes and the necessary treatment. Abnormal cells on the cervix indicate not only cervical cancer but also infections such as herpes and human papilloma virus (Hpv).
Some teens may want to establish a routine of monthly self-examinations for signs of problems. Although breast cancer is very rare among women under twenty, teenage girls who perform regular exams of their own breasts will become familiar with the exercise and the feel of a normal healthy breast. Your daughter should do this while sitting or standing, and use a circular, massaging motion with one hand over the breast and her other arm raised above her head. If she has any concerns, she should discuss them with her doctor.
Boys in their late teenage years might also learn to do a regular check for testicular cancer, which is very rare at this age. They should check each of their testicles individually for the presence of a lump, soreness, or tenderness, and discuss any concerns (abnormal lumps, discharge from the penis) with their doctor.
Excerpted from Understanding Your Teen: Ages 13 to 19 by Christine Langlois. Copyright 1999 by Telemedia Communications Inc. Excerpted, with permission by Ballantine Books. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.