Acne
Definition
Pimples and blackheads on the face caused by blocked oil glands
Symptoms of Acne
Whiteheads (pimples) are plugged oil glands that are closed.
Blackheads are plugged oil glands that are open. Reason: The oil turns black when it is exposed to air.
Whiteheads and blackheads are also called "zits."
Red bumps are from blocked oil glands that have leaked oil. This causes irritation in the skin around them. Larger red bumps can be quite painful.
Acne mainly appears on your face, neck, and shoulders
Causes of Acne
Acne skin changes are from plugged oil glands. Acne has several causes.
Increased levels of hormones during puberty have a part. Heredity also plays an important role.
Some skin bacteria can make it worse.
Acne is not caused by diet. You do not need to avoid eating fried foods, chocolate, or any other food.
Acne is not caused by dirt or by not washing your face often enough.
Call Doctor or Seek Care Now
Spreading red area around the acne with fever
Spreading red area or streak that's very large
Your child looks or acts very sick
Call Doctor Within 24 Hours
Spreading red area or streak around the acne, but no fever
You think your child needs to be seen
Call Doctor During Office Hours
Tender red lumps that are large occur
Yellow soft scab that drains pus or gets bigger occurs
After treating with Benzoyl Peroxide (BP) for 2 months, acne not improved
BP makes the face itchy or swollen
You have other questions or concerns
Self Care at Home
Mild acne
Care Advice
What You Should Know About Acne:
More than 90% of teenagers have some acne. Acne is a normal part of the teen years.
There is no medicine at this time that will cure acne.
However, good skin care can keep acne under control and at a mild level.
Here is some care advice that should help.
Benzoyl Peroxide Gel:
Benzoyl Peroxide (BP) is the best OTC medicine for bringing acne under control. Use a Benzoyl Peroxide 5% gel product (such as the store brand). OTC means no prescription is needed.
It helps to open pimples and to unplug blackheads. It also kills bacteria.
Apply the lotion once a day at bedtime to the area with acne. Redheads and blonds should apply it every other day for the first 2 weeks. Reason: More sensitive skin.
Use an amount of lotion the size of a pea. This should be enough to cover most of the acne.
If the skin becomes red or peels, use less of it. Other option: You can use it less often.
Caution: Avoid the corners of the eyes, nose and mouth. Reason: These areas are very sensitive.
Caution: Benzoyl Peroxide bleaches clothing, towels, blankets, etc. Apply it only at bedtime and put it on sparingly. Use a plain white pillowcase.
Antibiotics for Red Bumps:
Large red bumps mean the infection has spread beyond the oil gland. If you have several red bumps, your doctor may prescribe an antibiotic.
Antibiotics come as solutions for the skin or as pills.
The antibiotic will kill the bacteria that are causing the infection.
Give the antibiotic as directed.
Washing the Face:
Wash your skin twice a day. The most important time to wash is bedtime. Just use warm water or you can use a mild soap (such as Dove).
Shampoo your hair daily.
Avoid scrubbing your skin. Reason: Hard scrubbing of the skin irritates the openings of the oil glands. This causes them to close off even more tightly.
Pimple Opening:
Opening (popping) pimples is not advised by many doctors. But, most teens and adults do it anyway.
So, here's how to open a pimple safely without any squeezing.
Never open a pimple before it has come to a head.
Wash your face and hands first.
Use a sterile needle (cleaned with rubbing alcohol). Nick the surface of the yellow pimple with the tip of the needle. The pus should run out without squeezing.
Wipe away the pus and wash the area with soap and water.
Opening small pimples in this way will not cause skin damage.
Avoid Picking or Squeezing Acne:
Many young people pick at their acne when they are not thinking about it. Picking makes acne worse.
Try not to touch the face at all during the day.
Squeezing blackheads causes bleeding into the skin. The bleeding turns into brownish blotches on the skin. They can take 1 or 2 months to fade.
Squeezing red lumps can force bacteria into the skin. This too leaves blotches. It can also cause a serious face infection.
Prevention - Avoid Triggers of Acne:
Avoid putting any oily or greasy substances on your face. Reason: They block oil glands and make acne worse. If you use cosmetics, use water-based cosmetics.
Avoid hair tonics or hair creams (especially greasy ones). When you sweat, they will get on the face and irritate the acne.
What to Expect:
With treatment, new whiteheads and blackheads will decrease. But, it takes 6 to 8 weeks.
Acne usually lasts until age 20 or 25.
So, you will need to continue the treatment for several years.
You don't need to worry about scarring. It is very rare for acne to leave any scars.
Call Your Doctor If:
With treatment, the acne has not improved after 2 months
It looks infected (large, red, tender bumps)
You think your child needs to be seen
Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Animal or Human Bite
Definition
Bite from a pet, wild animal or human
Types of Wounds
Bruise. There is no break in the skin. No risk of infection.
Scrape (Abrasion) or Scratch. A wound that doesn't go all the way through the skin. Low chance of infection. Antibiotic drugs are not needed.
Cut (Laceration). A wound that goes through the skin to the fat or muscle tissue. Some chance of infection. Most need to be seen. Cleaning the wound can help prevent this. Antibiotic drugs may be needed.
Puncture Wound. These wounds break through the skin. Greater risk of infection. Puncture wounds from cat bites are more likely to get infected. Antibiotic drugs may be needed.
Wound Infection. This is the main risk of an animal bite. The main finding is redness around the bite and pain. It starts 8 hours to 3 days after the bite. It can often be prevented by early, careful cleaning of the bite. This is why most animal bites need to be seen.
Types of Animal Bites
Large Wild Animal Bites. Rabies is a disease that can kill people. Bites or scratches from any large wild animal can pass on rabies. Animals at highest risk are bats, skunks, raccoons, foxes, or coyotes. These animals may spread rabies even if they have no symptoms.
Small Wild Animal Bites. Small animals such as mice, rats, moles, or gophers do not carry rabies. Chipmunks, prairie dogs, squirrels and rabbits also do not carry rabies. Exception: one of these small animals actually attacks a human (an unprovoked bite). Sometimes, their bites can get infected.
Large Pet Animal Bites. Most bites from pets are from dogs or cats. Bites from other pets such as horses can be handled using this guide. Dogs and cats are free of rabies in most U.S. and Canadian cities. Stray animals are always at risk for rabies until proven otherwise. Cats and dogs that always stay indoors should be safe. The main risk in pet bites is wound infection, not rabies. Cat bites become infected more often than dog bites. Cat scratches can get infected just like a bite because cats lick their claws.
Small Indoor Pet Animal Bites. Small indoor pets are not at risk for rabies. Examples of these pets are gerbils, hamsters, guinea pigs, or mice. Tiny puncture wounds from these small animals also don't need to be seen. They carry a small risk for wound infections.
Human Bites. Most human bites occur during fights, especially in teenagers. Sometimes a fist is cut when it strikes a tooth. Human bites are more likely to become infected than animal bites. Bites on the hands are at higher risk. Many toddler bites are safe because they don't break the skin.
Bat Bites and Rabies. In the U.S., 90% of cases of rabies in humans are caused by bats. Bats have spread rabies without a visible bite mark.
Animals at Risk for Rabies
Bat, skunk, raccoon, fox, or coyote
Other large wild animals
Pets that have never had rabies shots and spend time outdoors
In the U.S., rabies occurs 4 times more in cats than in dogs.
Outdoor animals who are sick or stray
Dogs or cats in countries that do not require rabies shots
In the U.S. and Canada, bites from city dogs and cats are safe.
In the U.S., there are 2 - 3 deaths from rabies per year in humans.
When To Call
Call 911 Now
Major bleeding that can't be stopped
Not moving or too weak to stand
You think your child has a life-threatening emergency
Go to ER Now
Bleeding that won't stop after 10 minutes of direct pressure
Any scratch or cut from an animal at risk for Rabies
Call Doctor or Seek Care Now
Wild animal bite that breaks the skin
Pet animal (such as dog or cat) bite that breaks the skin. Exception: minor scratches that don't go through the skin.
Puncture wound (holes through skin) from a Cat's teeth or claws
Puncture wound (holes through skin) of hand or face
Human bite that breaks the skin
Bite looks infected (redness or red streaks) or has a fever
Bat contact or exposure, even without a bite mark
Contact with a rabies-prone animal, even without a bite mark
Minor cut or scrape and no past tetanus shots
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
Last tetanus shot more than 5 years ago
You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
You have other questions or concerns
Self Care at Home
Bite did not break the skin or is only a bruise
Minor scratches that don't go through the skin from a pet
Tiny puncture wound from small pet, such as a hamster or puppy. Exception: cat puncture wound.
Care Advice
What You Should Know About Bites:
Bites that don't break the skin can't become infected.
Cuts and punctures always are at risk for infection.
Here is some care advice that should help.
Clean the Bite:
Wash all wounds right now with soap and water for 5 minutes.
Also, flush well under running water for a few minutes. Reason: Can prevent many wound infections.
Bleeding - How to Stop:
For any bleeding, put pressure on the wound.
Use a gauze pad or clean cloth.
Press for 10 minutes or until the bleeding has stopped.
Antibiotic Ointment:
For small cuts, use an antibiotic ointment (such as Polysporin). No prescription is needed.
Put it on the cut 3 times a day.
Do this for 3 days.
Pain Medicine:
To help with the pain, give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil).
Use as needed.
Cold Pack for Pain:
For pain or bruising, use a cold pack. You can also use ice wrapped in a wet cloth. Apply it to the bruise once for 20 minutes. Reason: Helps with bleeding, pain and swelling.
What to Expect:
Most scratches, scrapes and other minor bites heal up fine in 5 to 7 days.
Call Your Doctor If:
Bite starts to look infected (pus, redness, red streaks)
Fever occurs
You think your child needs to be seen
Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Athlete's Foot
Definition
An itchy rash of the feet and between the toes
Skin infection caused by a fungus
Age over 10 years
Symptoms of Athlete's Foot
Red, scaly, cracked rash between the toes
The rash itches and burns
With itching, the rash becomes raw and weepy
Often also involves the insteps of the feet
Unpleasant foot odor
Mainly in teens. Before age 10, it's usually something else.
Cause of Athlete's Foot
A fungus infection that grows best on warm, damp skin
Other health problems of Athlete's Foot
Jock Itch. A fungus infection of the groin and inner, upper thighs. Caused by the same fungus that causes athlete's foot. Transferred by a towel used to dry the feet and then the groin.
Impetigo. A local bacterial infection that starts in the cracks between the toes. Gives sores, soft scabs and pus.
Cellulitis. The bacterial infection spreads into the skin. Gives redness spreading into the back of the foot. The red area is painful to the touch.
Lymphangitis. The bacterial infection spreads up the lymph channels. Gives a red line that goes up the leg. More serious because the infection can get into the bloodstream. This is called sepsis.
When To Call
Call Doctor or Seek Care Now
Fever and looks infected (spreading redness)
Call Doctor Within 24 Hours
Looks infected and no fever
Pus drains from the rash
Foot is very painful
Call Doctor During Office Hours
You think your child needs to be seen
Rash has spread to the top of the foot
Age less than 10 years
Rash is not better after 1 week on treatment
Rash not gone after 2 weeks on treatment
You have other questions or concerns
Self Care at Home
Mild athlete's foot
Care Advice
What You Should Know About Athlete's Foot:
Athlete's foot is common in teens.
It's caused by a fungus that grows best on warm, damp skin.
Here is some care advice that should help.
Anti-Fungal Cream:
Use an anti-fungal cream (such as Lotrimin). No prescription is needed.
Use 2 times per day.
Put it on the rash and 1 inch (25 mm) beyond its borders.
Continue the cream for at least 7 days after the rash is gone.
Keep the Feet Dry:
Rinse the feet 2 times per day before using the cream.
Go barefoot or wear sandals as much as possible.
Wear socks made of man-made fibers. They will keep the feet drier and cooler than cotton. Change them twice daily.
Do Not Scratch:
Scratching infected feet will delay a cure.
Rinse the itchy feet in cool water for relief.
Return to School:
Athlete's foot is not easily spread to others. The fungus can't grow on dry, normal skin.
Children with athlete's foot do not need to miss any school. Your child may take gym and play sports.
The socks can be washed with the normal laundry. They don't need to be boiled.
Jock Itch Prevention:
The athlete's foot fungus can spread to the groin area. This is called jock itch.
The fungus can be spread by a towel or washcloth.
Therefore, after bathing, dry the groin area before the feet.
You can also use a different towel for the feet.
Do this until the athlete's foot is cured.
What to Expect:
With proper treatment, athlete's foot goes away within 2 weeks.
Call Your Doctor If:
It looks infected
Rash is not better after 1 week on treatment
Rash is not gone after 2 weeks on treatment
You think your child needs to be seen
Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Bed Bug Bite
Definition
Bites from bed bugs
Symptoms of Bed Bug Bites
Usually cause itchy, red bumps in a group or line
Often they look like a hive or mosquito bite
Bite may have a red dot (puncture) in the center. This is where the bed bug bit through the skin.
Occasionally, a small blister can occur in the center
Bites are usually on exposed skin (arms, legs and face)
Bites are usually first noted in the morning
Diagnosis of Bed Bug Bites
Live bed bugs hide and are not usually seen. Close inspection of the mattress may find some.
They are ¼ inch (6 mm), flat, oval shaped, reddish-brown bugs.
Suspect bed bugs if over 3 red bumps in a row are on exposed skin. The bumps or bites are very itchy.
Bed bug waste is found on bedding or mattress seams. It looks like dark brown flecks or coffee grounds.
A blood stain on the sheet may sometimes be found. This is from a bug smashed after feeding.
Cause of Bed Bug Bite Reactions
The skin bumps are the body's reaction to the bug's saliva.
While the bug is sucking blood, some of its secretions get mixed in.
Bed bugs are small visible blood-sucking bugs. They are about ¼ inch (6 mm) in length.
During the day, bed bugs hide in the corners of mattresses. They may also be found in bed crevices, floors, and walls.
At night, the bed bugs come out of hiding. They feed on humans for about 5 minutes.
Prevention of Getting Bed Bugs
Over half of bed bug infestations within homes start after recent travel.
Avoid hotels and hostels where bed bugs have been reported.
When you check into a hotel room, look for signs of bed bugs. Look for flecks of their waste (like coffee grounds) in the bedding and mattress. If present, ask for another room.
Keep your luggage and clothing on a luggage rack off the floor.
When you return from a trip, place all travel clothing into the clothes dryer. Run the dryer for 20 minutes. (Reason: The heat will kill any bed bugs or their eggs that are present). One pregnant bed bug can spread bed bugs to an entire house.
Frequent Questions (FAQs)
Can bed bugs transmit HIV or hepatitis? This is highly unlikely. It has never been reported.
Do bed bugs like dirt? Not really. What bed bugs like is the warmth of the human body. Dirty and cluttered spaces just give bed bugs a place to hide.
Are bed bugs too small to be seen? No. You can see adult bed bugs. They are about the size of an apple seed (4-7 mm; ¼ inch).
Are bed bugs scared of the light? They do prefer darkness. But keeping the light on will not stop bed bugs from biting you.
When To Call
Call 911 Now
Life-threatening allergic reaction suspected. Symptoms include sudden onset of trouble breathing or swallowing.
You think your child has a life-threatening emergency
Call Doctor or Seek Care Now
Spreading red area or streak with fever
Spreading red area or streak that's very large
Your child looks or acts very sick
Call Doctor Within 24 Hours
Painful spreading redness started more than 24 hours after the bite. Note: any redness starting in the first 24 hours is a reaction to the bite.
More than 48 hours since the bite and redness gets larger
You think your child needs to be seen
Call Doctor During Office Hours
Severe itching not better after 24 hours of using steroid cream
Scab that looks infected (drains pus or gets bigger) not better with antibiotic ointment
After 7 days, bites not better
After 14 days, bites not gone
You have other questions or concerns
Self Care at Home
Normal bed bug bite
Care Advice
What You Should Know About Bed Bug Bites:
Bed bug bites cause itchy red bumps.
They are usually less than ½ inch (12 mm) in size.
Some are larger (like a hive). These are normal reactions to a bed bug.
A large hive does not mean your child has an allergy.
The redness does not mean the bite is infected.
Bed bugs do not carry any infectious diseases.
Don't panic: You can get rid of bed bugs from your home.
Here is some care advice that should help.
Steroid Cream for Itching:
To reduce the itching, use 1% hydrocortisone cream (such as Cortaid). No prescription is needed.
Apply 3 times a day until the itch is gone.
If you don't have, apply a baking soda paste until you can get some.
Allergy Medicine For Itching:
If the bite is still itchy, try an allergy medicine by mouth.
Benadryl is a good one. No prescription is needed.
Try Not to Scratch:
Cut the fingernails short.
Help your child not to scratch.
Reason: Prevent a skin infection at the bite site.
Bed Bug Repellents - Not Helpful:
Insect repellents do not keep bed bugs from biting.
Repellents containing DEET (used on skin) and permethrin (used on clothing) do not help.
Removing Bed Bugs from Your Home:
Getting rid of bed bugs requires a licensed pest control service.
Look in the phone book or on the internet under Pest Control.
What to Expect:
Any pinkness or redness usually lasts 3 days.
The swelling may last 7 days.
The itch may last for 2 weeks.
Call Your Doctor If:
Bite looks infected (redness gets larger after 48 hours)
Large red bumps last more than 7 days
You think your child needs to be seen
Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Bee or Yellow Jacket Sting
Definition
Sting from a bee, hornet, wasp, or yellow jacket
Over 95 percent of stings are from honey bees or yellow jackets
The main symptoms are pain and redness
Cause of Bee Sting Reactions
The bee's stinger injects venom into the skin.
The venom is what causes the symptoms.
Local Skin Reactions to the Sting
The main symptoms are pain, itching, swelling and redness at the sting site.
Pain. Severe pain or burning at the site lasts 1 to 2 hours. Itching often follows the pain.
Swelling. The bee sting may swell for 48 hours after the sting. The swelling can be small or large. Stings on the face can cause a lot of swelling around the eye. It looks bad, but this is not serious. The swelling may last for 7 days.
Redness. Bee stings are often red. That doesn't mean they are infected. Infections rarely happen with stings. The redness can last 3 days.
Anaphylactic Reaction to the Sting