by SUSAN J. MARGOLIN, M.D., M.P.H.
CHIEF, GENERAL PEDIATRICS
If you have a question for the pediatrician, please e-mail it to ESALAMON@SBHCS.COM or mail it to Elizabeth Salamon, Public Relations, Saint Barnabas Medical Center, 95 Old Short Hills Road, West Orange, NJ 07052
Questions should be applicable to children in general, and not focused on the specific case of an individual child.
Q. My daughter turned six this year. She just started to have underarm perspiration and odor. Should we be concerned? |
A. There are two types of sweat glands that we have under our arms, the eccrine glands and the apocrine glands. Only the apocrine glands are affected puberty and begin by to develop with the approach of maturation. However, underarm odor can occur when normal skin bacteria act on skin that has been macerated (worn away) by excessive sweating of the eccrine glands. These glands are present and active even in young children. Use of an antibacteral soap should help.
If you are worried about the approach of puberty in your six-year-old, consult your physician, who will look for signs of pubertal development. |
| Q. At what age can a child get contact lenses? My friend's daughter is 13 an is getting them for her birthday. My daughter has not mentioned them yet, but I think in time it maybe be an issue. I thought they might not be a good idea while my daughter is growing. Presumably her eyes are "growing" too? What's the best approach? |
| A. I spoke to my colleagues in pediatric ophthalmology, who told me that they do not usually recommend contact lenses before the age of 13. At that time there is sufficient maturity of both eyes and the child to warrant the use of contacts. Before that age children may forget to remove the lenses at night, may not clean them properly, and generally may not care for them well. Consequently, ophthalmologists wait until understanding and a sense of responsibility have developed sufficiently to assure the proper use and maintenance of contact lenses. |
| Q. My 11-year old is just starting to break out a little. I don’t know if she needs to wash her face more or if it is related to hormones (no menstruation yet). So far, we’re just using soap and water, but I wondered if there is a gentle product out there that might work better. |
| A. Acne may begin one or two years before the onset of pubertal changes when hormones begin to stimulate sebaceous glands, located in highest concentration on the face, chest and back. These glands may become plugged, and the sebum produced by them becomes "backed up," producing pimples. The condition is made worse by a harmless bacterium, P. acnes, that is present in the gland. |
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So what helps? Studies have shown that dietary restrictions (i.e., chocolate, cola, fats) do not affect acne. Washing with a mild soap and water is always a good idea. In addition, there are a wide variety of over-the-counter washes and medications that contain benzoyl peroxide, which helps control mild acne. For more severe forms of this problem, prescription medications must be recommended by your pediatrician or dermatologist.
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