Dr Bernadette Carr answers your questions on tonsillitis and acne

My six-year-old son has had two episodes of tonsillitis in the last year. Is there any way to prevent further episodes?

Tonsillitis affects children and adults of all ages but is most common in children between the ages of five and 10 years. Caused by an infection of the tonsils, either viral or bacterial, it spreads in the same way as other upper respiratory infections through coughing and sneezing and hand contact.

It takes between two and four days to develop symptoms from the time you pick up the infection. The majority of sore throats and tonsillitis are caused by viral infections and do not respond to antibiotics. Some are bacterial (usually ‘strep throat’) and will respond to antibiotics, although, your own immune system is normally able to clear these infections itself.

Most children will have an episode of tonsillitis at some time, however some suffer recurring episodes which can be very distressing. Symptoms include sore throat, earache, headache, tiredness, vomiting and drooling in some children.

It is difficult to prevent young children from being around other children, who are usually the source of the infections. As the viruses that cause tonsillitis are infectious (colds) good hand hygiene is important. You should encourage your son to:

- Wash his hands frequently to prevent the virus entering through the eyes or nose.

- Be careful touching objects when away from home such as keyboards and door handles.

- Use tissues to cover his nose and mouth when he sneezes or coughs and dump them immediately.

It might be useful to bring your son to his GP to discuss a management plan to try and reduce the number and frequency of the infections.

Sometimes a longer course of treatment can be helpful, and, if the infections are very frequent, it may be worth talking to an ear, nose and throat specialist about the treatment options.

If your son’s sore throats last longer than three to four days or he develops any other symptoms you are concerned about such as a fever or has difficulty swallowing, then seek medical attention.

My 16-year-old son developed acne on his back. It is not too bad but I know he is self conscious and uncomfortable. Have you any suggestions?

Most teenagers suffer from acne at some stage — it is very common with boys affected more than girls, with peak incidence at 13-16 years old, although it may continue into the 20s, 30s and later stage of life.

Acne develops when the small sebaceous glands in the skin which make the oil sebum start to produce more oil and these glands get blocked. Some may be inflamed and bleed. This happens as a result of changes in hormone levels at puberty. For most people acne is mild, however sometimes it can be quite bad and may need treatment to prevent scarring. Even mild acne can be very distressing and teenagers can be very sensitive about it. Fortunately, there are a wide range of treatments available to control acne and the good news is that most people will grow out of it completely.

I would suggest that your son see his GP, who can assess his acne and suggest the most appropriate type of treatment for him.

In the meantime, there are a number of simple options he can try:

- Avoid picking or squeezing any spots as this can make them more inflamed and more likely to scar.

- The temptation with acne is to wash frequently but this can irritate the skin and make the symptoms worse. If your son plays sports then he should shower after a game as sweat can aggravate acne.

- Ointments containing benzoyl peroxide are available from the pharmacy. They can be quite effective for mild acne; however they may irritate the skin. If this happens stop using it until the irritation goes, then try using it for a shorter time before washing it off.

It is important to reassure your son that most teenagers develop acne at some time and it almost always resolves itself over time.


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