Being Well 511: Health Pregnancy


>>Lori Casey:
Coming up on this edition of Being Well, our guest is Dr. Scott Meyer, obstetrician/gynecologist
from Sarah Bush Lincoln Health System. Our topic this week is focused on having a
healthy pregnancy. Dr. Meyer will talk about the things that
women should do before getting pregnant to aid in a healthy pregnancy, as well as those
things you can do during those 40 weeks so that you and your baby are happy and healthy.
We’ve got a lot of great information to share with you this week, so stay tuned for Being
Well. [Music Plays]
Production of Being Well is made possible in part by:
Sarah Bush Lincoln Health System, supporting healthy lifestyles.
Eating a heart healthy diet, staying active managing stress, and regular check-ups are
ways of reducing your health risks. Proper health is important to all at Sarah
Bush Lincoln Health System. Information available at sarahbush.org.
Additional funding by Jazzercise of Charleston. Hello, and thanks for joining us for this
edition of Being Well. I’m your host, Lori Casey.
And today, we’re talking about having a healthy pregnancy, and my guest is Dr. Scott Meyer,
obstetrician/gynecologist with women’s healthcare of Sarah Bush Lincoln.
I got all that out.>>Dr. Meyer:
That’s good.>>Lori Casey:
Thank you for coming over today. We appreciate it.
Tell me first what prompted you to get into this area of medicine?
>>Dr. Meyer: It was a good mix of everything I enjoyed
about medicine. When you go through medical school, you go
through many different clinical rotations, and you kind of find the ones that suit you
the best and go toward that direction. For me, my first rotation was obstetrics and
gynecology, and from the first time I was involved in delivering a baby, it was by far
the best thing I ever saw in medicine. I also enjoyed surgery, and I enjoyed getting
to know my patients. And obstetrics and gynecology gave me a mix
of all those things, so it was the perfect fit for me.
>>Lori Casey: So, tell me, just as an obstetrician/gynecologist,
what are the areas of women’s healthcare that you cover?
Because, you do a lot more than deliver babies, which he did this morning, by the way.
[Laughs]>>Dr. Meyer:
Yes. Basically, it’s being involved with a women
in the entire spectrum of her adult life. So, from the time she comes in for the first
time, not wanting to be pregnant, talking about ways to accomplish that, until going
through every pregnancy that she wants to have, and then helping her get through the
aging process, going through menopause and the changes that she’s going to experience
throughout her life.>>Lori Casey:
So, you do surgeries, too. What kind of surgeries do you perform?
>>Dr. Meyer: A lot of minor procedures, so things like
sterilization procedures. If a woman has a miscarriage or an ectopic
pregnancy that needs to be addressed in an urgent manner, we do that.
And then, finally, if a woman has a condition where she requires a hysterectomy, we do that,
as well.>>Lori Casey:
Okay, so the whole scope. Well, today our focus is on having healthy
pregnancies. So, let’s start by what’s the ideal range
for a women to have a healthy and fairly low risk pregnancy?
>>Dr. Meyer: It’s somewhat difficult to define.
Most people consider the ideal age range to be between the ages of 20 and 35.
We know that women who are very young when they become pregnant have more complications;
they’re more likely to have preterm delivery, low birth weight infants, their babies are
more likely to die after delivery. From a socioeconomic standpoint, they’re more
likely to live in poverty, they’re more likely to be victims of domestic violence, they’re
more likely to suffer depression. Older women, on the other hand, it’s more
of a physiological problem. Older women over the age of 35 have diminished
fertility, they’re more likely to have miscarriages or ectopic pregnancies, they’re more likely
to have medical complications in pregnancy like hypertension, diabetes, heart disease,
and maternal deaths are much more common at older ages.
So, ideally we want to stay in the center of the age range.
That being said, there’s certainly healthy women over the age of 35 can conceive, carry
healthy pregnancies. But medical complications definitely increase
at an older age.>>Lori Casey:
So, if you have a patient that comes in and says, I’m ready to have a baby, Dr. Meyer,
not pregnant yet, but my husband and I want to start, what would you tell her?
>>Dr. Meyer: The first thing would be to get rid of the
bad habits. Almost 50% of the pregnant women I see smoke
at the time they become pregnant. And the first thing is to stop smoking; it’s
the most important thing a woman could possibly do to help her have a healthy pregnancy.
Beyond that, it’s just being as healthy as possible.
So, if a woman is overweight before she wants to become pregnant, trying to get closer to
an ideal bodyweight or trying to become more physically fit before she becomes pregnant
is beneficial.>>Lori Casey:
Mmhmm.>>Dr. Meyer:
Pregnancy is a physically demanding state, and the healthier a woman is before she becomes
pregnant is definitely better. Also, women should start taking prenatal vitamins
before they conceive.>>Lori Casey:
Okay. What does that do?
>>Dr. Meyer: The most important component in a prenatal
vitamin is folic acid. Folic acid helps decrease the risk of neural
tube defects like spina bifida. The problem is that the neural tube closes
before a lot of women even know they’re pregnant. So, starting prenatal vitamins after a women
has the first positive pregnancy test a lot of times is not terribly beneficial.
So, if they can start them before they attempt conception, that’s when the biggest benefit
is attained.>>Lori Casey:
Okay. So, what about for women who have been on
birth control for several years? Will it take them longer to conceive if they’ve
been on a birth control for, you know, more than a few years?
>>Dr. Meyer: In general, no.
It’s not a matter, it’s not a fact of how long they’ve been on birth control which makes
the difference, it’s more a matter of how old they are.
So, a woman who’s 35 who’s been on birth control for 10 years has lower fertility than a woman
who’s 25 and has been on birth control for 10 years.
The vast majority of contraception available to women is completely reversible within a
few days. Birth control pills are out of their system
within about 48 hours.>>Lori Casey:
Okay.>>Dr. Meyer:
So, it’s not a matter of how long they’ve been on the birth control, it’s more a matter
of what their age is, and what their underlying fertility is in the first place, as opposed
to how long they’ve been on birth control. The one exception to that is the Depo-Provera
injection. It’s a shot that a woman gets every three
months to prevent pregnancy. It’s designed to prevent conception for three
months; however, in some women it can last one to two years beyond the last dose.
So, for women who are on Depo-Provera who are wanting to conceive, I encourage them
to get to a different form of contraception sooner rather than later, because it may take
a year or longer to get it out of their system before their fertility returns to normal.
>>Lori Casey: What if a woman has an IUD?
Does that have any effect on how long it takes to get pregnant?
>>Dr. Meyer: Not really.
Again, there are three different IUD’s on the market right now.
Two of them work via hormonal manipulation of the uterus, and those hormones are gone
within a few days. The second one is actually a piece of copper
which is spermicidal. Once the copper’s gone, it’s not effective
anymore. So, really, they’re completely reversible
within just a few days.>>Lori Casey:
So, what do you tell women, what’s kind of the average number of months it takes to get
pregnant before they should start thinking about going to the next step of fertility
treatments?>>Dr. Meyer:
I encourage women to try at least six months to a year.
You know, the odds, after six months of trying, the odds of conceiving spontaneously definitely
decrease. The reality is that most insurance companies
won’t pay for any form of infertility treatments or counseling until a woman has been trying
for a year spontaneously and has not conceived. It is certainly normal for it to take six
months to a year, even for women who are completely healthy, have normal fertility, their partner
has normal fertility. So, especially younger women, I encourage
to wait at least a year. A woman who’s a little bit older in the first
place and maybe less fertile up front, I may only wait six month.
>>Lori Casey: Because what really is the fertility time
frame in a woman’s cycle? It’s not a couple of weeks; is it more like
a couple of days?>>Dr. Meyer:
As far as when they’re actually fertile? Well, the ideal menstrual cycle is 28 days,
which means a woman ovulates on day 14, and they’re most fertile right around that time.
They’re certainly women who conceive, can conceive at almost any time because certainly
sperm are viable in the genital tract for a week or more sometimes.
But we try to target around the date of ovulation as best as possible.
>>Lori Casey: Are there things, we’ve talked about some
of the physical things that women should do before they get pregnant, are there some mental
things that they should start to kind of wrap their head around before conceiving?
>>Dr. Meyer: Definitely women with underlying health issues
should have those under control before they get pregnant.
Pregnancy is an incredibly stressful state, and if a woman has some mental health issues
beforehand, they don’t get better with pregnancy; if anything, they get worse.
>>Lori Casey: Such as, like, are you talking about anxiety?
>>Dr. Meyer: Depression, anxiety, bipolar disorder; all
those kind of conditions can get worse with pregnancy, rather than better.
So, they need to make sure that they are stable before they become pregnant, preferably stable
on either medications or counseling that are safe during pregnancy.
Beyond that, even for women without underlying health issues, pregnancy is an incredibly
stressful time. There is a lot of anxiety throughout the pregnancy,
not only about, you know, what’s going on with the pregnancy, I haven’t felt my baby
move in an hour, is that normal, but also what’s going to happen in delivery, how good
a mom am I going to be. And it just is an incredibly stressful time.
So, they have to be prepared for that. It’s not a state, for nine months you feel
the baby move, and then out pops a happy baby, and you’re a mother naturally.
So, there’s a lot of stress involved. And the more a woman is prepared for that,
the better. Ideally, having a good social network is beneficial.
We definitely know that women with supportive partners or spouses, supportive family, definitely
have better outcomes than women who don’t have a good social support network.
>>Lori Casey: So, let’s talk about the care plan for a pregnant
woman. As she probably takes that first pregnancy
test that comes back positive, makes an appointment to see her doctor, what’s the care plan for
a pregnant woman? How often do they see their doctor?
>>Dr. Meyer: In general, we start pregnancy care somewhere
between 10 and 12 weeks gestation. So, when a woman finds out she’s pregnant,
she needs to, number one, pick a provider she would like to see and call that office
so they can find out, try to determine how far along she really is and get her scheduled
for her first appointment. At that first prenatal visit, it’s a very
thorough visit. We do a complete history, both medical and
mental health history, a complete physical exam that includes a breast exam, a pelvic
exam, a pap smear if that’s indicated. There is a lot of blood work that’s necessary
during pregnancy, and most of that is done at the first prenatal visit to screen for
certain conditions that the state mandates we should screen for, frankly.
And then, we also usually do an ultrasound at the first visit to verify that she actually
has a viable fetus, and to verify how far along she really is.
After that, then the first half of pregnancy, a woman is seen about once a month.
So, between the first visit and 28 weeks, we see the woman every four weeks.
There are some genetic tests that are offered usually in the late first or early second
trimester to screen for down syndrome, spina bifida, cystic fibrosis, and a few other genetic
conditions. Those are optional tests, but a lot of women
opt to have those performed. Usually, an ultrasound is performed between
18 and 20 weeks gestation to look at, basically to evaluate the fetal anatomy.
And then beyond that, most of the visits just involve making sure the woman is gaining the
appropriate amount of weight; the baby is growing appropriately, and then answering
the many questions women have. Routine vaginal exams usually don’t start
until 38 weeks gestation, so we give women a reprieve from their first visit to the 38
week visit, in most cases.>>Lori Casey:
So, I know a lot of women probably are saying how much weight should I gain?
And what are some of the downsides of gaining too much weight?
>>Dr. Meyer: Gaining too much weight, number one, can make
the labor process more difficult. So, if a woman gains too much weight during
pregnancy that also sometimes means a bigger baby.
Also, extra body weight sometimes causes additional soft tissue swelling that makes it harder
for a baby to get through. The biggest downside of gaining weight during
pregnancy is there’s a lot more weight to lose after pregnancy, and that’s not an easy
task to perform. The recommended weight gain during pregnancy
has a lot to do with what the woman weighed before she got pregnant.
So, women who are underweight we recommend they gain a little bit more, women who are
overweight would gain a little bit less. We try to keep pretty close tabs on it now.
>>Lori Casey: Yeah, it used to probably, in the old days
it was eat whatever you want, gain however much you want.
But back in the 50s, a lot of Americans or people weren’t as overweight as they are now.
So, if a woman is at a normal weight, what is the recommended amount of weight?
>>Dr. Meyer: The recommended weight gain for a normal weight
is 25 to 35 pounds during pregnancy. The majority of that is actually gained in
late pregnancy. So, the usually recommendation is a half a
pound per week through the first half of pregnancy, and then one pound per week through the second
half of pregnancy.>>Lori Casey:
Okay. So, now you’re pregnant.
What are some nutritional things that you recommend for women, as far as eating to maintain
their healthy pregnancy?>>Dr. Meyer:
Try to eat as healthy and balanced a diet as possible.
The recommended caloric intake for a woman is essentially whatever her normal diet is,
plus about an extra 300 calories a day.>>Lori Casey:
Okay, so it’s not that terribly much.>>Dr. Meyer:
Right, so it’s not an extra pizza at night time, it’s an extra apple at some point during
the day. But basically, eat a balanced, healthy diet.
There are a lot of physiological changes during pregnancy.
Most women suffer constipation, so eating a lot of fruits and vegetables during pregnancy
is beneficial from that standpoint. There are certain foods that we recommend
women avoid, but in general, not very many. In general, we recommend avoiding long lived
sea fish, like sharks, and swordfish, and things like that.
>>Lori Casey: Okay.
Because of the…>>Dr. Meyer:
Because of the long, when they live a long time, they can have more toxins.
So, normal fish is fine, it’s just the long lived fish we try to avoid.
There are some references that say women should avoid lunch meat during pregnancy.
In reality, if they like lunch meat and they’re worried, they should just heat it to steaming,
then go ahead and eat it.>>Lori Casey:
Mmhmm. Is that because of the risk of, like, listeria?
>>Dr. Meyer: There’s an infection called listeria, which
can have extremely adverse effects on the fetus.
In reality, that’s an incredibly rare occurrence. I tell women they’re more likely to get hit
by a car than get listeria. But if they’re worried about it, they can
just steam their meat.>>Dr. Meyer:
What about caffeine, and coffee, and soda, things like that?
>>Dr. Meyer: It’s recommended that caffeine intake be as
minimal as possible. It’s generally accepted that one can of soda
a day or one cup of coffee a day is probably okay.
Definitely higher amounts of caffeine slightly increase the risk of miscarriage, so we try
to avoid high caffeine amounts if possible.>>Lori Casey:
Are there other foods or things that women should avoid?
Obviously, alcohol and smoking.>>Dr. Meyer:
Yes. Beyond that, sushi, things like that.
Anything that’s not fully cooked. So, one of the other conditions in pregnancy
is called toxoplasmosis. Most women think they get it from changing
the cat litter. In reality, most women get it from eating
undercooked meat. So, make sure chicken and foods like that
are fully cooked before you eat them. But beyond that, there aren’t a lot of restrictions.
>>Lori Casey: Well, let’s talk about some of the common
pregnancy health, well, not health problems, but side effects: morning sickness, joint
pain. What causes some of that sort of stuff?
Anything women can do to prevent some of those things?
>>Dr. Meyer: In general, no.
[Laughter] Some of it is certainly genetic predisposition.
Morning sickness has a lot to do with the hormones of pregnancy, and the hormones of
pregnancy peak toward the end of the first trimester.
So, most women have morning sickness much worse in the first trimester, then it tends
to get better later in pregnancy. There’s also some, most people have somewhat
of a psychological component to morning sickness. So, women who are more anxious or suffer from
depression, things like that are more likely to get morning sickness, but that doesn’t
necessarily hold true all the time, either. Things like joint pain; again, there is a
physiological basis for them during pregnancy. High levels of hormones in pregnancy tend
to make all the ligaments a little more loose. And also, there tends to be a smooth muscle
relaxation during pregnancy. From a pregnancy standpoint, that’s a good
thing because the pelvis can flex more, and the baby can fit through there easier.
But in late pregnancy, it tends to cause a lot of hip pain, wrist pain, knee pain, elbow
pain, and there’s not a lot you can do about it.
>>Lori Casey: And what about swelling?
You hear women talk about their feet and their lower extremities swelling, especially towards
the end.>>Dr. Meyer:
Again, that’s somewhat of a normal physiologic response during pregnancy.
We counsel women to watch their salt intake and drink plenty of fluids, but even women
that are on a complete low sodium diet and drink the water they’re supposed to drink
still swell. So, there’s not a lot of good ways to prevent
it. Usually, it’s a harmless condition, other
than it causes some discomfort.>>Lori Casey:
So, if you have your first pregnancy, you go through with a lot of morning sickness,
a lot of those side effects, are you probably going to have that in the second and maybe
the third? Or you probably, do you see both?
>>Dr. Meyer: Every pregnancy’s a little bit different.
Certainly, it seems with morning sickness, if a woman has it with her first one; she’s
highly likely to get it with the second one. The joint pain and things like that tend to
be compounded with pregnancies because, after the baby’s born, nothing completely goes back
to the way it was before the pregnancy. And then, when you get pregnant again, those
conditions are still already there, and then you add the pregnancy on top of it, things
appear to get worse. So, a lot of women will tell you this is a
lot worse than my last pregnancy. The baby’s riding lower now, and things like
that. That’s, yes, that’s normal.
>>Lori Casey: Let’s talk about some of the more significant
health problems that you see with pregnancy, like pre-eclampsia and that sort of stuff.
What are some of the more severe things that can happen?
>>Dr. Meyer: Well, pre-eclampsia is one of the worst ones
we see during pregnancy. Most of the time, pre-eclampsia is detected
very late in pregnancy, and usually it’s cured with just delivery of the baby.
Where pre-eclampsia becomes a bigger concern is if it happens earlier in pregnancy, and
it sometimes necessitates delivery of the baby, sometimes very early.
We know women who are less healthy before they get pregnant are more likely to get pre-eclampsia.
So, women who are morbidly obese before pregnancy, women who already have underlying hypertension,
women who are diabetic before they get pregnant are much more likely to get pre-eclampsia.
Again, women who are very old or very young are more likely to get pre-eclampsia.
It can be a life threatening condition for both the mother and the baby.
So, in general, it does result in delivering the infant, even if it’s early, mainly to
save the mother’s life.>>Lori Casey:
Okay. Are there other things like that, or is that
kind of the most common one that can occur?>>Dr. Meyer:
Pre-eclampsia seems to be the most common one.
Obviously, with our population getting heavier, diabetes is much more common in pregnancy.
That tends to not be so much of a life threatening condition for the mother, as it is sometimes
potentially a complicating factor for the baby.
Certainly, women with diabetes have much larger infants in general.
Women with poorly controlled diabetes have much higher risk of stillbirth.
Then again, sometimes delivery is necessitated early because the baby is not safe inside
anymore, essentially.>>Lori Casey:
Let’s talk about, now we’re, you know, to the end, and we’re talking about birth, what
determines for you as the doctor to decide this one’s going to have a C-section or not?
Because, is it the mother that gets to decide that?
Or is it…?>>Dr. Meyer:
That’s kind of a controversial subject. In general, vaginal delivery is considerably
safer for the mother. There are certainly conditions where it’s
not safer, but for the most part, vaginal deliveries safer on the mother and probably
not any more dangerous on the infant. Having a vaginal delivery also makes subsequent
pregnancies a little bit safer, as well. So, if we end up with a C-section with a first
pregnancy that complicates subsequent pregnancies. So, we definitely encourage women to have
vaginal deliveries, if at all possible. If infants are extremely large, sometimes
that prevents us from attempting a vaginal delivery, especially in diabetic women.
If the mother has some sort of underlying condition which would make vaginal delivery
contraindicated, we perform cesarean sections. There’s definitely a push now nationwide for
cesarean section on demand, which means the mother can come in and say, I want a cesarean
section. From an ethical standpoint, that is acceptable.
As long as a women is counseled about the risks she wants to do, it’s her body, she
can do what she wants to do. From an insurance company standpoint, that
becomes an issue, because right now, most insurance companies aren’t paying for elective
cesarean sections. So, if a woman comes in and says, I want a
cesarean section, I can counsel her about the risks and benefits of doing that, and
then she has to decide if she wants to pull a bunch of money out of her pocket to pay
for that, in most cases. So, although it is certainly becoming more
popular in certain areas, most of the time it’s not performed because of financial constraints.
>>Lori Casey: And the, you know, the recovery is longer
if you have a C-section. You’re in the hospital a little bit longer.
>>Dr. Meyer: Much longer.
In general, a woman who has a vaginal delivery is in the hospital one to two days after vaginal
delivery. After a cesarean section, it’s usually two
to four days. In addition, women with vaginal delivery go
home without very much discomfort. Women with cesarean sections usually need
pain medicine for a week or more. So, they’re slower to get up and get around
when they get home, they need much more help taking care of their infant when they get
home, or taking care of their children when they get home, and they have a much slower
return to normal functioning because of a cesarean section.
>>Lori Casey: In these last few minutes, I want to talk
about wives’ tales or myths; I’m sure you’ve had many a mother come in and say, I heard
this. What are some of the most common ones that
you hear that are just completely outlandish?>>Dr. Meyer:
I have yet to hear any that are true. The most common ones have to do with the fetal
heart rate determining the sex of the baby, meaning it’s usually if the heart rate is
high, it’s a girl; if it’s low it’s a boy. But nobody can tell me what’s high and what’s
low. And I really wish it would hold true; that
would save us a lot of ultrasounds probably. The other one is that if you have a lot of
heartburn, you’re going to have a baby with a lot of hair.
That doesn’t hold true. A lot of women believe that they’re more likely
to go into labor when there’s a full moon or when there’s a thunderstorm.
Again, that doesn’t hold true. Beyond that, there’s a lot of advice from
mothers that I tell people to ignore. I get a lot of mothers telling their daughters
to take castor oil to make them go into labor; don’t do it.
>>Lori Casey: Don’t do it.
>>Dr. Meyer: It’s not fun.
>>Lori Casey: No, I would think not.
And just finally, as we wrap up, just give our viewers out there just a few last things
that they should be thinking about to have a healthy pregnancy, even before they get
pregnant, and during their pregnancy. What are your last bits of advice?
>>Dr. Meyer: My first piece of advice is don’t get pregnant
until you’re ready to. About 50% of the pregnancies in this country
are not planned, and that certainly complicates things, both physically and emotionally.
But for a woman who is planning a pregnancy, be as healthy as you can before you get pregnant.
So, it’s probably beneficial to wait a year to get in good physical health, as opposed
to trying to hurry up before you get to a certain age, because in general, a healthier
woman a year later is going to do better than a younger woman who’s not healthy.
So, if they’re not regularly exercising, get into a regular exercise routine.
Pregnancy is stressful on the body, and labor is incredibly stressful on the body, and the
better physical shape a woman is in beforehand, the better she’s going to do.
Similarly, any medical conditions that she has should be well controlled before she tries
to get pregnant. You shouldn’t try to get pregnant two weeks
after being diagnosed with diabetes. You should have your diabetes well controlled;
make sure your doctor who’s controlling your diabetes is comfortable with you getting pregnant
before you even attempt it.>>Lori Casey:
Okay. Sounds like a… We’ve got a lot of questions
we didn’t get through, so you know what that means.
You have to come back.>>Dr. Meyer:
That’s okay.>>Lori Casey:
Thank you for coming by Being Well today, Dr. Meyer.
>>Dr. Meyer: You’re welcome.
[Music]>>Ke’an Armstrong: Remember this? You’re
all excited about a high school dance and the day of
the event you wake up with a giant zit. Acne happens to everyone at some point or
another and it can be a huge source of embarrassment and stress for many teens.
Doctors at Mayo Clinic have tips on how to best prevent and treat teenage acne.
No matter how much you wash your face or apply anti-acne ointment, breakouts
still happen. Some people argue that acne is not a
medical disease but, rather, a developmental condition because
everyone gets acne. That’s the tough truth of youth. The
medical term is acne vulgaris, and Mayo Clinic Dr. Dawn Davis says there are four
main factors that cause it. Over growth of skin, clogged pores, oil production and
bacteria, called propionibacterium, or p- acnes. The bacteria grow on our skin all the
time, but then once we get one of the other components of acne, which is oil
production, the p. acnes has a food source and then it can grow and multiply
easier. Your immune system fights back causing
redness. Plus you can get whiteheads and blackheads, which many think are
plugs of dirt stuck in pores. People assume it’s due to chocolate or
to pizza or to dirt, and a lot of parents encourage their teenagers to scrub their
face harder or the teenager thinks they should scrub their face harder to get out
the dirt. But actually, what happens is an oxidization reaction between the oil and
the bacteria and their byproducts. The pore is simply congested with bacteria,
oil and bacterial waste. And when this oil gets exposed to the oxygen in the air, it
turns brown. So I always tell my patients this is not
dirt. It is not chocolate. It’s not from pizza. It’s simply biology of your skin. So how do you prevent and get rid of
acne? Dr. Davis says start with using your hands to gently wash your face with
a mild soap and water. For milder cases, try over the counter products that contain
salicylic acid or benzyl peroxide. If that doesn’t work, Dr. Davis recommends
seeing your primary care doctor who can prescribe stronger medication such as
antibiotics and acid products. If acne persists or is severe, dermatologists are
there to help. Dermatologists use isotretinoin for very
severe acne. As you can see here, treatment can
work. It does take time; your skin has many layers and it takes about three
months to turn over. But with diligence and the right products, most teens can
end up with clearer skin. For Mayo Clinic News Network, I’m Vivien Williams.
Production of Being Well is made possible in part by:
Sarah Bush Lincoln Health System, supporting healthy lifestyles.
Eating a heart healthy diet, staying active managing stress, and regular check-ups are
ways of reducing your health risks. Proper health is important to all at Sarah
Bush Lincoln Health System. [music]

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