Boosters for vaccines taken in infancy are given during adolescence. Certain vaccines which might have been missed earlier can also be given to adolescents. Adolescents at school are also a captive population for mass immunization programs. These campaigns also give an opportunity for health check ups.

Tdap vaccine

Tdap vaccine includes standard dose tetanus vaccine, reduced dose diphtheria vaccine and acellular pertusis vaccine. Standard DTP vaccine is not useful for children above 7 years of age.

Hepatitis B vaccination
 
WHO has recommended it for universal immunization.
 
Human papilloma virus vaccine [HPV]
 
16 and 18 are the important types of viruses involved in human cervical cancer. Vaccination of females before onset of sexual activity and before the age of 26 years.  
 
Varicella vaccination
 
If not exposed  earlier or wthin 72 hours of exposure [90 percent efficacy].
 
Japanese B encephalopalitis vaccination
 
Given in endemic areas

Androgen dependant skin problems

Acne – closed and open comedones. Macrolides have a high follicular concentration and are useful in the treatment of acne. Retinoids are also used frequently. Systemic antibiotics are also useful. Systemic retinoids should be used with caution. Comedone extraction is one of the common office procedures.

Hirsuitism if associated with metabolic syndrome should initiate a search for polycstic ovarian syndrome.

Seborrhoeic dermatitis is also androgen dependant and may sometimes be associated with metabolic syndrome.

Psychocutaneous disorders

Dermatitis artefacta
Prurigo nodularis – a form of neurodermatitis

Obesity related deaths are on the increase. Body mass index (BMI) = weight in kg divided by the square of height in meters.

BMI for adults:

Normal BMI: 18 – 25
Overweight: 25 – 30
Obesity: BMI 30 – 40
Morbid obesity: BMI > 40

To avoid obesity, ban eating in front of television. Food should be served only in the dining room. Encourage healthy eating habits and outdoor games. Bariatric surgery is only for the morbidly obese with comorbidity. On the preventive aspect, both low birth weight and high birth weight are to be prevented as they are fore runners of obesity. Obesity is the after effect of easy availability of inexpensive food and sedentary jobs.

Television was available in the 1950s. Ever since, medical community has started raising concerns on the effect media on adolescents. Of course, it has its own advantages like an early readiness for learning. Availability of multiple media like television, computers and mobile phones lead the adolescnts to multitasking with only partial attention to each. Only few adolescents can study well with partial attention. Media violence can lead to aggressive behaviour. Studies have docuented
160% increase in aggression. and hostility is more. Dsensitization to media violence leads to decrease in concern for other persons’ pain. Often more time is spent watching media than at school. Time spent talking talking on mobile phones is also high. Child may spent time on phone overnight and be sleepy at school in the morning. Interactive video games with violence increase the tendency for personal violence. Sexual references are too many on the media and often give a distorted picture. Body image perceptions cause eating disorders. Commercials promote unhealthy eating and obesity increases. Substance abuse also is promoted by commercials. Accidents are increasing due to drunken driving. Countries in which tobacco ads are banned, there is a 6% decrease in smoking. Internet is very useful as an information highway and a home library, but most often it is a source of harmful information. Media has a high power for shaping the future of the adolescent.