Skin & Body Hair
Dr. J Answers Questions: Young Women's Concerns
Dr. Johnson is a member of the editorial advisory board of the Teengrowth website. Reproduced below are a few of Dr. Johnson's answers to original questions submitted to the site.
I have a weight problem. I’m not overweight but my stomach is huge. In the morning my stomach is quite flat but as I eat it grows until in the evening I look pregnant. I have tried to lose weight by eating a piece of fruit or cereal bar for breakfast fruit or a sandwich at lunch and then a fairly healthy dinner and I exercise but my belly fat just won’t disappear and it makes me really depressed when I look in the mirror as it is really noticeable. Is there something wrong with me? I feel like a freak!
Thanks for writing! Lots of teenage girls (perhaps most) have the same concern, and they’ll be glad you asked this question. Even though you feel like a “freak,” given that your weight is normal, I suspect your abdomen is normal, as well. Most normal women have a rounded “belly.” It’s easy to forget that most of the young women we see on TV and in magazines are underweight, and their images are digitally stretched so they look even thinner. Some women tend to store a higher proportion of body fat in the abdominal area than others, who may instead worry that their hips and/or thighs are too big.
As you’ve noticed, most “tummies” become rounder as the day goes on. Lying in bed in the morning, your abdomen might be quite flat. Standing up, gravity works to make it rounder. During the daytime, it’s not only the food or beverages we eat that may make an abdomen appear more full. Changes are also due to the movement of food wastes through the digestive tract. In the lower part of the intestine, known as the colon, the body adds water to food wastes so that they can be passed as stool during a bowel movement. After a bowel movement, the abdomen often becomes less round. Not having bowel movements as often as usual (constipation) will make a “belly” more full. And many women feel bloated or full for several days before their menstrual period begins.
I hope this information will help you feel better about your body. Please check out our Weight Corner for information about body shapes, body image, and dieting.
I'm a 13-year-old female and have found small "pimples" around the inner lip of my vagina. When popped they produce a white discharge. Is this normal? What is it?
Great that you feel comfortable examining yourself! Some girls hesitate to look “down there,” but I think it’s important to be acquainted with your body. Many girls have very small white bumps like the ones you described. There may be only a few. They may form a line. They may even cover the entire mucosal (moist) surface of the inner lip. The white material you expressed consists of secretions from tiny glands. So, your “pimples” sound entirely normal. Popping them could lead to infection, though, so I’d avoid that. (One note of caution: women who are sexually active and find bumps in their vaginal area should get checked for genital warts.)
I’m 14 years old, and I was masturbating and it started to bleed after i went to the bathroom. Its not my "Time of the month" and I was wondering if I popped my "cherry". Does this mean I’m not a virgin, or if i didn’t pop my cherry what was it?
Answer: “Popping the cherry” usually refers to the hymen being torn when a girl has sexual intercourse for the first time. The hymen is the very thin membrane at the vaginal opening. It is sometimes referred to as the “cherry.” The size of the opening varies from one girl to another. When something larger than the opening is pushed through it, the hymen gets torn and bleeds a little. In girls who have never had vaginal intercourse, the opening is usually large enough for a finger or tampon to pass through. Moving a finger in and out of the opening, though, could cause the hymen to tear. That’s probably what happened to you.
Since you have never had sexual intercourse, you are still a virgin. Your hymen may not be torn completely open, so you may still have a bit of bleeding the first time you have sex.
Masturbation is a very normal and healthy expression of human sexuality.
Skin and Body Hair
I had an accident and I cut up my elbow pretty bad. Afterward the doctor told me I should have had stitches. Now I have this big ugly purple scar. Is there anything I can do to reduce the appearance of this scar?
Nearly everyone has a few scars they’d like to make disappear. Some scars barely show, some are purple in the beginning then fade over the next few years and some form thick, raised scars called keloid that can become quite large. The depth of the damage to the skin affects the amount of scarring that occurs after an injury. If the wound becomes infected, scarring will be increased.
Everybody’s skin heals differently. Some people seem to develop more severe scars than others. If your scar is the keloid type there may be some treatments available to you. There is, however, a 50% chance that the keloid will return and may be worse so it is best for you to consult with your doctor. Otherwise new scars may be purple in color, but typically fade over time. It is helpful to keep covered with suntan lotion at least SPF 15 or wear long sleeve shirts to keep your scar protected from the sun.
I have cracked and callused heels. I've tried foot creams and vaseline under the protection of a sock too. I participate in a lot of sports and also have plantar warts on the heel which are painful. How do I treat my heels?
Athletes have hard-working feet. As you have already experienced, plantar warts can be frustrating little devils. Warts are caused by viruses, and wart viruses are very hard to eliminate. Most of the wart lies below the skin surface, and it's hard for treatments to penetrate the thick skin surrounding them. Fortunately, 75% of plantar warts disappear on their own within 2 years. Unfortunately, most therapies take a long time to work; some are ineffective; and others are painful. And, with or without treatment, warts may recur. When should you try to wait it out, and when should the wart be treated? That depends on the wart's exact location, whether it's painful, and whether it just plain embarrasses you. A simple, painless method of treating a plantar wart is to cover it with plain adhesive tape for an entire month. The surface of the wart is kept from contact with air. Skin moisture is captured under the continuous covering, and it can't evaporate. The tape is left on for 6 days, removed for 12 hours, and then reapplied. The most commonly used method is to use a chemical (keratolytic agent) to slowly peel off the wart. Usually salicylic acid, which comes in liquid or pad form, is placed directly onto the wart surface and left on for several hours. The surface of the wart is scraped clean and the acid is reapplied. This treatment is more effective when it is combined with the adhesive tape method described above. Nonetheless, it may take 6 to 12 weeks of treatment before the wart disappears. Occasionally, dermatologists use liquid nitrogen to freeze and destroy the virus and surrounding skin. Often, multiple treatments are needed. Plantar warts can also be surgically removed under local anesthesia. Both freezing and surgery can be painful, and can produce scarring and infection.
Another way to treat your heels is by preventing more cracked and callused heel formation by eliminating the friction and pressure placed on them. Shoes must fit correctly, and pressure over the toes must be evenly distributed. Softer shoe materials and sandals are often helpful. Try to avoid tight, pointed-toed shoes. Stockings/socks must fit properly and should cushion the foot/sensitive area. Keeping the feet dry by using powder and changing shoes daily also reduces friction. Symptomatic relief of calluses can be achieved by paring down a large lesion with a scalpel at the doctor’s office. After callus removal, it is essential that previous weight-bearing trauma not be continued, or the callus will recur. You can also use keratotic agents, such as salicylic and lactic acid combinations and 40% salicylic acid plasters to reduce the thickness of tissue for several days.
If these methods still fail to reduce your symptoms or recurrences, consider referral to a podiatrist or orthopedic surgeon for definitive treatment of a possible structural problem. Good luck, and hopefully you will be able to play sports again without the added pain in your heels.
Why is my genital hair curly? I have straight hair on my head?
This is a fascinating question! I had never asked that question myself, so I did a little research to find the answer. But here it is. As you might know, all hair grows in hair follicles. Follicles are like tiny holes beneath surface of the skin. They have an opening at the surface of the skin. (“Blackheads” and “whiteheads” are follicles whose openings are plugged up.) Hair follicles exist all over our bodies. The shape of the hair follicle and the “bulb” at the bottom of the follicle determine the shape of the hair growing out of the follicle. Hair follicles are generally round and straight, so that the hair that grows out of them is straight. Even before puberty there are short, straight, thin hairs in the pubic area. Sex hormones (called androgens) that are made during and after puberty circulate throughout the body. The hair follicles in the pubic region, underarms and beard are especially sensitive to androgens. Androgens apparently make hair follicles in these areas twist and also make their bulbs kink. The result is curly, kinky pubic hair. As you know, these hairs are also thicker and coarser than other body hair. You might wonder why girls don’t grow beards, if both boys and girls have these sex hormones. The answer is that boys’ bodies make more of the male sex hormones, and it takes more of these hormones to stimulate the change from straight to kinky in the facial area.
Also, you may be curious about why pubic hair and other body hairs do not grow as long as the hairs on our heads, or why eyelashes and eyebrows are so short. This is because there are many other differences in the hair follicles that determine the length and other characteristics of these hairs.
I am a 19 yr old girl. I am planning to wax my leg. Is there any danger about it? If I do one time, do I have to continue for the rest of my life? What if I stop after doing few times?
I’m glad you’re thinking about the possible side effects of waxing before you try it. Other simple methods of removing hair from the legs are shaving, and using a depilatory cream such as Nair. Despite any “old wives’ tales” you might have heard, none of these methods causes hair to grow back more quickly or to be more thick than before. Most beauty salons and spas offer waxing services. Or, you can do it yourself. You can purchase either wax that is warmed (most easily in a microwave oven) and then spread on the legs with a wooden paddle or wax that is embedded on 1” wide strips. The strips may be less effective than the hot wax, but they also eliminate the biggest danger of waxing: skin burns. If you are performing the waxing yourself, follow the package directions carefully. Also, although unlikely, you could be allergic to the wax or something it contains. Try your technique on a small patch of skin before applying wax to a larger area. Some women feel that their legs remain free of stubble for a day or two longer with waxing than when they use another technique. Virtually every woman reports that waxing is painful, sometimes very much so. For some, the discomfort of waxing a large area is not worth the result. There's no reason not to give waxing a try, if you're game for it. Evaluate the process and the results, then decide whether you want to wax again. There's no reason you'd need to do it more than once. In fact, if you're trying it at home, you can limit it to one single test patch.
What’s a fast, easy, preferably painless way to remove "bikini hair"? Do buffers or Nair work?
“Bikini hair” (pubic and upper thigh hair that is exposed by a high-cut swimsuit or bikini) is a problem for many women. You are not alone in the quest for a simple, painless method of hair removal. Unfortunately, nothing is guaranteed to fulfill your criteria. One way get around this problem is to wear the new swim shorts, or wear “board shorts” over your swimsuit!
Otherwise, here are some suggestions:
[Girls who frequently have troublesome painful bumps in this area should check with their physician. A topical medication can be helpful.]
I'm 15 and my breast are very tender and hurt so bad that I can't lay on my stomach at night. Also my areola's are very large and kind of pointy. Is there something wrong or will my breasts eventually grow and even it out?
Good news: you’re not only very observant, you’re in all likelihood also very normal. I’m glad you wrote, because nearly every girl experiences breast tenderness at some time. Many TeenGrowth readers may also be wondering why this happens. There are actually a number of reasons that can relate to pubertal development, the menstrual cycle, or other factors.
For example, breast tenderness is nearly universal in early puberty, when breasts first start to develop. That would be the most common cause of what you are describing. I’m assuming from your age that you are already having menstrual periods. Many women have breast tenderness starting 7 to 10 days before their period is due. This is caused by the higher levels of hormones during the second half of the menstrual cycle. These hormones also cause the extended breast tenderness (more than 2 weeks) that is characteristic of early pregnancy. If there is any chance you could be pregnant, check with your doctor about a test (confidential if necessary) as soon as possible. Since the tenderness you are experiencing is really bothersome, I’d suggest you try taking an over-the-counter pain medication such as acetaminophen or ibuprofen in the late evening.
One precaution: Breast tenderness in a single area of one breast with reddening or increased warmth of the skin indicates a possible infection. See your doctor right away if this occurs.
It sounds as though your areolas are very normal. They do come in all sizes (and colors). The “pointiness” that you describe is a typical stage of breast maturation. Just as you suspect, it will likely disappear in the coming months. Amazing, isn’t it, all the small steps that make up puberty?!
I am 14 and I have had my period for 2 years. Recently my period has been so heavy for the first 3 or 4 days of it that it will leak through a super plus tampon, a super plus pad, my underwear, and my pants! This is really horrible because I can’t do anything about it when I'm at school. Is there something wrong with my body?
Your bleeding sounds heavier than normal, unless you are going through a day at school without changing tampons or pads. But this doesn’t mean there is something terribly wrong with your body. It is not uncommon for young women to have very heavy periods; in this case, the periods are usually irregular as well. An example would be having a period 2 weeks after the last one, then not having another period for 2 months. If this is the problem you have, it is easily treated. In any event, you should see your doctor and discuss the situation with her. Your doctor will want to know how often you change pads and tampons. If you keep a menstrual calendar, your doctor will also want to review that with you.
By the way, we recommend that every woman keep track of her menstrual cycles. You can find a sample “menstrual calendar” to print and keep with your feminine hygiene supplies at the website of the Center for Young Women’s Health.
Nearly every woman has or has had trouble with menstrual blood leaking onto underwear or seeping through clothing. Here are a couple of suggestions that might be helpful. First, change tampons and pads frequently during the day. We all know, though, that some school bathrooms can be smelly, dirty, and/or disgusting. Some girls are not comfortable using them, especially during their periods. If that is the case, speak with the school nurse or a trusted teacher or counselor. She might be able to identify a separate restroom for you to use at those times or have a way to address specific problems with the restrooms. Also, talk about this with your doctor. Second, wearing black underwear and pants makes leakage less visible and less likely to leave stains (remember to wash stained clothes in cold water).
I’m 15 and have had my period since I was 11. My periods don't come regularly. An ultrasound showed that that my ovaries are kind of large. What does that mean?
Irregular periods are common in the first several years after girl first starts having her period. Usually an egg matures and leaves the ovary at the middle of each menstrual cycle. For ovulation to occur there must be a great deal of communication between the brain and the ovaries. Hormones are the messengers in this communication. Sometimes it can take awhile for this axis to mature. Usually, though, by 2 years after beginning to menstruate this axis is mature and a girl’s periods are regular. If you have been menstruating for 4 years and are still having irregular cycles, there may be disruption in activity of the ovaries and/or in the communication cycle between the ovaries and the brain. One of the more common problems is an overproduction of androgens, which are male sex hormones (something all women have normally). In this disorder, multiple cysts may form and cause enlargement of the ovaries. This condition is called Polycystic Ovarian Syndrome. If you are having other problems like increasing body hair or acne or are overweight, you may have something that requires a more in depth evaluation, like PCOS (Polycystic Ovarian Syndrome). If you have already had an ultrasound, then I am assuming you have a doctor who is following you. Make sure you keep any follow up appointments that might be scheduled! Most conditions that are discovered early are easily corrected. Later on, it may be more difficult.
[For more information about PCOS, visit the Center for Young Women's Health at Boston Children's Hospital. Dr. Johnson can diagnose and treat PCOS.]
I have yet to see a gynecologist but I do have a doctor. Once I start going to a gyno, do I stop going to my doctor?
Answer: No, you can still see your regular doctor. In fact, you should ask your doctor what kind of gynecological services he/she can provide. Many primary care doctors (pediatricians, internal medicine specialists, and family medicine specialists) do routine gyn care such as Pap smears and testing for STDs. They can also help with birth control and with menstrual problems such as cramps or heavy periods. [Dr. Johnson provides all these services.]
If you have sex, you should be tested regularly for sexually transmitted diseases. This can often be done without the need for a pelvic (internal) exam. You should have a Pap test, which is done painlessly as part of the pelvic exam, when you turn 21.
Reprinted with permission from TeenGrowth.com. (c)1999-2010. www.TeenGrowth.com