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Still struggling with acne in college? We’re here to help!

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Did you come to college hoping to leave the battle with acne behind you in high school? I know I did. Fortunately, there are many treatment options for mild acne available at the Student Health Services Pharmacy that do not require a prescription. If you are experiencing more severe breakouts (>10 pimples at once) you should make an appointment with your doctor or dermatologist before treating yourself.

General Skincare Advice:

Make sure you wash your face twice a day with a gentle cleanser, such as Cetaphil. It is also important to take off any makeup before going to bed. Try and avoid touching, picking, or squeezing any pimples as it may cause permanent scarring. There are some studies that suggest dairy and diets high in sugar may cause acne, but no specific dietary changes are currently recommended for acne control.

Over-The-Counter (OTC) Options for Acne:

Benzoyl Peroxide (BP)

How does it work? BP kills bacteria that typically causes acne and helps unclog pores.

What’s out there? BP comes in washes, foams, creams, and gels in a variety of strengths.

What side effects does it cause? You may experience redness and peeling while using BP.

What else should I know before trying it? BP can bleach fabrics or hair, so wash your hands after use and avoid contact with with clothing and furniture. You will also want to make sure that you put on sunscreen while using it because it may make you more sensitive to the sun. BP can be used alone or in combination with a topical retinoid.

Topical Retinoids

How do they work? Retinoids help to keep your pores unclogged.

What’s out there? Several options exist, but only adapalene (Differin) 0.1% gel is currently available without a prescription.

What side effects does it cause? Retinoids can cause dryness, peeling, redness, and irritation. If you experience any of these side effects, cutting back use to once every other day may help.

What else should I know before trying it? You may see an initial increase in acne and redness, but these side effects should get better after a few weeks. Make sure to wear sunscreen while using because retinoids can cause sun sensitivity. Adapalene gel and other retinoids can be used alone or in combination with benzoyl peroxide.

Salicylic Acid (SA)

How does it work? SA helps to remove top layers of skin and unclog pores.

What’s out there? SA comes in washes, cleansers, creams, gels, and lotions in a variety of strengths.

What side effects does it cause? Salicylic acid may cause dryness or peeling.

What else should I know before trying it? Increased contact time on the face may help with how well salicylic acid works (meaning that cleansers and washes may not be as effective as other formulations).

Alpha Hydroxy Acids (AHAs)

How do they work? AHAs work as exfoliating agents for the skin.

What’s out there? Citric, glycolic, and lactic acids are the most commonly seen AHAs.

What side effects does it cause? AHAs may cause irritation or skin sloughing.

What else should I know before trying it? AHAs are also included in many anti-aging skin care regimens.

Topical Sulfur

How does it work? It is still unknown how sulfur helps with treatment of acne.

What’s out there? Several creams and lotions are available. Sulfur is sometimes found in combination with salicylic acid or resorcinol.

What side effects does it cause? Sulfur has the potential to cause some skin scaling, especially on darker skin tones.

What else should I know before trying it? Sulfur products may be more useful for short-term spot treatment. Some older sulfur products have a strong odor that can be bothersome.

Complementary Alternative Medicine (CAM): tea tree oil

How does it work? Tea tree oil kills bacteria that typically causes acne and helps with inflammation.

What’s out there? Tea tree oil comes in creams, gels, sprays, and patches.

What side effects does it cause? A small percentage of people may develop a rash when using tea tree oil.

What else should I know before trying it? Tea tree oil has been shown to work as well as benzoyl peroxide in some studies, but it may take up to 12 weeks to see the full effects. Only use tea tree oil topically because it can be toxic if ingested.

This is just a short list of what skincare options are out there for the treatment of acne. Many products are prescription only, such as oral and topical antibiotics, hormone therapy, azelaic acid, and isotretinoin (Accutane). If your acne is severe enough you may need to see a doctor for one of these medications.

Don’t forget that your doctors and pharmacists at the Student Health Center are here to help if you have any questions or want a recommendation!

Allison Carr, PharmD Candidate 2019

References

  1. Adapalene (topical), alpha hydroxy acids, benzoyl peroxide, salicylic acid, sulfur (topical), and tea tree oil. Lexi-Drugs. Lexicomp. Wolters Kluwer. Hudson, OH. Available at https://online.lexi.com. Accessed June 5, 2018.
  2. Zaenglein MD, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol . 2016;74(5):945-973. doi: 10.1016/j.jaad.2015.12.037.

 

Want a better alternative to sports drinks? Try Pedialyte

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Dehydrated from the weekend? We have good news for you! The Student Health Services Pharmacy is now carrying Pedialyte products. Both the liquid and powder packs will be kept on the shelves to help you recover.

How do you know if you’re dehydrated? Some signs of dehydration include dry mouth, thirst, dark colored pee, headache, and dry skin.

What does your body need when it’s dehydrated? Water of course! But plain water may not be enough for your body. That’s where something like Pedialyte may come in handy. These products contain the chloride, potassium, and sodium electrolytes that your body has lost. Sports drinks and juices may contain too much sugar (which can cause some diarrhea) so more balanced drinks like Pedialyte are recommended for rehydration.

What are some causes of dehydration?

Alcohol

It’s no secret that alcohol is dehydrating and can make you feel terrible. See a previous blogpost on hangovers here and visit http://partysmart.osu.edu/ for more information on responsible drinking and the effects of alcohol. So what you can do to help beat dehydration from alcohol use? Pre-hydrate with drinks like Pedialyte, and don’t forget to drink more before going to bed after a night out. 

Exercise

As you probably know, sweating from exercise can cause enough electrolyte and water loss to dehydrate you. If you feel tired, lightheaded, or notice any of the other symptoms above, make sure to get plenty of fluids in. 

Food Poisoning or Stomach Flu

Diarrhea and vomiting can both cause significant dehydration. After experiencing either of these symptoms, it is important to replace the electrolytes and fluid that is lost. If you think you can manage your symptoms on your own, be sure to only take small sips of Pedialyte at a time and eat a bland diet to not make your symptoms worse.

Contact your doctor if you are severely dehydrated, also have a fever > 101⁰F, experience diarrhea more than 6 times a day, have severe abdominal pain, are pregnant, notice any blood in your stool or vomit, or symptoms continue for over 24 hours. 

Heat

Spending a little too much time at Oval Beach? Sweating it out on the Oval or by the pool while you work on your tan may actually cause some dehydration. Bring fluids with you the next time you decide to lay out.

Travel

Believe it or not, travelling by plane can be very dehydrating. Moisture in the air decreases as you increase in altitude on a flight. You can stay hydrated and still comply with TSA liquid rules by bringing Pedialyte powder packs with you on any upcoming flights.

Stop by the Student Health Service Pharmacy to pick up some Pedialyte today! Our pharmacists are also available to answer any questions you may have about dehydration or the products we carry.

Allison Carr, PharmD Candidate 2019

References:

  1. Baugh CW, Graff L. Observation medicine and clinical decision units In: Walls RM, Hockberger RS, Gausche-Hill M, editors. Rosen’s Emergency Medicine. Elsevier; 2018.
  2. Blumen IJ, Rinnert KJ. Altitude physiology and the stresses of flight. Air Med J. 1995;14(2):87-100. https://www.ncbi.nlm.nih.gov/pubmed/10143549. Accessed June 8, 2018.
  3. Ferrari SP, Welch A. Nausea and vomiting In: Krinsky DL, Ferrari SP, Hume AL, Newton GD, Rollins CJ, et al., editors. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care. Washington DC: American Pharmacists Association; 2015.
  4. Guttman J. Nausea and vomiting In: Walls RM, Hockberger RS, Gausche-Hill M, editors. Rosen’s Emergency Medicine. Elsevier; 2018.
  5. Lazarciuc. Diarrhea In: Walls RM, Hockberger RS, Gausche-Hill M, editors. Rosen’s Emergency Medicine. Elsevier; 2018.
  6. Oral rehydration solutions. Med Lett Drugs Ther. 1983;25(629):19-20.
  7. Walker PC. Diarrhea In: Krinsky DL, Ferrari SP, Hemstreet B, Hume AL, Newton GD, et al., editors. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care. Washington DC: American Pharmacists Association; 2017.

From meal plan to apartment plan

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Its apartment time!

You put in your dorm time, but now you are free.  Free to find an apartment and free from the food plan and you are certain this will save you money. Think carefully about what lies ahead in this department and ask yourself some questions.

Where is the closest

Adjusting from meal plan to apartment plan

full grocery store?

 

Do I know who much groceries cost?

How will I get there? Do I have a backup plan if the first one does not work?

Do I know how to menu plan so I can create a grocery list?

What, if anything, do I know how to cook from scratch or a box?

What will be my budget for food including groceries and eat out?

How big is the refrigerator and how will we divide the space?

Will my roommates and I keep food individual or will we make group meals?

Over the summer, before you move into that apartment, practice grocery shopping and acquire a sense for cost. Think about meal planning. Learn what to keep on hand in your college pantry. Practice packing lunches over summer if you will do that in the fall. Build a library of 15 minute meals for when you are pressured for time.  Research college friendly cooking.  Here’s a great book to get you started:

The $5 a Meal College Cookbook: Good Cheap Food for When You Need to Eat by Rhonda Lauret Parkinson, B.E. Horton.

Kristina Houser, LD

Medical Marijuana

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Cannabis is also called marijuana. Its psychoactive properties are primarily due to one cannabinoid: delta-9-tetrahydrocannabinol (THC) and THC concentration is commonly used as a measure of cannabis potency.

The legal status of cannabis use, for medical as well as recreational purposes, varies internationally as well as across the United States. In Ohio, House Bill 523, effective on September 8, 2016, legalizes medical marijuana. However the program will not be fully operational until September 8, 2018. The Ohio Medical Marijuana Control Program will allow people with certain medical conditions, to purchase and use medical marijuana. This is after the recommendation of an Ohio-licensed physician certified by the State Medical Board.

Patients will require an identification card. The only valid state ID cards will be issued by the State of Ohio Board of Pharmacy once the state’s patient registry becomes available no later than September 2018. Please note that no patient identification cards are being issued by the state of Ohio’s Medical Marijuana Control Program (MMCP) at this time.

Certified physicians may recommend medical marijuana only for the treatment of a qualifying medical condition. Under Ohio law, all of the following are qualifying medical conditions: AIDS, amyotrophic lateral sclerosis, Alzheimer’s disease, cancer, chronic traumatic encephalopathy, Crohn’s disease, epilepsy or another seizure disorder, fibromyalgia, glaucoma, hepatitis C, inflammatory bowel disease, multiple sclerosis, pain that is either chronic and severe or intractable, Parkinson’s disease, positive status for HIV, post-traumatic stress disorder, sickle cell anemia, spinal cord disease or injury, Tourette’s syndrome, traumatic brain injury, and ulcerative colitis.

Patients taking cannabis for medical treatment should consider:

  • Prior experience with cannabis – Patients with no prior experience with cannabis are more likely to experience the psychoactive effects as dysphoric rather than pleasurable. Patients who are regular cannabis users are more likely to be tolerant to some of the adverse effects, eg, cognitive and psychomotor impairment.
  • Cannabinoid content – “Dosing” of cannabis is determined by the means of administration, frequency, and amount used as well as the cannabinoid content of the recommended strain (especially in terms of THC and THC:cannabidiol ratio).
  • Route of administration:
  • Smoked and inhaled cannabis have a rapid onset of effect which is typically minutes and relatively short duration of action which is typically two to four hours. These routes are preferred by some patients because they allow frequent and precise titration of dose to effect (eg, analgesia).
  • Oral cannabis has a slow onset of effect (typically half to one hour) and long duration of action (typically 4 to 12 hours). This may lead to inadvertent overdosing; when patients don’t experience effects as soon as they expect, they may take another dose, resulting in a cumulative overdose. This is especially likely by patients familiar with the rapid onset of smoked or inhaled cannabis

At this time The Ohio State University Wilce Student Health Center is not participating in Ohio’s Medical Marijuana Program however you can find updates at : Ohio Medical Marijuana Control Program 
http://medicalmarijuana.ohio.gov

Annmarie DiMeo

September is National Fruits and Veggies-More Matters Month

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September is National Fruits and Veggies-More Matters Month. 90% of Americans do not eat the amount of fruits and vegetables recommended. There are many benefits to trying to include more in your diet including:

  • Increase variety and flavor to you diet
  • High in vitamins and minerals
  • High in fiber
  • May reduce diseases including heart diseases and some cancers
  • Easy to prepare

Try to consistently fill half your plate with fruits and vegetables at every meal. Also, try to include them with your snacks. All forms of fruits and vegetables count toward your daily intake including fresh, frozen, dried, and canned. Consider trying a new fruit or vegetable to your diet each week.

Dr. Matthew Peters, MD

 

VOICES: A Herpes Support Group

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First meeting: September 4, 2018

A diagnosis of Herpes can feel overwhelming and isolating, but it does not have to. Voices is a group designed to provide a safe, confidential space in which to:

 

  • share experiences
  • learn accurate information about transmission
  • explore treatment options
  • learn how to live with the virus
  • hear from a medical professional as well as others living with Herpes

VOICES is confidential and open to anyone:

  • all genders and ages
  • those living with Herpes
  • those simply wanting to learn factual information

VOICES is held:

  • first Tuesday of each month, 4pm – 5pm
  • Wilce Student Health Center, room 360
  • attendance is free, no registration required

Facilitated by Sarah Philip, CNP, Certified Nurse Practitioner, Student Life Student Health Services

Medical Mythbusters – Poison Ivy!

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poison ivy

rashes caused by poison ivy

Now that we are in the dog days of summer, an old friend is rearing it’s ugly, leafy head.  Yes, it’s poison ivy season, my friends, and while most of us think we know all there is to know about this itch-inducing plant, there are some medical myths lurking around it that need to be busted!

First, the facts:  Poison ivy, poison oak, and poison sumac plants are all coated with a colorless oil called urushiol.  Urushiol is a very sticky, colorless substance present in the leaves, stems, fruit, and roots of the plant. After contact with urushiol, about half of us will develop intense itching, swelling, and skin redness. Then, we will develop fluid-filled blisters that are often arranged in a line or streak.  (See photos)  The symptoms are usually most severe within 1 to 14 days after exposure to the plant, but can occur up to 21 days after exposure if someone had never been exposed to urushiol before.

Technically speaking, poison ivy usually resolves within 1-3 weeks without treatment, but without something to control the itching they will be the longest 3 weeks of your life.  Cool wet compresses can be placed on the affected areas for 15 to 30 minutes at a time.  A group of medications called antihistamines are very good at reducing the itching: diphenydramine (Benadryl) is good for night time because it makes you sleepy and loratadine (Claritin) and cetirizine (Zyrtec) are good for daytime because they don’t.  Oatmeal baths, calamine lotion and hydrocortisone cream are also sometimes helpful, but the best way to knock out the rash and itching is to see your primary health care provider to get a prescription steroid treatment.  Sometimes you can get by with just a shot, but that often does’t last long enough (1-2 days) so you can take a course of pills over a couple of weeks.

Now, on to the myth…

TRUE OR FALSE: Poison Ivy is contagious

FALSE!! 

Poison ivy is not contagious and can not be passed from person to person.  Only contact with urushiol will cause someone else to get poison ivy – the fluid that leaks from blisters does not contain the oil and can not cause symptoms.  Once you’ve washed the urushiol off of your skin (and clothes and fingernails and gardening tools and pets…) you can not spread poison ivy to someone else or yourself.  The rash sometimes appears to be “spreading” from one part of the body to another, but this is because blisters develop at different rates in different parts of the body – any real spreading that went on happened before you realized you had the urushiol on your skin.  This explains why poison ivy has such an unfortunate predilection for our privates.  Please believe me – if you’ve been weeding in the yard, or camping in the woods, make sure you wash your hands before you go to the bathroom as well as after…

John Vaughn, MD – Student Life Student Health Services

Updated by Maribeth Mulholland, MD – Student Life Student Health Services

Irritable bowel syndrome (IBS)

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Irritable bowel syndrome (IBS) can definitely be a frustrating diagnosis as a college student as late night pizza and ice cream binges can exacerbate symptoms. IBS is a common disorder affecting 5% to 15% of the general population. Unfortunately, the list of foods to enjoy and those to avoid may be different for each person. There are some general rules that those with IBS should follow. These standard recommendations include establishing regular eating times, eating smaller frequent meals, and drinking enough fluids. Foods that should (generally) be avoided for those with IBS include banana, coffee, corn, eggs, milk, peas, potatoes and wheat. Caffeine and alcohol are known IBS triggers. Recent studies of low FODMAP diets have shown promising preliminary data in decreasing IBS symptoms. It is also recommended that you make sure to consume enough fiber (25-38Gg/day) though your diet or through fiber supplementation. You can also purchase probiotics over the counter that can aid in reducing IBS symptoms. In conclusion, IBS is a very common disorder that can be difficult to manage as a college student. If you have questions about how to better manage your IBS or think you have IBS, please call the Wilce Student Health Center to schedule an appointment with one of our providers today.

Megan Lottes, C.N.P.

Medical Marijuana and Student Life Student Health Services

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So marijuana is now legal in the state of Ohio….what does that mean for me as a student here at The Ohio State University?

Can I get marijuana prescribed by a provider at the Student Life Student Health Center (SLSHS)?

I haven’t heard of anyone who has been prescribed medical marijuana yet.

As of September 8, state licensure, registration, and certification are required for Ohio’s Medical Marijuana Control Program. Ohio law requires the Ohio Medical Marijuana Control Program to be fully operational by this date.

 

Can I get a prescription from any doctor?

“The federal government prohibits doctors from being able to prescribe marijuana. Instead, patients must have a recommendation from a certified physician. Physicians interested in recommending the use of medical marijuana for patients must apply for a certificate to recommend from the State Medical Board of Ohio.” The Ohio Medical Marijuana Control Program

Many students will not qualify by age alone, as one must be at least 21 years old.

Physicians at the Wilce Student Health Center will not be certified. They will not be prescribing medical marijuana. That being said, it is very important that patients always disclose all supplements or other medications they are prescribed when seeking medical care. Be sure to let your SLSHS provider know if you are taking medical marijuana (or using recreational marijuana).

 

What kind of medical problems can be treated with marijuana?

The State of Ohio Medical Board has a defined list of medical diagnoses that qualify for treatment with medical marijuana.

The most common use is for pain control, especially nerve pain. Medical marijuana can also be helpful with certain types of nausea, muscle spasticity (as with multiple sclerosis and Parkinson’s disease), and glaucoma.

There are some initial studies that indicate marijuana may have a place in treating post traumatic stress disorder.

 

Keep in mind…

Marijuana is still illegal per federal law. The Federal Drug Free Schools and Community Act of 1989 prohibits the use of drugs (including marijuana) on campus if the school is receiving any federal funds.

We are in need of more medical research in the benefits and side effects/complications of marijuana use.

Just like with alcohol, one should not drive while using marijuana (medical or recreational).

The smoke from marijuana has toxic chemicals just like tobacco smoking.

In a student population already struggling with anxiety, depression and attention deficit disorders, the use of marijuana is likely to compound the issues. There is also increased risk of psychosis and impairments in learning, perception and judgement.

Kathryn McKee, M.D.

What’s in your work out supplements?

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It’s the start of 2018, which means the “new year, new me” resolutions are picking up some good momentum by now. Hitting the gym more often is definitely one of my resolutions, and if our resolutions are on the same page, then this post can be of some help to you!

Work out supplements… we see them advertised all over our social media pages, and if you are walking into your local GNC, or Vitamin Shoppe the selection can be intimidating. What I’ve learned so far is that there are supplements that you take as a pre-workout, and supplements that do just as they are named, supplement.

Pre-workout Supplements:

What’s the scoop? Boosting your performance is all part of the plan. Growing bigger muscles, having quicker gains, and hoping for an easy solution is something we all strive for. Most of us understand that easy isn’t necessarily so, and may not entirely be the correct way in doing something. Unlike medications, workout supplements are not as strictly regulated by The Food and Drug Administration (FDA), which means dangerous ingredients may be incorporated without the knowledge of consumers. Some of the ingredients may actually have detrimental effects, and potentially cause death.

1, 3- dimethylamine, methylhexanamine or geranium extract—also known as DMAA is an ingredient that has been found illegally in some dietary supplements, where manufacturers mask the component as a “natural” stimulant. In 2013, a case report was published in the Clinical Journal of Sport Medicine, highlighting an incident where a 21- year old male suffered from cardiac arrest after ingesting a workout supplement containing DMAA. Structurally, DMAA is similarly related to amphetamine, methamphetamine, and MDMA. DMAA does not produce any type of stimulant similar to the mentioned substances, but if you are set to take a urine drug test for a new job, or professional program at The Ohio State University… heads up, you may fail.

Good news, DMAA has been banned by the FDA after the unfortunate incident that occurred in 2013, however, there are still some supplements through online purchase that may have the ingredient incorporated within the product, and I would recommend reading the back of the nutrition label before purchasing any type of supplement. The discontinued substance that contained DMAA was specifically the pre-workout supplement marketed as Jack3d made by USPLabs.

Regular Supplements:

“First off, let me drink some protein.” Protein supplements are frequently consumed by athletes, as well as those who work out recreationally. There is much debate on the theory of amount of protein per day a person should intake and the timing of supplementation, and if you have any questions towards these matters PubMed.gov is a good source for you to do some more research about the topic.

Protein powders come in three common forms, those being—whey, soy and casein. A study by Kanda, A. et al in 2016, looked at the co-ingestion of all three substances and their effects on muscle protein synthesis after exercise in rats. The results of the study demonstrated a difference in peak time according to the type of protein ingestion, the authors concluded that whey protein was quicker to initiate the process compared to casein and soy.

Branched chained amino acids (BCAAs) especially leucine have been shown to increase muscle synthesis after exercise. Leucine is another component to keep an eye out for. Kanda, A et al. also noted that leucine displays a specific saturation point. The threshold described was around 43 mg of leucine, which means anything above this dose resulted in no further increase in the muscles anabolic response.

This is just the tip of the iceberg when it comes to the types of supplements that are available commercially, the big take away from this blog is to get you use to looking at the nutrition label located on the back of the products up for purchase. Speaking to your healthcare providers about any of your concerns is a good thing to do, especially if some of the components of your supplements seem a bit off.

 

Justin Corpus

PharmD Candidate 2018

References:

  1. Kanda, A. et al. Effects of whey, caseinate, or milk protein ingestion on muscle protein synthesis after exercise. Nutrients. 2016 Jun; 8(6): 339.
  2. Lioudmila, K et al. Cardiac arrest in a 21-year old man after ingestion of 1,3 dmaa—containing workout supplement. Clin J Sport Med. 2015 Jan; 25 (1): 23-25