By RX FOR READERS/JUDY SIEGEL-ITZKOVICHGirl with a headache(photo credit: INGIMAGE)My 15-year-old son complains of headaches quite often, but when I take him for an examination, the doctor finds no problem and tells us not to worry, the boy is perfectly healthy. When are headaches in teenagers – or for that matter, children – something to be concerned about? T.A., Givatayim Dr. Ya’acov Genizi, head of the pediatric neurology unit at Bnai Zion Medical Center in Haifa, replies:Headaches in children and adolescents are quite common, with 15 percent of young children and 80 percent of teenagers complaining about headaches. The problem usually does not point to a dangerous disease, but a doctor should be consulted.One has to distinguish between a non-worrisome primary headache, which need not arouse worry, and secondary headaches, which need immediate attention. This second kind may result from a rise in intracranial pressure, such as from a tumor or bleeding, causing more frequent complaints – and more serious issues. The pain here becomes more intensive and is accompanied by additional symptoms, such as vomiting, avoidance of light or noise, and sleep disturbances.In this case, the youngster must be taken for treatment immediately.Even though primary headaches, such as tension headaches or migraines, should not cause extreme worry, they do have to be treated. Migraines in children and teens can cause intensive pain, usually on both sides of the head, accompanied by pulsation or pressure. In many cases, the sufferer wants to lie down and sleep.The condition generally lasts for a few hours and passes, usually after sleep. Migraines often come in the form of strong attacks that disrupt functioning.There is a family history of migraines in about 70% of cases, and they sometimes happen while traveling in a vehicle, accompanied by dizziness and nausea. About a quarter of children describe themselves as feeling an aura – with changes in vision, pain, weakness, a stomachache, and even a feeling as though ants were running up and down their limbs before the migraine occurs.These attacks in children are usually triggered by tiredness, lack of sleep, tension or even vigorous physical activity. Foods such as yellow cheese or chocolate or the additive monosodium glutamate – which are known to trigger migraine attacks in adults – almost never start them in children. Children’s migraines are usually halted when they take pain relievers such as paracetamol.To prevent the migraine headaches, it is important to keep to a regular schedule including sleeping, eating and organized sport activities, as well as removing the triggers of the condition. When children continue to suffer from frequent episodes, one may add complementary therapy such as biofeedback or treatment with herbs, but in serious cases, medications taken preventively for several months should be considered.Tension headaches, unlike migraines, are characterized by mild-to-moderate intensity discomfort that does not interfere with normal activities. This headache is not accompanied by nausea, vomiting or sensitivity to light and sound. This pain usually appears for a short time and may occur even on a daily basis.Tension-type headaches apparently result from contraction of the scalp muscles due to stress, and the pain is felt like a “belt” around the head and especially the forehead. In these cases, one must be careful not to take too many pills for the pain.Instead, one should eliminate the factors that cause emotional tension. In serious cases, one should take medications only for a limited time.Thus, in summation, headaches in children and adolescents are common, and their causes are varied. Doctors must differentiate between the various kinds of headaches, take a detailed medical history, and treat each patient according to his or her individual circumstances.I am a 42-year-old woman and business executive. I took on a complicated and pressured project at work six months ago and have noticed that since then, the skin on my face has become dry, reddish, with some pimples that take time to go away and other phenomena that I never had before. I was wondering whether they could be due to the pressure and stress I have been going through. Can anything be done about it (besides stopping my project)? V.M., Herzliya Tel Aviv aesthetic dermatologist Dr. Monica Elman replies:Tension and anxiety can definitely affect the condition of our skin, and it is likely to be a consideration in your case if you are not doing anything differently than you did before your began your project.Skin reacts to outside factors and is very sensitive. It is comprised of several layers, each of which contains receptors that react to different factors. Tension can trigger or worsen skin conditions such as atopic dermatitis and psoriasis, as well as acne, the expansion of capillaries, redness and skin herpes.As your condition has continued for some time, you should consult a dermatologist. In the meantime, you could buy aromatic oils such as lavender and chamomile, in the form of drops or emulsions added to your bath to calm yourself and your skin down. Regular exercise neutralizes the negative hormone named cortisol and boosts positive hormones such as serotonin and endorphins. Don’t pick at any pimples or sores so you don’t get scars.Make sure your diet is healthy, with a lot of greens and other vegetables and fruits. Drink a lot of water – about six to eight glasses per day.Rx for Readers welcomes queries from readers about medical problems.Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 9100002, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or email it to jsiegel@jpost.com, giving your initials, age and place of residence.