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Social media and stores are full of products that promise perfect skin. Increasingly, these products are being marketed not just to adults but to teens and tweens. Many are benign, but some can cause skin irritation — and can be costly. And even if these products are benign, does buying them support unhealthy notions about appearance and beauty?

It’s worth looking at this from a medical perspective. Spoiler alert: for the most part teens and tweens do not need specialized skin products, especially expensive ones. But let’s talk about when they may make sense.

When can a specialized skin product help tweens and teens?

So, when should your child buy specialized skin products?

• When their doctor recommends it. If your child has a skin condition that is being treated by a doctor, such as eczema or psoriasis, over-the-counter skin products may help. For example, with eczema we generally recommend fragrance-free cleansers and moisturizers. Always ask your doctor which brands to choose, and get their advice on how best to use them.
• If they have dry and/or sensitive skin. Again, fragrance-free cleansers are a good idea (look for ones recommended for people with eczema). So are fragrance-free, non-irritating moisturizers (look for creams and ointments rather than lotions, as they will be more effective for dry skin). If you have questions, or if the products you are buying aren’t helping, check in with your doctor.

What about skin products for acne?

It’s pretty rare to go through adolescence without a pimple. Many teens aren’t bothered by them, but if your child is bothered by their pimples or has a lot of them, it may be helpful to buy some acne products at your local pharmacy.

• Mild cleansers tend to be better than cleansers containing alcohol. You may want to check out cleansers intended for dry skin or eczema.
• Over-the-counter acne treatments usually contain benzoyl peroxide, salicylic acid, azelaic acid, or alpha-hydroxy acids. Adapalene can be helpful for more stubborn pimples.
• Steer away from astringents or exfoliants, which tend to irritate the skin.
• Talk to your doctor about what makes the most sense for your child — and definitely talk to them if over-the-counter products aren’t helpful. There are many acne treatments available by prescription.

Ask questions and help dispel myths

If your teen or tween doesn’t fall into one of these groups, chances are they don’t need anything but plain old soap and water and the occasional moisturizer if their skin gets dry.

If your child has normal, healthy skin yet is asking for or buying specialized skin products, ask them why. Do your best to dispel the inevitable marketing myths — like that the products will prevent problems they do not have. Let them know that should a problem arise, you will work with them — with the advice of their doctor — to find and buy the best products.

Use it as an opportunity, too, to talk about self-image and how it can be influenced by outside factors. This is an important conversation to have whether or not your child is pining for the latest cleanser they see on Instagram. Helping your child see their own beauty and strengths is a key part of parenting, especially for a generation raised on social media.

About the Author

Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing

Claire McCarthy, MD, is a primary care pediatrician at Boston Children’s Hospital, and an assistant professor of pediatrics at Harvard Medical School. In addition to being a senior faculty editor for Harvard Health Publishing, Dr. McCarthy … See Full Bio View all posts by Claire McCarthy, MD

When preschoolers are melting down or teens are slamming doors, parents face two difficult tasks: keeping themselves composed and supporting their kids’ ability to self-soothe while building skills to handle future challenges.

These abilities are at the heart of co-regulation, a parenting tool that requires patience and practice. But what exactly is involved, and how does it help support children and teens wrestling with big emotions?

What is co-regulation?

“Co-regulation is a supportive, interactive, and dynamic process,” says Lauren Marchette, a child, adolescent, and family psychologist and a lecturer in psychiatry at Harvard Medical School.

Through warm and responsive interactions, caregivers help young people learn better ways to regulate their emotions during the inevitable upsets and challenges of life. “At its heart, co-regulation is connecting with a child who’s in distress and being able to evaluate what that child needs in the moment to help calm themselves.”

But before a parent or trusted adult can help a child, they need to understand — and possibly expand — their own emotional skills and limitations. Emotions are often contagious, whether a person is upset or sharing a sense of calm.

“The tricky part of co-regulation is that adults have to recognize how they’re feeling and be able to regulate their own emotions in difficult moments so they can help children to gain these same skills,” Marchette says. “But this will be so important for kids to develop healthy relationships over time, and affects how people do in school, work, and life in general.”

How does building emotional skills help children and teens?

As children grow up, they learn different skills — how to build a block tower, play a sport, or solve a math equation. They also learn emotional skills: how to recognize and handle feelings of anger or anxiety, for example.

Known as self-regulation, such emotional skills are truly the basis of wellness in life, Marchette says. By consistently practicing co-regulation, parents and other trusted adults foster self-regulation skills in kids.

The list of self-regulation skills is wide-ranging, involving

• emotional awareness and literacy, including the ability to identify emotions
• emotional regulation skills such as self-soothing
• perspective-taking, or the ability to "walk in another’s shoes”
• social skills such as taking turns and practicing patience
• paying attention and remaining focused when needed
• problem-solving
• thinking flexibly
• time management skills
• goal-setting.

What are the potential benefits of co-regulation?

Co-regulation enables kids to eventually learn to

• handle stress
• resist immediate gratification
• avoid hasty, ill-informed decisions
• make and stick to plans
• solve problems
• adapt to challenges
• take healthy risks.

Some research suggests that having better self-regulation skills is linked to more positive outcomes in life, such as higher income and lower rates of substance use and violence.

Who might especially benefit from co-regulation?

Everyone wins when kids are better able to navigate frustrations and manage their reactions to their thoughts and feelings. Parents, teachers, coaches, guidance counselors, mentors, and other adults who interact closely with children also stand to benefit.

As for kids themselves, it’s hard to think of any whose lives won’t be improved by adults who have invested themselves in practicing co-regulation, Marchette says.

But practicing co-regulation skills with certain children and adolescents — including those whose families are experiencing economic hardship, substance abuse, divorce, or other distressing situations — can be especially important.

Is there evidence that co-regulation works?

“While co-regulation is built upon a solid theoretical framework, not many studies have delved into its effectiveness — at least across all age groups,” Marchette says. “Research that does focuses mainly on infants and preschoolers.”

“Much less is known about how co-regulation interventions work for older youth,” she says. “The research is trying to catch up to what we know from years of clinical experience.”

How can a parent coach a child through co-regulation?

Co-regulation doesn’t stand alone as a skill. It relies on fostering a warm, responsive relationship with children, providing structure, and setting limits. “Children benefit from consistent, predictable routines with clear expectations and consequences,” Marchette says.

When a child begins experiencing big emotions, a co-regulation response will look different depending on the child and circumstances. But the steps to take are similar.

“First, the parent needs to pause and self-regulate their own emotions, such as by taking a deep breath,” Marchette explains. “The next steps are validating the child’s feelings, observing the child’s response, and then deciding how to respond next, including verbally and nonverbally, such as with a touch.”

Marchette offers an example based on her own practice: 12-year-old “Eric” is tackling a writing assignment in his bedroom when his mother suddenly hears loud noises. She walks to his door and finds him throwing a stapler, notebook, and container of pens off his desk. “What’s wrong with me?” he yells. “I suck at writing and I hate school!” Then Eric puts his head down on his desk.

The sixth grader’s mom knows he needs help calming down, so she pauses and takes a deep breath. Then she walks over and whispers his name, placing her hand on his shoulder. After more silence, Eric gradually starts sitting up in his chair. “I can tell how frustrated you are with this assignment,” she says to him, validating his feelings. “It must be a really challenging one.”

Eric’s mother knows he needs a break after he mutters, “I can’t do it.” She suggests a getting a glass of ice-cold water, and Eric glumly follows her to the kitchen. After the break, they can re-evaluate if Eric is ready to return to his homework or needs further coping strategies — like a walk outside or a round of jumping jacks — to get his frustration out.

What resources can help parents practice co-regulation?

The Administration for Children and Families offers a free Co-Regulation in Action video series. And some therapists — especially those who specialize in behavioral parent training or cognitive behavioral therapy — can help parents who feel their skills need a boost.

It’s worth noting that it can be hard to have sufficient resources — emotional, financial, and other supports — to practice co-regulation consistently. Those who wish to try should give themselves some grace as they learn the process. “Even parents who are thinking their own self-regulation skills aren’t where they want them to be should realize this is a muscle they can strengthen,” Marchette says. “It’s important to have that growth mindset.”

About the Author

Maureen Salamon, Executive Editor, Harvard Women's Health Watch

Maureen Salamon is executive editor of Harvard Women’s Health Watch. She began her career as a newspaper reporter and later covered health and medicine for a wide variety of websites, magazines, and hospitals. Her work has … See Full Bio View all posts by Maureen Salamon

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

Are online gambling and sports betting new to your area? Are gambling advertisements catching your eye? Have you noticed sports and news shows covering the spread? Recent changes in laws have made gambling widely accessible, and its popularity has soared.

Occasional bets are rarely an issue. But uncontrolled gambling can lead to financial, psychological, physical, and social consequences, some of which are extreme. Understanding whether gambling is becoming a problem in your life can help you head off the worst of these issues and refocus on having more meaning, happiness, and psychological richness in your life. Gambling screening is a good first step.

Can you screen yourself for problem gambling?

Yes. Screening yourself is easy. The Brief Biosocial Gambling Screen (note: automatic download) is a validated way to screen for gambling disorder. It has three yes-or-no questions. Ask yourself:

• During the past 12 months, have you become restless, irritable, or anxious when trying to stop/cut down on gambling?
• During the past 12 months, have you tried to keep your family or friends from knowing how much you gambled?
• During the past 12 months, did you have such financial trouble as a result of your gambling that you had to get help with living expenses from family, friends, or welfare?

What do your answers mean?

Answering yes to any one of these questions suggests that you are at higher risk for experiencing gambling disorder. Put simply, this is an addiction to gambling. Like other expressions of addiction, for gambling this includes loss of control, craving, and continuing despite bad consequences. Unique to gambling, it also often means chasing your losses.

A yes doesn’t mean that you are definitely experiencing a problem with gambling. But it might be valuable for you to seek a more in-depth assessment of your gambling behavior. To find an organization or person qualified to help, ask a health care provider, your local department of public health, or an advocacy group like the National Council on Problem Gambling.

Are you ready for change?

Your readiness to change a behavior matters when deciding the best first steps for making a change. If someone asks you whether you want to change your gambling, what would you say?

Depending on your answer, you might seek out different solutions. What’s most important initially is choosing a solution that feels like the right fit for you.

What if you don’t feel ready to change? If you haven’t thought about your gambling or only occasionally think about changing your gambling, you might explore lower intensity actions. For example, you could

• read more about how gambling could create a problem for you
• listen to stories of those who have lived experience with gambling disorder.

If you are committed to making a change or are already trying to change, you might seek out more engaging resources and strategies to support those decisions, like attending self-help groups or participating in treatment.

Read on for more details on choices you might make.

What options for change are available if you want to continue gambling?

If you want to keep gambling in some way, you might want to stick to lower-risk gambling guidelines:

• gamble no more than 1% of household income
• gamble no more than four days per month
• avoid regularly gambling at more than two types of games, such as playing the lottery and betting on sports.

Other ways to reduce your risk of gambling harm include:

• Plan ahead and set your own personal limits.
• Keep your entertainment budget in mind if you decide to gamble.
• Consider leaving credit cards and debit cards at home and use cash instead.
• Schedule other activities directly after your gambling to create a time limit.
• Limit your use of alcohol and other drugs if you decide to gamble.

What are easy first steps toward reducing or stopping gambling?

If you’re just starting to think about change, consider learning more about gambling, problem gambling, and ways to change from

• blogs, like The BASIS
• books like Change Your Gambling, Change Your Life
• podcasts like After Gambling, All-In, and Fall In, which offer expert interviews, personal recovery stories, and more.

Some YouTube clips demystify gambling, such as how slot machines work, the limits of skill and knowledge in gambling, and how gambling can become an addiction. These sources might help you think about your own gambling in new ways, potentially identifying behaviors that you need to change.

What are some slightly more active steps toward change?

If you’re looking for a slightly more active approach, you can consider engaging in traditional self-help experiences such as helplines and chatlines or Gamblers Anonymous.

Another option is self-help workbooks. Your First Step to Change is a popular workbook that provides information about problem gambling, self-screening exercises for gambling and related conditions like anxiety and depression, and change exercises to get started. A clinical trial of this resource suggested that users were more likely than others to report having recently abstained from gambling.

Watch out for gambling misinformation

As you investigate options, keep in mind that the quality of information available can vary and may even include misinformation. Misinformation is incorrect or misleading information. Research suggests that some common types of gambling misinformation might reinforce harmful beliefs or risky behaviors.

For example, some gambling books, websites, and other resources exaggerate your likelihood of winning, highlight win and loss streaks as important (especially for chance-based games like slots), and suggest ways to change your luck to gain an edge. These misleading ideas can help you to believe you’re more likely to win than you actually are, and set you up for failure.

The bottom line

Taking a simple self-screening test can start you on a journey toward better gambling-related health. Keep in mind that change can take time and won’t necessarily be a straight path.

If you take a step toward change and then a step back, nothing is stopping you from taking a step forward again. Talking with a care provider and getting a comprehensive assessment can help you understand whether formal treatment for gambling is a promising option for you.

About the Author

Debi LaPlante, PhD, Contributor

Dr. Debi LaPlante is director of the division on addiction at the Cambridge Health Alliance, and an associate professor of psychiatry at Harvard Medical School. She joined the division in 2001 and is involved with its … See Full Bio View all posts by Debi LaPlante, PhD

Colon cancer is the second-deadliest form of cancer after lung cancer. If recent messages about colon cancer screening have left you a little confused, that's understandable. In August, the American College of Physicians (ACP) released updated guidance for colon cancer screening that differs from other major organizations, including recommendations from the American Cancer Society (ACS) and the US Preventive Services Task force (USPSTF).

So, what do you need to know?

How does the advice differ?

First, please note that this advice applies only to people at average risk without a family history of colon cancer. If you have family history, or if other health issues put you at higher-than-average risk for colorectal cancer, talk to your doctor about the best course of action for you.

The main point of disagreement relates to the age at which people should start getting screened. The new ACP guidance says 50, while the other two organizations recommend 45. That earlier age is endorsed by the U.S. Multisociety Task Force on Colorectal Cancer. It's also endorsed by many physicians, including Harvard Medical School professor Dr. Andrew T. Chan, a gastroenterologist and director of epidemiology at Massachusetts General Hospital Cancer Center, who helps explain key facts below.

Why do experts suggest starting screening earlier?

"We're facing an unexplained and alarming increase in the incidence of colon cancer in people younger than 50," says Dr. Chan.

Overall, deaths from colon cancer dropped by 2% per year from 2011 to 2020. But that's not the case among people younger than 50. In that age group, deaths from colon cancer rose between 0.5% and 3% during the same time period, according to statistics published in 2023.

The rising rates of colon cancer in younger people are occurring in all racial and ethnic groups, with the steepest rises seen among Alaskan Natives and Native Americans. Overall, Blacks and African Americans are more likely to get and die from colon cancer than whites, and early-onset cases are higher in Black individuals than whites.

Efforts to encourage colon cancer screening began in the mid-1990s. Today, about 60% of adults over 50 follow the advice to receive a colonoscopy (described below) on a regular basis. This track record, while not perfect, likely explains the decline in deaths from colon cancer in older adults.

"I think that promoting earlier screening will help stem the rise in early-onset cases, at least for those in their 40s. We've also seen that earlier colonoscopies may be associated with lowering incidence of colon cancer even later in life, "says Dr. Chan.

What are the different screening tests for colon cancer?

The two most widely used screening tests are a standard colonoscopy and various stool-based tests.

Colonoscopy. For this test, a gastroenterologist or surgeon snakes a long, flexible tube with a camera on the end through your rectum and beyond to inspect the entire length of your colon. Considered the gold-standard test, this procedure can detect precancerous polyps called adenomas, and allow for their removal.

The test requires taking laxatives and drinking lots of fluids beforehand to clean all the fecal material (stool) out of your colon. Serious complications, which include perforation or bleeding, are rare, occurring in about three in 1,000 procedures. If no polyps are found, a repeat colonoscopy isn't recommended for another 10 years. If you have polyps, or your risk or symptoms change, this interval will be shorter.

Stool tests. The more worrisome colon polyps (adenomas) often shed tiny amounts of blood and abnormal DNA into the stool. This can be detected from samples you collect yourself at home.

• Two tests, the fecal occult blood test (FOBT) and fecal immunochemical test (FIT), check for blood. They require small stool samples that you put on a card or in a tube that's then mailed to a lab. These tests should be done every year.
• A third option, the FIT-DNA test, checks for both blood and abnormal DNA; it's usually repeated every three years.

Additionally, the guidelines from the American College of Physicians suggest another option: flexible sigmoidoscopy, which inspects only the lower part of the colon, once every 10 years, combined with a fecal FIT testing every two years. However, doctors in the United States rarely order sigmoidoscopy today.

If flexible sigmoidoscopy or any of these stool tests show evidence of a problem, a colonoscopy is needed to check for adenomas or cancer.

Why might stool-based screening make sense for younger adults?

Colonoscopy isn't necessarily the best initial screening test for everyone, says Dr. Chan. That's especially true for younger people, mainly because it's time-consuming and inconvenient.

"Maybe you just can't find time in your schedule or are worried about having a colonoscopy," he says. If that's the case, a stool-based test — which is noninvasive and takes very little time — is an appropriate option.

"The worst option is not doing anything, because early detection and treatment can prevent deaths," he says.

About the Author

Julie Corliss, Executive Editor, Harvard Heart Letter

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She … See Full Bio View all posts by Julie Corliss

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD