Calling all COLA parents. If your kids have hit the teenage years and you feel at a loss about how to navigate its challenges,you're not alone. The good news? We called in the pros and got some expert advice about eating disorders, teen depression, screen time, acne, sex + more.

To help us gather your need-to-know questions, we recently asked our readers (aka you) to send us their teen health + safety questions for this month's installment of Prisma Health On Call. Here with the answers are Prisma Health pediatrician April Nicole Hobbs, MD, and Chief of the Division of Adolescent and Young Adult Medicine Mike F. Guyton-Nunley, MD.

How do I encourage my daughter to have healthy habits without making her worry about body image?

It may be tough to encourage a "healthy" body image no matter how hard a parent tries, because the parent is not going through the experience their teen is. Instead, show your teen what it means to have a healthy body image by maintaining a predictable, consistent, and confident perception of yourself, both through actions and conversations. Our teens are watching us for guidance more than we realize. Building up their confidence will help them make this world deserving of them, not the other way around!

How do I know if my teen is just moody or actually struggling with depression?

There are many signs that can be seen in children experiencing depressive symptoms, including:

No longer interested in spending time with their close friends and family
Loss of interest in activities they previously enjoyed
Significant change in their sleep pattern or eating habits
Signs of self-harm
Drug/alcohol use or high-risk behaviors
Decline in school performance
Persistent negative mood/feelings of hopelessness

See more signs of depression — and if you notice any of these signs in your teen, please reach out to your child’s doctor.

Are there any resources for teenagers who are dealing with an eating disorder?

First, talk with your pediatrician. They are trained to recognize concerns with growth and weight and determine if more help is needed for stabilization of nutrition. Adolescent medicine doctors care for teens struggling with eating disorders and would be a great next step.

Outside of a doctor's office, there are great community services to help parents (such as Caregiver Connections' Margaret Yeakel, myeakel@sc.rr.com), patients (National Eating Disorder Association), and providers (Carolina Resource Center for Eating Disorders).

What causes teen acne? What topicals help it and what makes it worse?

Teenage acne is caused by hormonal changes that occur during puberty. The increase in hormones causes oil glands in your skin to overproduce. This results in clogged pores. The clogged pores can become inflamed or infected resulting in acne. To treat it, you can use topical acne products such as washes, lotions, or gels. Note that washes and lotions are better tolerated, since gel products can dry out the skin and make it more irritated.

Your options include:

Over-the-counter acne products, many of which include benzoyl peroxide as the active ingredient. Benzoyl peroxide helps to kill bacteria in the clogged pores and ultimately unclogs the pores to eliminate the pimples or prevent them from forming.
Stronger topical treatments that may be recommended or prescribed if benzoyl peroxide treatments are not working (e.g., topical retinoids and topical antibiotics). If using topical retinoids, use exactly as directed. Also, avoid excessive sun exposure and use sunscreen while using topical retinoids to prevent irritation of the skin.

Acne treatment takes multiple weeks before noticing improvement. Be consistent and patient, and don’t fall for common acne myths.

At what age should a teen get a pelvic exam?

The recommended age for a first pelvic exam is 21, which is when cervical cancer screenings typically begin. However, if there are concerns about abnormal menstrual bleeding, infection, or pain in the pelvic area, a pelvic exam may be recommended earlier.

The American College of Obstetricians and Gynecologists recommends that girls have their first GYN visit between the ages of 13 and 15. This visit doesn’t usually involve a pelvic exam, but is just a conversation with the doctor. Pediatric and adolescent gynecologists are specially trained to care for these younger patients.

I think teens are not emotionally mature enough to have sex, but it's so "normal" nowadays. How do I discourage my teen from having sex too young (or am I just supposed to be ok with it)?

It’s important to focus on decreasing risk in any behavior, whether it be sex or something else. If teens are not ready for it, sex can be risky, both physically and mentally. If sex happens in a relationship where there is trust, honesty, communication, and preparation, that's when sex is the best. But if not — such as when you haven't talked to your partner about the risks and whether you both are ready for the emotions that come with sex — then it can be more difficult. In that situation, sex can make you feel physically and mentally bad, it can lead to emotions such as depression and anxiety, or it can be used as a form of victimization or abuse.

It's never too early for a parent to check in with their teen about their knowledge, questions, or thoughts around sex. For advice on how to have this conversation, listen to this podcast.

How much screen time is too much screen time?

Children are spending more time on screens than ever before. It is important for families to balance media use with healthy activities to optimize growth and development. For children 5 and younger, the American Academy of Pediatrics recommends these limits on screen use:

No media use for children under 18 months.
Families with children 18 to 24 months should limit screen time choosing high-quality programming and planning to watch together.
Screen time for children 2 to 5 years should be limited to one hour a day.
There is no standard limit on screen use for ages 6 and older, but parents are encouraged to set their own screen time limits and ensure that screen time is not replacing sleep, family time, educational activities, or exercise. Parents are also encouraged to talk to their children about how they use media, who they are communicating with, and what their child is learning from their media use.

Families may visit healthychildren.org/mediauseplan to create an individualized family media plan.

Want to speak to a Prisma Health pediatrician about your teen? Schedule an appointment.