Prepubertal gynecomastia linked to lavender and tea tree oils

N Engl J Med. 2007 Feb 1;356(5):479-85. doi: 10.1056/NEJMoa064725.

Abstract

Most cases of male prepubertal gynecomastia are classified as idiopathic. We investigated possible causes of gynecomastia in three prepubertal boys who were otherwise healthy and had normal serum concentrations of endogenous steroids. In all three boys, gynecomastia coincided with the topical application of products that contained lavender and tea tree oils. Gynecomastia resolved in each patient shortly after the use of products containing these oils was discontinued. Furthermore, studies in human cell lines indicated that the two oils had estrogenic and antiandrogenic activities. We conclude that repeated topical exposure to lavender and tea tree oils probably caused prepubertal gynecomastia in these boys.

Publication types

  • Case Reports
  • Research Support, N.I.H., Intramural

MeSH terms

  • Androgen Antagonists / pharmacology*
  • Breast Neoplasms
  • Cathepsin D / biosynthesis
  • Cathepsin D / genetics
  • Cells, Cultured / drug effects
  • Child
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Genes, myc / drug effects
  • Gynecomastia / chemically induced*
  • Humans
  • Insulin-Like Growth Factor Binding Protein 3
  • Insulin-Like Growth Factor Binding Proteins / biosynthesis
  • Insulin-Like Growth Factor Binding Proteins / genetics
  • Male
  • Oils, Volatile / adverse effects*
  • Oils, Volatile / pharmacology
  • Plant Oils / adverse effects*
  • Plant Oils / pharmacology
  • RNA, Messenger / biosynthesis
  • Receptors, Estrogen / drug effects
  • Tea Tree Oil / adverse effects*
  • Tea Tree Oil / pharmacology

Substances

  • Androgen Antagonists
  • IGFBP3 protein, human
  • Insulin-Like Growth Factor Binding Protein 3
  • Insulin-Like Growth Factor Binding Proteins
  • Oils, Volatile
  • Plant Oils
  • RNA, Messenger
  • Receptors, Estrogen
  • Tea Tree Oil
  • Cathepsin D
  • lavender oil