Prepubertal gynecomastia and chronic lavender exposure: report of three cases

J Pediatr Endocrinol Metab. 2016 Jan;29(1):103-7. doi: 10.1515/jpem-2015-0248.


Introduction: Prepubertal gynecomastia is a rare condition characterized by the growth of breast tissue in males as a consequence of early exposure to sexual hormones. When this condition is present, pathological sources of testosterone/estrogen production, such as adrenal or gonadal tumors must be searched for. A few reports have described an association between gynecomastia and substances that produce stimulation of the estrogen receptor, such as lavender and tea tree oil.

Methods: Here we describe the cases of three boys who presented with prepubertal gynecomastia and were chronically exposed to lavender. Two of these boys were exposed to a cologne, named agua de violetas, used by Hispanic communities in the US, and in their countries of origin.

Results: We studied a sample of the cologne used by one of the patients. Analysis of the chemical composition of the agua de violetas cologne was performed using high-performance liquid chromatography as well as off-line mass spectrometric detection. All these, combined with the physical appearance and the smell, determined that the cologne had lavender as an ingredient.

Conclusion: Exposure to estrogenic substances, such as lavender, should be explored in children presenting with prepubertal gynecomastia/thelarche.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Gynecomastia / chemically induced*
  • Gynecomastia / diagnosis*
  • Humans
  • Lavandula / chemistry*
  • Male
  • Oils, Volatile / adverse effects*
  • Plant Oils / adverse effects*
  • Puberty / drug effects*


  • Oils, Volatile
  • Plant Oils
  • lavender oil