The diagnosis of adolescent gynecomastia is reported to occur in three percent to 65 percent of adolescent males. The reason for this wide range is the lack of standardized sizing of the glandular tissue. In studies of the condition, doctors use a size range of anywhere from 1/2 to 2 centimeters to make their diagnosis. The growth of glandular tissue seems to occur between the ages of 10 to 13 years old, starting approximately six months after the onset of secondary male characteristics. This is triggered by an imbalance between estrogen, which stimulates breast growth, and testosterone, which reduces the effect of estrogen. Most cases of gynecomastia in boys regress with maturity, but it never diminishes for approximately five percent of males. In such cases, the tissue becomes firm and fibrous in nature upon reaching adulthood. At this point, the only treatment option is surgery.
Medical treatment of adolescent gynecomastia is currently under investigation. To date, there are no drugs approved by the FDA (Food and Drug Administration) for the treatment of gynecomastia. Some of the drugs under investigation are tamoxifen, which blocks estrogen receptors; danazol, an androgen that blocks estrogen productions; and dihydrotestosterone, an androgen. Obviously, much further research is needed to develop an effective drug that will be approved by the FDA for the general public.
All men with enlarged breasts are candidates but the more extreme cases of gynecomastia will require more extensive surgery and possibly skin excision. It is important for the patient to be healthy and emotionally stable. Men whose gynecomastia is exacerbated by drugs should take this into consideration prior to surgery.