Boys with Gynecomastia: the Lavender and Tea Tree Oil Debate Continues
The numerous mini-wars that go on in the far reaches of medicine can be fascinating. Many don’t reach the front pages (or any pages, for that matter) of popular publications, however; meaning average people never hear about most of these disagreements among experts.
But if you’re interested in gynecomastia for any reason, you should probably know something about the debate concerning whether lavender and tea tree oil can prompt the growth of breast tissue in young males. Just last month, an article in the Journal of Pediatric Endocrinology and Metabolism explored three cases of breast growth among Miami area boys chronically exposed to lavender. The authors suggested that doctors should ask their young gynecomastia patients whether they use the substance, stirring up an eight year old debate.
Where it All Started
A suspected link between lavender and tea tree oil and gynecomastia was first suggested in 2007 in a study published in the New England Journal of Medicine and followed up by the National Institutes of Health. A pediatric endocrinologist from the University of Colorado had noted breast growth in three of his patients who had used the essential oils. Scientists from the NIH then conducted experiments that appeared to confirm that the oils can mimic the effects of estrogen and suppress androgen (a male hormone).
Since then, the debate has rumbled on, with individuals and organizations in the essential oil industry lining up against researchers who believe lavender and tea tree oil may indeed be “endocrine disruptors.” Industry folks point to drawbacks in the initial study, such as the tiny group of just three subjects. Scientists counter with examples of patients whose hormone levels-and cases of gynecomastia-resolve after discontinuing use of the essential oils, and the results of their experiments on human and rodent tissues indicating an estrogen response to the substances.
The Debate Today
In the latest skirmish, triggered by the Miami doctors, both sides raise some interesting points. In a response to the Miami study, the CEO of the Australian Tea Tree Industry Association discussed the possibility that other endocrine disrupting substances may have been present in some of the tests conducted. He further pointed out that tea tree oil (unfortunately) varies widely in its concentration and purity in the marketplace.
The Miami researchers countered, saying that they have seen many more than three pre-adolescent boys with breast growth who were exposed to lavender but were unable to study these patients in depth. They emphasize that breast growth in boys prior to puberty is rare, and they can find no other logical explanation. They also reiterate evidence that lavender and tea tree oils can indeed prompt an estrogenic response, whereas possible contaminants that may have been present in past studies have no such properties.
You can read this latest exchange on PubPeer.com, a website that encourages scientists to discuss and comment on timely research. The researchers in Miami conclude that publishing work like theirs is necessary to offer balance and add to the body of information about the topic. They say they are motivated to protect consumers from unnecessary harm.
What’s It All Mean?
Here’s where we fall in this debate: our first and most important responsibility is the safety and well being of our patients. Therefore, although we agree that the evidence to date is far from flawless and overwhelming, it’s best at this point to limit contact for boys to lavender and tea tree oil. And, if a youngster using these substances begins to develop breasts, he should discontinue their use immediately.
In our thirty years of plastic surgery practice in New York, gynecomastia has become one of our specialties. It’s very possible we have treated more males with enlarged breasts than any other practice in the country-and we see young men with the condition as well as adults. Naturally we don’t operate on pre-adolescent boys except in very rare cases. But we can provide in-depth examinations, educate parents and patients and provide expert advice.
If you’d like to talk, give us a call at 212-570-6080 or send us an email.