When Breasts Form in Males

What is gynecomastia?
Gynecomastia is a condition in which firm breast tissue forms in males. The breast tissue is usually less than 1-1/2 inches across and is located directly under the nipple. Gynecomastia may be present on one side or on both sides. This condition may make the breast tender.

Some men and boys have fat on their chests that makes it look like they have breasts. This condition is called pseudogynecomastia (false gynecomastia). It is not the same thing as gynecomastia.


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What causes gynecomastia?
Gynecomastia is usually caused by changes in hormones at puberty or as part of aging. Gynecomastia may be caused by changes in the balance of 2 hormones: estrogen and testosterone. In rare cases, gynecomastia may be caused by prescription drugs, over-the-counter medicines, illegal drugs, tumors or disease.


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Are tests needed to find the cause of gynecomastia?
Sometimes tests are needed, and sometimes they're not. Your doctor will ask you questions about your symptoms, such as how long you've had the breast tissue, and whether or not the area is tender. Your doctor will also ask you about any illnesses you may have had in the past, medicines you take, and other matters relating to your health. Then you will have a physical examination.

Whether you need tests depends on your age and what your doctor learns from your history and physical examination. Gynecomastia is common in teenage boys. As many as 65% of 14-year-old boys have gynecomastia. If you are a teenager, you probably will not need tests. Your breast enlargement will probably go away on its own in 2 or 3 years. However, younger boys and adult men who have gynecomastia may need to have some tests. In these cases, it is possible that some kind of disease may be causing the problem.


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How is gynecomastia treated?
In most cases, no treatment is needed. Your doctor will probably want to check the size of your breast tissue every few months. In 90% of teenage boys, gynecomastia goes away in less than 3 years.

Sometimes the problem can be solved if you stop taking a medicine that is causing gynecomastia or stop using an illegal drug that is causing the problem.

Occasionally, medicines may be used to treat gynecomastia, especially if tenderness is a problem. The medicine will make the extra breast tissue go away. Rarely, surgery may be necessary to remove the extra breast tissue.

If gynecomastia is caused by a disease or a tumor, treatment is necessary . If gynecomastia is caused by a disease, the disease itself will need to be treated.


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Could the breast lump be cancer?
Probably not. Breast cancer is very rare in males. Lumps caused by cancer are usually not underneath the nipple--where breast tissue from gynecomastia grows. Breast cancer feels different than the breast tissue of gynecomastia. Breast cancer may also cause dimpling of the skin or a bloody discharge from the nipple. Your doctor will probably be able to tell whether your breast lump is cancer. If there is any question that you have cancer, you will need to have a mammogram and a biopsy.

Hair Loss and Its Causes

The normal cycle of hair growth lasts for 2 to 6 years. Each hair grows approximately 1 centimeter (less than half an inch) per month during this phase. About 90 percent of the hair on your scalp is growing at any one time. About 10 percent of the hair on your scalp, at any one time, is in a resting phase. After 2 to 3 months, the resting hair falls out and new hair starts to grow in its place.

It is normal to shed some hair each day as part of this cycle. However, some people may experience excessive (more than normal) hair loss. Hair loss of this type can affect men, women and children.



What causes excessive hair loss?
A number of things can cause excessive hair loss. For example, about 3 or 4 months after an illness or a major surgery, you may suddenly lose a large amount of hair. This hair loss is related to the stress of the illness and is temporary.

Hormonal problems may cause hair loss. If your thyroid gland is overactive or underactive, your hair may fall out. This hair loss usually can be helped by treatment thyroid disease. Hair loss may occur if male or female hormones, known as androgens and estrogens, are out of balance. Correcting the hormone imbalance may stop your hair loss.

Many women notice hair loss about 3 months after they've had a baby. This loss is also related to hormones. During pregnancy, high levels of certain hormones cause the body to keep hair that would normally fall out. When the hormones return to pre-pregnancy levels, that hair falls out and the normal cycle of growth and loss starts again.

Some medicines can cause hair loss. This type of hair loss improves when you stop taking the medicine. Medicines that can cause hair loss include blood thinners (also called anticoagulants), medicines used for gout, medicines used in chemotherapy to treat cancer, vitamin A (if too much is taken), birth control pills and antidepressants.

Certain infections can cause hair loss. Fungal infections of the scalp can cause hair loss in children. The infection is easily treated with antifungal medicines.

Finally, hair loss may occur as part of an underlying disease, such as lupus or diabetes. Since hair loss may be an early sign of a disease, it is important to find the cause so that it can be treated.



Can improper care of my hair cause hair loss?
Yes. If you wear pigtails or cornrows or use tight hair rollers, the pull on your hair can cause a type of hair loss called traction alopecia (say: al-oh-pee-sha). If the pulling is stopped before scarring of the scalp develops, your hair will grow back normally. However, scarring can cause permanent hair loss. Hot oil hair treatments or chemicals used in permanents (also called "perms") may cause inflammation (swelling) of the hair follicle, which can result in scarring and hair loss.

What is common baldness?
The term "common baldness" usually means male-pattern baldness, or permanent-pattern baldness. Male-pattern baldness is the most common cause of hair loss in men. Men who have this type of hair loss usually have inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. In male-pattern baldness, hair loss typically results in a receding hair line and baldness on the top of the head.

Women may develop female-pattern baldness. In this form of hair loss, the hair can become thin over the entire scalp.


Can my doctor do something to stop hair loss?
Perhaps. Your doctor will probably ask you some questions about your diet, any medicines you're taking, whether you've had a recent illness and how you take care of your hair. If you're a woman, your doctor may ask questions about your menstrual cycle, pregnancies and menopause. Your doctor may want to do a physical exam to look for other causes of hair loss. Finally, blood tests or a biopsy (taking a small sample of cells to examine under a microscope) of your scalp may be needed.


Is there any treatment for hair loss?
Depending on your type of hair loss, treatments are available. If a medicine is causing your hair loss, your doctor may be able to prescribe a different medicine. Recognizing and treating an infection may help stop the hair loss. Correcting a hormone imbalance may prevent further hair loss.

Medicines may also help slow or prevent the development of common baldness. One medicine, minoxidil (brand name: Rogaine), is available without a prescription. It is applied to the scalp. Both men and women can use it. Another medicine, finasteride (brand name: Propecia) is available with a prescription. It comes in pills and is only for men. It may take up to 6 months before you can tell if one of these medicines is working.

If adequate treatment is not available for your type of hair loss, you may consider trying different hairstyles or wigs, hairpieces, hair weaves or artificial hair replacement.