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Gynecomastia in Adolescence – Will it Go Away after Puberty?

The human body changes significantly as it goes through puberty. However, one of these changes can be quite concerning to adolescent boys – gynecomastia. Gynecomastia or man boobs (moobs) is a physiological finding during puberty amongst boys.

Man boobs are rightly considered trivial by pediatricians. However, for the teenage boy consumed by insecurities about his appearance, the condition affects his mental wellbeing and psychosocial relationships1.

What is Gynecomastia?

Gynecomastia, also known as man boobs, is the growth of glandular tissue and increased fat in the chest region of males that mimics female breasts2. Generally, males do have small amounts of this glandular tissue and fat cells in the chest region. However, when there is a hormone imbalance, this pre-existing tissue can undergo rapid growth.

Man boobs are common in newborn babies, teenage males, and older males. While it is normal during these phases of life, the latter two can be the cause of significant emotional distress for the affected individuals.

Gynecomastia in teenagers is relatively common, affecting approximately 69% of males between the ages of 10 years and 19 years worldwide3. In fact, it usually does not require any treatment. However, if the condition doesn’t resolve on its own, it might persist into adulthood.

Cause of Man Boobs in Teenagers

Teenagers suffer from gynecomastia as a result of disturbance of estrogen-testosterone balance in their bodies4. During adolescence, there could be a rapid increase in estrogen while testosterone levels are lagging.

What this means for the teenage male body is that the pre-existing breast tissue reacts with this increased estrogen. Consequently, this grows into breasts that mimic female breasts. Eventually, testosterone levels catch up to restore balance. As a result, teenage gynecomastia resolves spontaneously.

Man boobs differentiation is important. It is the result of hormonal fluctuations from male obesity, or, pseudo gynecomastia.  Pseudo gynecomastia develops from excess fat in the body7.

Therefore, this distinction is important to make as the treatment of gynecomastia and pseudo gynecomastia are quite different. The former may resolve on its own but the latter requires extensive weight loss and there still might be saggy, excess skin left behind.

an overweight man with gynaecomastia issue

Can Gynecomastia Persist Through Adulthood?

Gynecomastia presents in three different phases of life: newborn, teenage, and old age. The newborn gynecomastia usually resolves on its own as it is only due to exposure to maternal estrogen. However, teenage gynecomastia may persist well into adulthood.

Physiological gynecomastia in teenagers is only supposed to last for six months to two years. However, gynecomastia that lasts beyond the age of 17 years is pathologic and persistent pubertal gynecomastia, respectively5.

In many cases of persistent gynecomastia, there is an underlying disease or use of a gynecomastia-causing medication. However, there may be persistent gynecomastia without these underlying causes, and this type requires targeted therapy for the treatment of the condition.

a stress out teenager pulling his hair due to his man boobs or gynecomastia problem

Psychological Effects of Gynecomastia

Man boobs disrupts the appearance of the body during adolescence. Thus, they are more likely to suffer from body image issues which can be exaggerated by gynecomastia.

According to research published in the Plastic Reconstructive Surgery Journal, there is a marked decrease in mental health, emotional health, even self-esteem of boys that suffer from gynecomastia5.

The social functioning of these boys is severely impaired as they may be ridiculed for their appearance by their peers. The fear of ridicule leads to isolation and the quality of life of these boys. These factors have potential long-term side effects on their social relations; even in adulthood.

Treatments of Gynecomastia

Previously, the only therapy other than the reassurance for boys with significant man boobs has been surgical breast reduction. Nowadays, Non-invasive fat removal treatments such as body contouring have been seen to be effective in reducing the appearance of man boobs.

Body contouring treatments are a non-invasive approach used to target fat cells in specific areas of the body. Body contouring methods such as CoolSculpting and SculpSure are able to target stubborn pockets of fat away and treat gynecomastia7.

Targeting Stubborn Pockets of Fat

Developed by Harvard scientists, CoolSculpting is an FDA-approved non-invasive fat removal treatment that utilizes fat freezing to target stubborn fat pockets. During CoolSculpting, the stubborn pocket of fat in the chest would be exposed to sub-zero temperatures using vacuum cup applicators.

As a result, the freezing of the fat cells are then broken down and eliminated from the body naturally.

CoolSculpting

Developed by Harvard scientists, CoolSculpting is an FDA-approved non-invasive fat removal treatment that utilizes cryolipolysis to target stubborn fat pockets. During CoolSculpting, the stubborn pocket of fat in the chest would be exposed to sub-zero temperatures using vacuum cup applicators. As a result, the freezing fat cells are then broken down and eliminated from the body naturally.

a man going through a coolsculpting to lose waist and belly fat
a photo of a SculpSure machine treating a patient

SculpSure

Another treatment that is effective in treating man boobs would be SculpSure. SculpSure uses laser thermolysis to target stubborn pockets of fat located below the skin surface.

The non-invasive treatment utilizes lasers to induce constant and concentrated heat that targets the fat tissues. The constant heat between 45°C – 47°C causes the fat cells to break down which is then eliminated naturally via the body’s waste disposal mechanism.

Not only is SculpSure is an effective method for treating the fat deposits causing gynecomastia, but its induced lasers also penetrate deep within the dermis. This stimulates the production of collagen and results in firmer and tighter skin around the chest region.

Downtime

Both procedures are non-invasive and painless. Hence, do not require long recovery periods as compared with the surgical treatment.

References: 1. Dickson G. (2012). Gynecomastia. American family physician, 85(7), 716–722. 2. Narula, H. S., & Carlson, H. E. (2007). Gynecomastia. Endocrinology and metabolism clinics of North America, 36(2), 497–519. https://doi.org/10.1016/j.ecl.2007.03.013 3. Braunstein G. D. (1993). Gynecomastia. The New England journal of medicine, 328(7), 490–495. https://doi.org/10.1056/NEJM199302183280708 4. Moore, D. C., Schlaepfer, L. V., Paunier, L., & Sizonenko, P. C. (1984)Transient pubertal gynecomastia: abnormal androgen-estrogen ratios. The Journal of clinical endocrinology and metabolism, 58(3), 492–499. https://doi.org/10.1210/jcem-58-3-492 5. Rani, S., & Sachdeva, S. (2021). Pseudogynecomastia: A chance occurrence with acitretin. Indian journal of pharmacology, 53(5), 388–390. 6. Soliman, A. T., De Sanctis, V., & Yassin, M. (2017). Management of Adolescent Gynecomastia: An Update. Acta bio-medica : Atenei Parmensis, 88(2), 204–213. https://doi.org/10.23750/abm.v88i2.6665 7. Nuzzi, L. C., Cerrato, F. E., Erikson, C. R., Webb, M. L., Rosen, H., Walsh, E. M., DiVasta, A. D., Greene, A. K., & Labow, B. I. (2013). Psychosocial impact of adolescent gynecomastia: a prospective case-control study. Plastic and reconstructive surgery, 131(4), 890–896. https://doi.org/10.1097/PRS.0b013e3182818ea8 8. Sean Doherty, M. D. (2019, July 30). Three popular options for male body contouring. American Society of Plastic Surgeons. Retrieved January 24, 2022, from https://www.plasticsurgery.org/news/blog/three-popular-options-for-male-body-contouring