Four African-American girls ranging in age from 14 to 93 months showed signs of early sexual maturation 2–24 months after starting to use over-the-counter cosmetic hair preparations which were clearly labeled as containing estrogen or human/bovine placental constituents. The age when the hair product was started ranged from 10–60 months. The estriol concentrations of the products varied from 16 mg/g to 20 mg/g. Each girl was referred for premature development of pubic hair and/or breast enlargement and all demonstrated advanced bone age.
The use of estrogen or placenta-containing hair preparations must now be added to our list of specific questions when evaluating a patient with premature sexual development. This will be especially true if there is pubic hair and/or breast development but no nipple hyperpigmentation. Advanced bone age is usually not seen in premature adrenarche but was observed in these patients. Greater use of hormone- or placenta-containing hair preparations by African-American girls (64%) when compared to Caucasian girls (7%) has been reported.1
While the numbers are small, the findings are “hair-raising!”
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