Implicated compounds:
(1) lavender oil (Lavandula angustifolia)
(2) tea tree oil (Melaleuca alternifolia)
Features of the gynecomastia:
(1) onset of gynecomastia following continued exposure to an herbal product containing a compound with estrogenic or anti-androgenic activity
(2) reversal of gynecomastia on discontinuing the exposure
(3) exclusion of other causes of gynecomastia, with normal plasma levels of human steroid hormones
Herbal products containing implicated compounds may include:
(1) shampoo
(2) soap
(3) skin lotion or balm
(4) hair gels
Risk factors:
(1) use of products containing the implicated compound as a pure or highly concentrated preparation
(2) chronic use over a long period of time
(3) prolonged application time
(4) use of multiple products containing similar compounds
(5) break in skin integrity
(6) use of a barrier wrap
