Premature Adrenarche: What You Should Know

With premature adrenarche, hormonal production increases little by little. This increase causes hair to appear on the genitals, arms, legs and armpits, accompanied by a strong body odor and mild acne.

In children, symptoms occur before the age of nine. In girls, it can occur before age eight. What should you do if you notice that your child is experiencing premature adrenarche? Is there any specific treatment?

What is premature adrenarche?

In general, premature adrenarche is very common in children presenting symptoms of early puberty. It manifests as the early appearance of pubic hair, accompanied by hair growth in the armpits. In addition, the child will suffer from oily skin, increased body odor, and acne, among other signs.

The standard adrenarchal process

The adrenal gland is a large organ with various functions during the course of fetal life. For this reason, there is a high concentration of male sex hormones in umbilical cord blood.

Following birth, the reticular area of the gland recedes, greatly reducing the levels of sex steroid hormones. Then, it has a resurgence characterized by the increased production of progesterone, androgens, and other hormones. This is known as adrenarche.

What causes premature adrenarche?

This disorder is caused by the increased activity of the small adrenal glands, located in the upper part of the kidneys. This activation of the reticular adrenal zone can occur between three and eight years of age.

However, a diagnosis of other conditions that could cause premature adrenarche is required. Examples include late adrenal hyperplasia or virilizing tumors in the testicular or ovarian adrenal gland.

In addition, premature adrenarche is sometimes associated with children who were born small relative to their gestational age. Later on, they may experience a spontaneous recovery of growth.

A family history of premature adrenarche or polycystic ovary syndrome could also be a determining factor. Some believe obesity to be another trigger.

Clinical diagnosis of premature adrenarche

The pediatrician will be responsible for making the following evaluation to assess the possibility that a child is suffering from this problem:

• A current and detailed history of the evolution of the situation.
• A physical examination, including such data as weight, height and blood pressure.
• Studying the speed of growth. By means of an X-ray of the left hand, a doctor can determine your bone age.
• Sometimes, in order to rule out a pathological problem, the doctor may perform a hormonal assessment. This includes an examination of the function of hormones such as the thyroid gland, basal androgens, testosterone, and progesterone.
• An abdominal ultrasound. This supplementary evaluation occurs mainly when the doctor suspects an adrenal tumor.
• A pelvic ultrasound, relating to the possible removal of tumors in girls’ ovaries.
• For boys, your doctor may recommend a testicular ultrasound.
• A blood test.
• A urine test.
• Genetic studies.

Recommended treatment

Mostly, cases of premature adrenarche exist within the range of what is considered normal. For this reason, no specific medical treatment is recommended. This is a relatively common and benign condition in girls.

However, it’s important to have a follow-up about two years after the diagnosis in order to monitor any new signs. Some could be due to early puberty, accelerated growth, or some disease not detected in earlier analyses.

As parents, you need to be aware of your child’s physical appearance. In this respect, a difference from peers of the same age may affect children emotionally. If you sense they’re feeling vulnerable, seek support from a child psychologist.

Meanwhile, troublesome symptoms like strong body odor require deodorant or other specific products recommended by your doctor. You can also help them shave using a method that won’t irritate their skin.

If your children are overweight, modify their lifestyles and implement a healthy diet. A good regular exercise routine is very important.

In short, if you notice the symptoms of premature adrenarche in your child, visit your pediatrician.

Although most consider it a normal condition without serious consequences, it’s best to make periodic follow-ups to detect any subsequent changes. If necessary, more detailed and complex evaluations are available.