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Fast Fact
The mean age for a girl's first period is 12.75 years.
Precocious puberty is defined as the onset of true puberty before 8 years of age in girls or 9 years of age in boys. (Boepple, et al. Endocrinology, Surgery, and Technology, Vol 1, 1996)
Isolated breast development that doesn't progress to the rest of puberty is called premature thelarche, and is a different, benign condition.
Precocious puberty is 10 times more common in girls than in boys. Sexual development may begin at any age. Pregnancy has been reported as early as 5 1/2 years old.
The Lawson Wilkins Pediatric Endocrine Society recommends evaluating for an underlying medical condition in Caucasian-American girls who have development of breast and/or pubic hair before age seven and in African-American girls before age six (Kaplowitz and Oberfield, Pediatrics 1999 Oct;104(4 Pt 1):936-41). These medical conditions include tumors, cysts, thyroid problems, McCune-Albright syndrome, or external sources of estrogen. Doing studies to look into these possible causes is especially important in girls younger than 6, and in all boys.
The earlier before age 12 a girl starts her period, the higher her lifetime risk for breast cancer (probably from the prolonged estrogen exposure). The highest average risk for breast cancer is in non-Hispanic white women, where it is 1 in 8, or 12.5%. In all girls who start their periods before the age of 12, taken together, the risk is 16.25%.
As a girl reaches maturity, she needs to be made aware of controllable risk factors for breast cancer, such as use of estrogen-containing birth control pills (10 years of use would raise her risk to about 22%), first pregnancy after age 30 (if she did this also, it would raise the risk to about 35%), high-fat diet, alcohol use, fertility drugs, pesticides, and radiation exposure. Each of these factors multiplies her accumulated risk.
Angel kisses and stork bites are among the picturesque names given to these very common birthmarks. Parents often worry that these will last a lifetime or get darker with time – the opposite tends to be true. They are tiny windows into the past.
What are salmon patches?
Salmon patches (nevi simplex) are dilated capillaries in the skin. They are not new capillaries or new growths, but leftover patches of the way the blood vessels looked during fetal circulation.
Salmon patches appear as flat, dull pink patches. Most commonly they occur at the nape of the neck (stork bites), between the eyebrows or over the eyelids (angel kisses), or around the nose or mouth.
Because they are collections of blood vessels in the skin, they tend to look darker or redder when a baby is crying, excited, or upset. This may even be true after the patch has seemed to have disappeared.
Are salmon patches contagious?
No
How long does salmon patches last?
Salmon patches are present at birth (and before). The great majority disappear, usually within the first year. Those around the hairline at the back of the neck (called “Unna’s nevus”) are the most likely to remain.
How are salmon patches diagnosed?
Salmon patches are diagnosed by their appearance and location.
How is salmon patches treated?
No treatment is generally necessary. The overwhelming majority disappear with no treatment. Of those that do not, most are in a location that is covered by hair.
Mosquito bites are no fun and can be particularly hard on children who are often prone to large numbers of bites. Click here for tips on treating mosquito bites.
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