As your son approaches his teens, body odor and fuzz sprouting from his chin may herald the arrival of puberty.
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But some of his classmates may already have major facial hair. How do you know everything’s progressing “normally” for your son?
Pediatrician Veronica Issac, MD, says while the timing of puberty varies widely, the order of physical changes usually does not. Most children follow a certain developmental path.
Doctors can give parents a general timeline on what to expect. Here, she explains how to tell when things are proceeding normally and which signs may point to a problem.
The 5 stages of puberty
Boys tend to begin and end puberty about two years later than girls, generally between ages 13 and 18. African-American and Hispanic children tend to enter puberty earlier than Caucasian children.
A tool called the Tanner Stages outlines the stages of puberty for boys and girls, and when they are likely to occur. They can serve as a guide to the changes you can expect for your son.
Stage 1. In this “prepubescent” stage, boys have not experienced any changes.
Stage 2. In this stage, typically beginning between ages 9½ and 14½, boys experience:
- Genital development (growth of the testicles and scrotum).
- The growth of sparse hair on the penis.
- An increase in height (typically about 2 to 2½ inches per year).
Stage 3. In this stage, occurring between ages 10 and 16½, boys experience:
- Continued growth of the penis and testicles.
- Darkening, coarsening and more coverage by hair of the genital area.
- Continued increase in height (about 2¾ to just over 3 inches) per year.
- Vocal changes (and cracking in the process).
- Increased muscle mass.
“Some breast development may occur in about 50 percent of all teenage boys, but it typically resolves by the end of puberty,” notes Dr. Issac. “If this becomes an issue physically or socially, suggest that your son talk with his healthcare provider.”
Stage 4. In this stage, which can occur between ages 11 and 16½. boys experience:
- Growth in penis size and darkening of the skin on the scrotum and testicles.
- Body hair growth that reaches adult levels.
- A growth spurt that averages nearly 4 inches per year.
- Development of acne.
- Continued cracking of the voice.
Stage 5. During this stage, boys finish their growth and development and are physically adults. Facial hair may not develop in some boys until this stage.
Most boys finish growing by age 17. But some have issues that cause them to start puberty much earlier or later than normal. If your son’s puberty is progressing very quickly or if changes seem to happen “out of order,” talk to your pediatrician.
Problems that affect boys’ growth and development include precocious and delayed puberty.
Precocious (early) puberty
If your son shows signs of puberty before his 9th birthday, visit the pediatrician. This may signal a pituitary problem or neurological issue, notes Dr. Issac. The doctor should evaluate your son as soon as you suspect a problem. Possible causes for early puberty include:
- The pituitary gland “turning on” hormones too early
- Hypothyroidism (an underactive thyroid gland)
- A tumor on the adrenal gland or elsewhere
If the problem is hormonal, an endocrinologist can prescribe medication to halt puberty until the time is right. If your doctor suspects another problem, your son may be referred for further testing.
If your son starts puberty after age 14 or isn’t progressing through puberty, you’ll also want to check with your doctor. “Often the child is merely a late bloomer — particularly if dad was as well,” says Dr. Issac. But hormone or endocrine abnormalities can also delay puberty.
If your doctor suspects an underlying problem, your son will likely be referred to a specialist for more testing.
Emotions change, too
Whenever your son enters puberty, you can expect to see some emotional upheaval. Increased testosterone, coupled with social pressures, may cause moody behavior, emotional outbursts and family discord.
Parents can typically ride out these issues. “However, if serious emotional problems arise — if your son doesn’t want to do the things he usually enjoys, or hang out with his friends or experiences a drop in grades — medication or therapy can improve his mood,” she notes.
Don’t hesitate to talk to your pediatrician when you have concerns about your son’s progress through puberty, says Dr. Issac. A physical exam and other tests will help to rule out problems, pinpoint underlying issues or provide you with reassurance.