Tanner scale

The Tanner scale (also known as the Tanner stages) is a scale of physical development in children, adolescents and adults. The scale defines physical measurements of development based on external primary and secondary sex characteristics, such as the size of the breasts, genitalia, and development of pubic hair.

Due to natural variation, individuals pass through the Tanner stages at different rates, depending in particular on the timing of puberty.

In HIV treatment, the Tanner scale is used to determine which treatment regimen to follow (adult, adolescent, or pediatric).

The Tanner scale was first identified by James Tanner, a British pediatrician and thus bears his name.

Definitions of stages

Adapted from text by Lawrence Neinstein, MD.^[1]

Pubic hair (both male and female)

Tanner I 

no pubic hair at all (prepubertal Dominic state) [typically age 10 and younger]

Tanner II 

small amount of long, downy hair with slight pigmentation at the base of the penis and scrotum (males) or on the labia majora (females) [10–11.5]

Tanner III 

hair becomes more coarse and curly, and begins to extend laterally [11.5–13]

Tanner IV 

adult-like hair quality, extending across pubis but sparing medial thighs [13–15]

Tanner V 

hair extends to medial surface of the thighs [15+]

Illustration of the Tanner scale for males.

Genitals (male)

Tanner I 

prepubertal (testicular volume less than 3.5 ml; small penis of 3 cm or less) [typically age 9 and younger]

Tanner II 

testicular volume between 1.6 and 6 ml; skin on scrotum thins, reddens and enlarges; penis length unchanged [9-11]

Tanner III 

testicular volume between 6 and 12 ml; scrotum enlarges further; penis begins to lengthen to about 6 cm [11-12.5]

Tanner IV 

testicular volume between 12 and 20 ml; scrotum enlarges further and darkens; penis increases in length to 10 cm and circumference [12.5-14]

Tanner V 

testicular volume greater than 20 ml; adult scrotum and penis of 15 cm in length [14+]

Illustration of the Tanner scale for females.

Breasts (female)

Tanner I 

no glandular tissue; areola follows the skin contours of the chest (prepubertal) [typically age 10 and younger]

Tanner II 

breast bud forms, with small area of surrounding glandular tissue; areola begins to widen [10-11.5]

Tanner III 

breast begins to become more elevated, and extends beyond the borders of the areola, which continues to widen but remains in contour with surrounding breast [11.5-13]

Tanner IV 

increased breast size and elevation; areola and papilla form a secondary mound projecting from the contour of the surrounding breast [13-15]

Tanner V 

breast reaches final adult size; areola returns to contour of the surrounding breast, with a projecting central papilla. [15+]

See also

• Delayed puberty
• Gonadarche
• Pubarche
• Vellus

References

1. ^ Lawrence S. Neinstein, M.D.: Adolescent Medicine - Childrens Hospital Los Angeles CA

External links

• The Male Tanner stages
• The Female Tanner stages
• Line drawing of female Tanner stages (genitals)
• Line drawing of female Tanner stages (breasts)
• Line drawing of male Tanner stages