The nipple and areola diameter of 498 girls aged 8-17 years were studi
ed with the aim of finding measurable criteria for sexual maturation,
including breast and pubic hair development during female puberty. All
measurements were made holding a transparent ruler on both sides by t
he same observer. The smaller of the two measurements was used in the
analysis. Significantly nipple and areola development occurred between
breast stages BI (2.56 and 14.35 mm), B2 (3.32 and 20.26 mm), B3 (5.2
1 and 28.84 mm), and B4 (6.28 and 32.03 mm). The nipple and areola dia
meter were also significantly greater in pubic hair stage (PH)3 (5.05
and 25.24 mm) with respect to PH2 and PH1 (3.46, 2.62 mm and 19.32 15.
37 mm, respectively), in PH5 (6.79 and 35.62 mm) with respect to PH4 (
6.55 and 32.56 mm). A significant increase in nipple and areola diamet
er occurs between premenarchal girls and girls-older than 0-2 years po
stmenarche. Sexual maturation staging by nipple size and by areola siz
e appears to be feasible for female adolescent However, staging by nip
ple size does not appear to be feasible for B4 and B5 stage, because t
he incremental gradations are small. (C) Society for Adolescent Medici
ne, 1998.