Puberty typically begins between the ages of 9 and 11, which is when physical changes start to appear. The Tanner Stages are used to describe specific changes that children and teens may experience during puberty.

Puberty is a time of big changes for a teen that eventually ends with the full maturation of the body.

The different stages can be challenging and even confusing for teens, especially since the timeline of these changes is different for each person. Puberty may also be difficult for any teens questioning their gender identity.

Explaining the process to your child can help them know what to expect. And if you or your child have any concerns about how the process is unfolding, it may even be helpful to contact your pediatrician for additional guidance.

In this article, we take a look at the different stages of puberty, referred to as the “Tanner stages.” We’ll review how the body changes and what signs and symptoms to expect during each stage.

Sex and gender exist on spectrums. This article will use the terms “male” and “female” to refer to a person’s sex assigned at birth. Learn more.

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Professor James M. Tanner, a child development expert, was the first to identify the visible stages of puberty.

Today, these stages are known as the Tanner stages or, more appropriately, sexual maturity ratings (SMRs). They serve as a general guide to physical development, although each person has a different puberty timetable.

Here’s what you can expect to see based on the Tanner stages in males and females during puberty.

Tanner stage 1

Tanner stage 1 describes what’s happening to your child before any physical signs of puberty appear. It typically starts after a female’s 8th birthday and after a male’s 9th or 10th birthday. At this stage, these internal changes are the same for males and females.

Tanner stage 2

Stage 2 marks the beginning of physical development. Hormones begin to send signals throughout the body.


Puberty usually starts between ages 9 and 11. Visible changes include:

  • First signs of breasts, called “buds,” start to form under the nipple. They may be itchy or tender or one bud may be larger than the other, which is normal.
  • Darker area around the nipple (areola) will also expand.
  • Uterus begins to get larger, and small amounts of pubic hair start growing on the lips of the vulva.

On average, Black females start puberty a year before white females and are ahead when it comes to breast development and having their first periods. Also, females with higher body mass index experience an earlier onset of puberty.


In males, puberty usually starts around age 11. The testicles and skin around the testicles (scrotum) begin to get bigger.

Puberty usually starts around age 11. Changes include:

  • Testicles and skin around the testicles (scrotum) begin to get bigger.
  • Early stages of pubic hair form on the base of the penis.

Tanner stage 3

Physical changes are becoming more obvious for both males and females in stage 3. Along with a growth spurt in height, your teen’s hormones are hard at work, furthering development from the previous stage.


Physical changes in females usually start after age 12. These changes include:

  • Breast “buds” continue to grow and expand.
  • Pubic hair gets thicker and curlier.
  • Hair starts forming under the armpits.
  • The first signs of acne may appear on the face and back.
  • The highest growth rate for height begins (around 3.2 inches per year).
  • Hips and thighs start to build up fat.


Physical changes in males usually start around age 13. These changes include:

  • Penis gets longer as testicles continue to grow bigger.
  • Some breast tissue may start to form under the nipples (this happens to some teenage males during development and usually goes away within a couple of years).
  • Males begin to have wet dreams (ejaculation at night).
  • As the voice begins to change, it may “crack,” going from high to lower pitches.
  • Muscles get larger.
  • Height growth increases to 2 to 3.2 inches per year.

Tanner stage 4

Puberty is in full swing during stage 4. Both males and females are noticing many changes.


In females, stage 4 usually starts around age 13. Changes include:

  • Breasts take on a fuller shape, passing the bud stage.
  • Many females get their first period, typically between ages of 12 and 14, but it can happen earlier.
  • Height growth will slow down to about 2 to 3 inches per year.
  • Pubic hair gets thicker.


In males, stage 4 usually starts around age 14. Changes include:

  • Testicles, penis, and scrotum continue to get bigger, and the scrotum will get darker in color.
  • Armpit hair starts to grow.
  • Deeper voice becomes permanent.
  • Acne may start to appear.

Tanner stage 5

Stage 5 begins the culmination of your teen’s development. In this final phase, your teen will eventually reach full physical maturation, including their final adult height.


In females, stage 5 usually happens around age 15. Changes include:

  • Breasts reach approximate adult size and shape, though breasts can continue to change through age 18.
  • Periods become regular after 6 months to 2 years.
  • Females reach adult height 1 to 2 years after their first period.
  • Pubic hair fills out to reach the inner thighs.
  • Reproductive organs and genitals are fully developed.
  • Hips, thighs, and buttocks fill out in shape.


In males, stage 5 usually starts around age 15. Changes include:

  • Penis, testicles, and scrotum will have reached adult size.
  • Pubic hair has filled in and spread to the inner thighs.
  • Facial hair will start coming in and some males will need to begin shaving.
  • Growth in height will slow down, but muscles may still be growing.
  • By age 18, most males have reached full growth.
Tanner stages in femalesAge at the startNoticeable changes
Stage 1After the 8th birthdayNone
Stage 2From age 9–11Breast “buds” start to form; pubic hair starts to form
Stage 3After age 12Acne first appears; armpit hair forms; height increases at its fastest rate
Stage 4Around age 13First period arrives
Stage 5Around age 15Reproductive organs and genitals are fully developed
Tanner stages in malesAge at the startNoticeable changes
Stage 1After the 9th or 10th birthdayNone
Stage 2Around age 11Pubic hair starts to form
Stage 3Around age 13Voice begins to change or “crack”; muscles get larger
Stage 4Around age 14Acne may appear; armpit hair forms
Stage 5Around age 15Facial hair comes in

Acne in puberty

Changing hormones cause oils to build up on the skin and clog pores, resulting in acne. Your child can develop acne on the face, back, or chest. Some people have worse acne than others.

If you have a family history of acne or if your child has severe acne, your pediatrician may recommend prescription treatments. Otherwise, encourage your child to treat acne by washing daily with mild soap and using over-the-counter (OTC) creams and ointments as needed to control breakouts.

A trip to the dermatologist may be warranted for more persistent acne.

Body odor in puberty

Larger sweat glands also develop during puberty. To prevent body odor, talk with your child about deodorant options and make sure they shower regularly, especially after intense physical activity.

Learn more about hygiene habits for kids and teens.

Mood changes in puberty

Is your teen is moody or otherwise behaving differently? Hormones or your child’s feelings about physical changes, friends, or school may be the culprit. If you’re concerned, there are a number of mental health resources you can find online as well as local support groups, school psychologists, and community programs that may help.

Be on the lookout for signs of depression or anxiety, like trouble sleeping, avoidance, or poor performance in school. Any extreme or troubling mood changes should be discussed with your child’s doctor. In some cases, therapy or medication may help.

Puberty doesn’t happen overnight. It’s a years-long process involving various physical and hormonal changes — all of which can be uncomfortable to go through.

Your child is likely having a lot of feelings right now, whether it’s about acne, body odor, menstrual cramps, or something else. Keep the line of communication open and be patient while discussing these feelings. Reassure your child that what’s going on is normal and an expected part of puberty.

If something does seem particularly troubling or if you have concerns about your child’s development, don’t hesitate to speak with your child’s doctor.