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On July 29, 2010, the FDA issued an advisory stating that inadvertent exposure through skin contact to Evamist — an estrogen spray containing the hormone estradiol — has caused premature puberty, nipple swelling, and breast development in children aged 3 to 5 years. Evamist is used by women to reduce hot flashes during menopause and is sprayed on the skin between the elbow and wrist and on the inside of the forearm. Reported exposure in pets also has been associated with mammary/nipple enlargement and vulvar swelling. The FDA advises that patients using Evamist should avoid letting children and pets make skin contact with areas where Evamist has been applied and should wash children's skin with soap and water if exposure occurs.