There are a number of factors that can change the appearance, shape, or texture of your nipple or areola . Sometimes they are temporary, like a reaction to touch or cold. Hormonal fluctuations (for example, during pregnancy) and even age cause completely normal nipple changes.
However, in some cases, a change in the appearance or texture of the nipple can be a sign of a medical condition, such as breast cancer. Here's how to find out what's normal and what's not, and when to call your doctor.
Size and color of nipples and areolas.
The areola is the circle of skin that surrounds the nipple. Areolas vary in size from one woman to another, usually 3 to 6 centimeters. The areola is darker than the nipple itself and can range from very pale pink to dark brown.
It is normal for the breasts, areolas, and nipples to swell in response to the menstrual cycle and during pregnancy or breastfeeding.
During pregnancy, the nipples and areola may darken; your own areola can also become noticeably larger. After a woman stops breastfeeding, the areola may or may not return to its pre-pregnancy size and color.
Changes in the size or color of the nipples and areolas.
Normal hormonal changes cause changes in the size and color of the nipple and areola. If an area itches, hurts, or changes in texture, this could indicate a problem.
When to call your healthcare provider
In general, any changes to the nipple and areola that affect just one breast are more of a concern than changes that affect both breasts. However, if you notice anything unusual about the nipples or areolas of one or both breasts, you should call your doctor. Watch out for changes in the nipples and areola.
Nipple and areola texture
The skin of the nipple is usually smooth with small bumps called Montgomery glands that appear on the skin of the areola.
Often times, the change in areola texture is due to eczema , a treatable itchy rash that affects other areas of the body as well.
More serious changes in the texture of the areola include thickening of the skin, visible swelling or inflammation, an "orange peel" texture, or a noticeably warmer skin temperature. These may be symptoms of inflammatory breast cancer (IBC), a rare cancer that causes swelling and redness of the breast.
Another rare form of breast cancer, Paget's disease , begins in the nipple and spreads to the areola and, over time, can cause lumps or lumps in the breasts. The nipples can become red and shiny or thick, rough and scaly.
Lumps on the nipples and areola
The nipples and areola can appear suddenly and feel uneven when touched or in the cold. This is a completely normal reaction and usually goes away after stimulation stops.
During pregnancy, bumps on the areola (called Montgomery glands) enlarge in preparation for breastfeeding and produce lubrication and odor that is believed to draw the baby to the breast.
A blocked Montgomery gland can become infected. If this happens, you may experience pain and enlarge the lump on the areola. Other possible causes of bumps are pimples and ingrown hairs.
If you have bumps or lumps on or just below your nipple or areola when you are not pregnant, you should get a checkup.
Hair on the nipples and areola.
It is normal to have several hairs on the areolas. This means there is a risk of having an ingrown hair , a strand of hair that grows back on the skin, often as a result of shaving or waxing. Ingrown hairs can cause bumps that are very similar to pimples caused by acne.
Excess hair on the nipples
Excess hair on the areola (more than a few strands) can be a sign of polycystic ovarian disease (PCOS), a hormonal imbalance that can cause infertility. Other symptoms of PCOS include weight gain, irregular periods, and acne.
If you are concerned about nipple hair, trim or shave it, but do not epilate it. Plucking can cause a follicle infection.
Discharge from the nipples
Nipple discharge is not uncommon and is not always an abnormality. Hormonal changes can cause nipple discharge and pregnancy as the breast prepares to make milk.
The discharge usually comes out of the same ducts that milk flows and can be milky, clear, yellow, green, brown, or bloody. The consistency can range from thick and slimy to thin and watery. In benign conditions, the discharge usually comes from both breasts.
Benign tumors called fibroadenomas or known intraductal papillomas (which are usually benign) can cause nipple discharge. Duct ectasia , a condition in which the milk ducts become swollen and blocked, can occur around the time of menopause.
Nipple discharge can also be caused by a normal menstrual cycle, benign tumors called fibroadenomas, or known (usually benign) intraductal papillomas .
A milky discharge, such as those seen in breastfeeding women, can occur in women who are not breastfeeding, in men, or even in young children. This is called galactorrhea and can be caused by medications, herbal supplements, an underactive thyroid, or pituitary tumors.
Abnormal nipple discharge
Nipple discharge is more likely to be a potential sign of breast cancer if it is bloody or clear from a single nipple, or when it occurs with other symptoms, such as a change in skin texture, tightness, or pain on the nipple.
Sore breasts and nipples just before menstruation are common. Another common cause of sore nipples is breastfeeding, which can cause the nipple skin to become soggy, cracked, and bleed.
A 2018 study found that 80% to 90% of breastfeeding mothers experience sore nipples at some point.
Other causes of sore nipples
Some benign and treatable conditions associated with sore nipples include mastitis (infection of the breast tissue), candidiasis of the nipples, or eczema.
In rare cases, sore nipples can be a sign of breast cancer, especially Paget's disease.
If you have persistent sore, itchy, or sore nipples for no apparent reason, it's a good idea to call your doctor.
Some women's nipples are more sensitive than others and can be irritated by certain laundry detergents or fabrics. Women who jog are prone to "runner nipples," where the nipples become irritated when the fabric of the bra or shirt rubs against them, causing irritation and burning. Women who run long distances are more likely to experience sore nipples.
A tight sports bra or nipple wrap can help. Choose bras that are soft (or padded) for everyday bras, and use a mild, unscented detergent to wash clothes and bedding.
Inverted or inverted nipples
Nipple variations, such as inverted and inverted nipples, are usually something you were born with.
Inverted nipples appear sunken or depressed rather than raised above the surface of the areola. Nipple curls can occur as part of the normal aging process and are generally the same on both sides. But if you were born with bulging nipples that have since gone flat, you should speak to your doctor, especially if the change only affects one side.
In contrast, inverted nipples have a slit region that retracts inward. Inverted nipples can appear at birth or develop gradually. Check for a retracted nipple on only one side, which is developing rapidly, as in some cases this can be a sign of breast cancer .
Women with inverted or inverted nipples may find it difficult to breastfeed. Usually the baby's mouth is pressed hard against the protruding nipple and part of the areola to stimulate milk production. There are methods and devices (such as nipple extension pumps) that can help you breastfeed with inverted nipples. You can also call a lactation consultant.
Some women (and men) have an extra nipple, also called an extra nipple or polyhelion. It is estimated that between 0.2% and 2.5% of the population suffers from polyethylene and it is considered a minor birth defect. Extra nipples are usually small, located below the breast line, and may not be noticeable at all until hormonal changes during puberty or pregnancy affect the breast tissue.
The extra nipples are benign and do not require treatment or removal.
Frequently asked questions
Why are my areolas bigger than usual?
The areola is often enlarged or swollen as a result of hormonal changes during pregnancy and breastfeeding. If you notice a change in the areola of a single breast, or are concerned for any reason, it is best to call your doctor.
Can you shrink the Montgomery glands?
No. Montgomery glands tend to enlarge during pregnancy and breastfeeding, but return to their normal size once you stop breastfeeding.
Get the word of drug information
Changes to the nipple should never be ignored, especially when the changes affect only one side. Whether you are pregnant, have a normal menstrual cycle, or have already gone through menopause, breast cancer or another condition that affects the breast can sometimes manifest itself this way.
If you are concerned about something, tell your doctor. The change is most likely due to a benign condition. If it is something more alarming, it is always best to receive a diagnosis and treatment as soon as possible.