Changes of the Nipple and Areola

Many things can alter the appearance, shape, or texture of your nipple or areola. Sometimes these are temporary, like a reaction to the cold.

Hormonal changes and aging can cause normal changes in the nipples as well. But in some cases, nipple changes are a sign of a medical problem.

This article will teach you what's normal, what's not, and when you should call your healthcare provider.

Size and Color

The areola is a circle around the nipple. Areolas vary in size. On female breasts, they typically range between 3 and 6 centimeters (1.2 inches to 2.4 inches).

The areola is often darker than the nipple itself. Depending on your skin tone, it can range from pale pink to dark brown.

Normal Changes

It's normal for breasts, areolas, and nipples to swell at times, such as:

• During puberty
• At certain stages of your menstrual cycle
• When you're pregnant
• When you're breastfeeding

Your nipples and areola may get darker during pregnancy. Your areola may also get larger.

They'll likely stay that way during pregnancy and breastfeeding. Later, they may or may not go back to their pre-pregnancy size and color.

Abnormal Changes

It could indicate a problem is size and color changes accompany:

• Itching
• Pain
• Changes in texture

Texture

The skin on the nipple is normally smooth. The areola has small bumps called Montgomery glands.

Normal Changes

Often, a change in areola texture is due to eczema. That's a treatable, itchy skin rash. Eczema is likely if it affects other areas of the body, as well.

Abnormal Changes

More concerning areola texture changes include:

• Thickening skin
• Visible swelling or inflammation
• An "orange peel" texture
• Noticeably warmer skin temperature

These can be symptoms of inflammatory breast cancer (IBC). That's a rare disease that causes swelling and redness of the breast.

Another rare cancer is Paget's disease of the nipple. It starts on the nipple and spreads to the areola. It may cause breast lumps or tumors over time. The nipple may become red and shiny, or thick, rough, and scaly.

Bumps

Your nipple normally becomes erect when touched or exposed to cold. The areola may get bumpy as well.

Mongomery's glands (areola bumps) may change at other times. These changes may be normal or abnormal.

Normal Changes

During pregnancy, the Montgomery glands enlarge. That prepares you for breastfeeding. Your areola may get bumpier.

The glands also make lubrication and an odor believed to attract an infant to the breast.

Pimples or ingrown hair can also cause areola bumps.

Abnormal Changes

Montgomery glands can get clogged and become infected. That can cause pain plus one enlarged bump on the areola. This may need to be treated with antibiotics.

You should see a healthcare provider if you're not pregnant and develop any bumps or lumps:

• On your nipple
• On your areola
• Under the skin of your nipple or areola

Areola Hair

It's normal to have a few hairs on your areolas. But you should watch for problems that can arise and be aware of changes.

Normal Changes

Plucking or shaving your areola can cause ingrown hair. That's when a strand of hair grows back into the skin.

Ingrown hairs can cause bumps similar to pimples.

Cutting or shaving are better options. Tweezing can lead to infected follicles.

Excess Nipple Hair

It's not typical to have more than a few strands of hair on the areola. More than that can be a sign of polycystic ovary disease (PCOS).

PCOS is a hormonal imbalance that can cause infertility. Other symptoms include:

• Weight gain
• Irregular periods
• Acne

Talk to your healthcare provider if you notice an increase in hair on your breasts.

Nipple Discharge

Discharge from the nipple is fairly uncommon and not always abnormal. They can be caused by hormonal changes.

Nipple discharge typically comes out of the milk ducts. It may be:

• Milky
• Clear
• Yellow
• Green
• Brown
• Bloody

The consistency can vary from thick and viscous to thin and watery. In benign (not harmful) conditions, the discharge usually comes from both breasts.

It may come out on its own (spontaneously) or only when your breasts are squeezed or stimulated.

Normal Changes

During pregnancy, a milky discharge is normal. That's because the breasts are getting ready to produce milk.

Sometimes, the menstrual cycle can cause discharge.

Abnormal Changes

You should have any nipple discharge checked by your healthcare provider. Common causes include:

• Mammary duct ectasia (clogged or swollen milk ducts)
• Galactorrhea (discharge similar to breastmilk but when you're not lactating)
  
• Intraductal papillomas (benign tumors called fibroadenomas)

Nipple discharge is more likely to be related to breast cancer when:

• It comes out spontaneously
• It's bloody or clear
• Comes out of only one nipple
• You have other symptoms like a lump, nipple pain, or changes in skin texture

Nipple Pain 

Some causes of pain are normal or expected. Others may be cause for concern.

Normal Changes

It's common for your breasts and nipples to hurt right before your period. Breastfeeding can cause raw, cracked, and bleeding nipples.

Abnormal Changes

Several benign, treatable conditions are associated with nipple pain. They include:

• Mastitis (a breast infection)
• Yeast infection in the nipple
• Eczema

All of these can be easily treated.

Raynaud's phenomenon, or nipple vasoconstriction, occurs during breastfeeding. It causes episodes of pain, burning, and/or tingling when:

• You breastfeed
• You're exposed to cold
• You have nipple trauma

No symptoms occur between episodes.

In rare cases, nipple pain is a symptom of breast cancer. That's particularly true of Paget's disease of the nipple.

Sensitive Nipples

Some people's nipples are more sensitive than others. They may be irritated by certain laundry detergents or fabrics.

For example, if you jog or run long distances, you're more likely to have nipple pain. It's caused by chafing from the fabric of a bra or shirt.

A snug-fitting jogging bra or bandages over your nipples can help. Choose bras made of soft fabrics (or padding) for your everyday bras. And use a mild, scent-free laundry detergent.

Inverted or Retracted Nipples

Nipple variations are usually something you are born with. They include inverted nipples and retracted nipples.

Inverted nipples look sunken or indented. They can occur as part of the normal aging process. It usually happens on both sides.

But if your nipples used to stick out and have become flattened, especially if it's just on one side, talk to your healthcare provider.

Retracted nipples have a slit-like area that is pulled inward. They may appear at birth or develop gradually over time.

A retracted nipple on one side or one that develops quickly should be checked out. In some cases, this can be a sign of breast cancer.

Breastfeeding Challenges

Inverted or retracted nipples can make it difficult to breastfeed. A baby's mouth typically "latches" firmly onto the protruding nipple and part of the areola. That's what stimulates milk production.

Techniques and devices, like pumps that pull the nipple out, can help. You may also want to see a lactation consultant.

Extra Nipple 

If you have extra nipples, it's called supernumerary nipples or polythelia. An estimated 0.2% to 2.5% of the population has polythelia. It's considered a minor birth defect.

Extra nipples are usually small and beneath the breasts. They may not be noticeable until hormonal puberty or pregnancy affect breast tissue.

Extra nipples are benign. They don't need to be treated or removed.

Summary

Changes in your nipple or areola may be normal or abnormal. Hormones cause most normal changes.

Abnormal changes in color, size, or texture may be signs of a medical condition. Increased hair, nipple discharge, nipple pain, and variations like inverted or retracted nipples can also be due to disease.

Extra nipples and other variations that are present from birth don't require treatment.

Many of these issues aren't serious and are easy to treat. Others may be more serious, such as some forms of breast cancer.

A Word From Verywell

Never ignore nipple or areola changes—especially if it's a one-sided change. If it is something worrisome, it's always best to have it diagnosed and treated as soon as possible.

Most of the time, though, changes are due to harmless conditions. Having a healthcare provider confirm this can offer you peace of mind.