Changes of the Nipple and Areola

There are a number of things that can alter the appearance, shape, or texture of your nipple or areola. Sometimes these are temporary, such as a reaction to touch or cold temperature. Hormonal fluctuations (such as during pregnancy) and even age cause perfectly normal changes in the nipples as well.

In some cases, however, a change in the appearance or texture of the nipple can be a sign of a medical problem, such as breast cancer. Here's how to know what is normal, what is not, and when you should call your healthcare provider.

Nipple and Areola Size and Color

What Is Normal? 

The areola is circle of skin that surrounds the nipple. Areolas vary in size from woman to woman, typically from 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 your breasts, areolas, and nipples to swell in response to your menstrual cycle or when you are pregnant or breastfeeding.

During pregnancy, your nipples and areola may become darker in color; your areola itself may also become visibly larger. Once a woman has stopped breastfeeding, the areola may or may not go back to its pre-pregnancy size and color.

Changes in Nipple and Areola Size or Color

Normal hormonal changes are responsible for changes in size and color of the nipple and areola. If the area itches, hurts, or changes in texture, it may indicate a problem.

Nipple and Areola Texture

What Is Normal?

The skin on the nipple is normally smooth with small bumps called Montgomery's glands appearing on the skin of the areola.

Changes in Texture

Often, a change in texture of the areola is due to eczema, a treatable, itchy skin rash that also affects other areas of the body.

More concerning changes in areola texture include thickening of the skin, visible swelling or inflammation, an "orange peel" texture, or noticeably warmer skin temperature. These can 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 of the nipple, starts on the nipple and extends to the areola, and may cause breast lumps or tumors over time. The nipple may become red and shiny, or thick, rough, and scaly.

Bumps on Nipple and Areola

What Is Normal?

Your nipple and areola can suddenly become erect and may feel bumpy when touched or exposed to cold. This is a perfectly normal response that typically resolves once the stimulation is removed.

During pregnancy, the bumps on the areola (called Montgomery glands) enlarge in preparation for breastfeeding and produce lubrication, as well as an odor that is thought to attract the infant to the breast.

Abnormal Bumps

It is possible for a clogged Montgomery gland to become infected. If that happens, you may experience pain as well as an enlarged bump on the areola. Other possible causes of a bump include a pimple and an ingrown hair.

If you develop any bumps or lumps on or just beneath your nipple or areola when you aren't pregnant, you should have them checked out.

Nipple and Areola Hair

What Is Normal?

It is normal to have a few hairs on your areolas. That means there is a risk of getting an ingrown hair, a strand of hair that grows back into the skin, often as a result of shaving or tweezing. Ingrown hairs can cause bumps that look very similar to pimples caused by acne.

Excess Nipple Hair

An excess of hair on the areola (more than a few strands) can be a sign of polycystic ovary disease (PCOS), a hormonal imbalance that can cause infertility. Other symptoms of PCOS include weight gain, irregular periods, and acne.

If your nipple hair bothers you, cut or shave it, don't tweeze it. Tweezing can cause the follicle to become infected.

Nipple Discharge

What Is Normal? 

Discharge from the nipple is not uncommon and not always abnormal. Hormonal changes can cause nipple discharge, as can pregnancy as the breasts get ready to produce milk.

A discharge will typically come out of the same ducts that carry milk and may be milky, clear, yellow, green, brown, or bloody. The consistency can vary from thick and viscous to thin and watery. In benign conditions, the discharge usually comes from both breasts.

Benign tumors called fibroadenomas or lumps known intraductal papillomas (which are typically noncancerous) can cause nipple discharge. Mammary duct ectasia, a condition in which milk ducts become swollen and clogged, can occur around the time of menopause.

Nipple discharge can also be caused by a normal menstrual cycle, benign tumors called fibroadenomas or lumps known intraductal papillomas (which are typically noncancerous).

A milky discharge, similar to that seen in women who are breastfeeding, may occur in women who aren't breastfeeding, men, or even young children. This is referred to as galactorrhea, and may be due to 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 when it is bloody or clear and comes out of only one nipple, or when it occurs along with other symptoms, such as changes in skin texture, a lump, or nipple pain.

Nipple Pain 

What Is Normal? 

Painful breasts and nipples right before a menstrual period are common. Another common cause of nipple pain is breastfeeding, which can cause nipple skin to become raw, cracked, and bleeding.

Other Causes of Nipple Pain

Several benign, treatable conditions associated with nipple pain include mastitis (an infection of breast tissue), a yeast infection in the nipple, or eczema.

Rarely, nipple pain can be a symptom of breast cancer, particularly Paget's disease of the nipple.

If you have persistent nipple tenderness, itchiness, or pain that does not have an obvious cause, it's a good idea to give your healthcare provider a call.

Sensitive Nipples

Some women's nipples are more sensitive than others' and may become irritated by certain laundry detergents or fabrics. Women who jog are prone to "jogger's nipple," in which the nipples are irritated when the fabric of a bra or shirt rubs against them, causing chafing and a burning sensation. Women who run long distances are more likely to experience nipple pain.

Wearing a snug-fitting jogging bra or putting bandages over your nipples can help. Choose bras made of soft fabrics (or padding) for your everyday bras and use a mild, scent-free detergent to wash your clothing and bedding.

Inverted or Retracted Nipples

Nipple variations, such as inverted nipples and retracted nipples are usually something you are born with.

Inverted nipples appear sunken or indented, rather than raised above the surface of the areola. Nipple inversion can occur as part of the normal aging process and is usually equal on both sides. But if you were born with nipples that stuck out and have since become flattened, you should talk to your healthcare provider, especially if the change only affects one side.

Retracted nipples, by contrast, have a slit-like area that is pulled inward. Retracted nipples may appear at birth, or develop gradually over time. A retracted nipple on one side only that develops quickly should be checked out, as in some cases, this can be a sign of breast cancer.

Breastfeeding Challenges

Women with inverted or retracted nipples may find it difficult to breastfeed. Typically, a baby's mouth will "latch" firmly onto the protruding nipple and part of the areola in order to stimulate milk production. There are techniques and devices (such as pumps to pull the nipple out) that can help you breastfeed with inverted nipples. You may also want to call a lactation consultant.

Extra Nipple 

Some women (and men) have an extra nipple, also called a supernumerary nipple or polythelia. Polythelia is estimated to affect around 0.2% to 2.5% of the population and is considered a minor birth defect. Extra nipples are usually small, located under the breast line, and may not be noticed at all until hormonal changes during puberty or pregnancy affect breast tissue.

Supernumerary nipples are benign and do not require treatment or removal.

Frequently Asked Questions

Why are my areolas bigger than usual?

The areola often enlarges or swells as a result of hormonal changes during pregnancy and breastfeeding. If you notice a change in the areola of one breast only, or are concerned for any reason, it is best to give your healthcare provider a call.

Can you reduce the size of Montgomery's glands?

No. Montgomery's glands tend to enlarge during pregnancy and lactation, but go back to their normal size once you have stopped breastfeeding your baby.

A Word From Verywell

You should never ignore changes of the nipple—especially when the changes only affect one side. Whether you are pregnant, have a normal menstrual cycle, or have already gone through menopause, breast cancer or another medical condition affecting the breast can sometimes manifest in this way.

If you are at all concerned, mention it to your healthcare provider. More likely than not, the change will be due to a benign condition. If it is something more worrisome, it's always best to have it diagnosed and treated as soon as possible.