Nipple Color and Other Changes

Nipples color can temporarily change due to things like normal hormonal shifts, pregnancy, or breastfeeding. The same goes for nipple size and texture.

Permanent changes of the nipple can also occur and are often seen with breast surgeries, weight loss, and aging.

While these are usually no cause for concern, there are some nipple color and other changes that can indicate an underlying condition that needs evaluating.

This article discusses the normal and abnormal variations of nipple color, size, and more. Changes in the areola—the dark skin around the nipple—are also discussed.

While suggestions on when you should absolutely see a healthcare provider about nipple changes, remember that anything out of the norm for you is worth bringing to your practitioners attention.

Nipple Color

It is normal for your nipple color and areola color to be a little different. The areola is often darker than the nipple itself. Depending on your skin tone, the color can range from pale pink to dark brown.

Your nipples/areolas can change color because of:

• Hormonal changes (menstrual cycle and menopause)
• Breast surgery
• Pregnancy
• Breastfeeding

Nipple color will return closer to normal as hormones normalize and after pregnancy.

See a healthcare provider about nipple changes immediately if:

• The nipple turns red or purple
• The color change is accompanied by itching or drainage
  

Nipple Size

Nipples and areolas vary in size. The areola is usually between 3 centimeters and 6 centimeters (1.2 inches to 2.4 inches) across.

It's normal for nipples and areolas to change in size during:

• Puberty
• Certain stages of your menstrual cycle
• Pregnancy
• Breastfeeding

See a healthcare provider about nipple size changes if:

• You notice changed to one nipple/areola, as opposed to both
  

Nipple Texture

The skin texture of the nipple is normally smooth, whereas the areola can be bumpy and pimple-like.

Montgomery glands, which are responsible for lubricating the nipple and areola during lactation, are the raised areas on the areola. They may look like bumpy, white dots. Eczema, a treatable skin rash, can change the texture of the areola.

See a healthcare provider about nipple texture if you notice:

• Changes in your normal nipple/areola texture, such as an orange peel feeling
• Ulcerations
• Skin thickening
• Redness, warmth, and/or swelling and/or swelling

While a skin condition may be at play, serious conditions like inflammatory breast cancer or Paget's disease of the nipple are also possibilities.

Bumps on the Nipples

Your nipples normally become erect when touched or exposed to the cold. The areolas may become more firm as well.

During pregnancy, Montgomery glands enlarge in preparation for breastfeeding. As a result, they can become clogged, resulting in an infection. Clogged Montgomery glands can be treated with antibiotics and home remedies.

See a healthcare provider about nipple size changes if:

• You have bumps on the nipples/areola and are not pregnant
• You develop any new lumps or bumps, especially if they are firm and not moveable
  

Areola Hair

It's normal to have a few hairs on your areolas. More hair than that can be a sign of polycystic ovary syndrome (PCOS).

PCOS is a hormonal imbalance (when there are more androgen hormones than typical) that can cause infertility.

See a healthcare provider about areola hair if:

• You notice an increase in hair growth on your breasts
• You notice areola hair growth along with other symptoms of PCOS, including weight gain, irregular periods, and acne

Nipple Discharge

Although nipple discharge is uncommon, it's not always abnormal. It can be caused by hormonal changes or pregnancy.

Nipple discharge is typically released from the milk ducts and may be:

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

The consistency can vary from thick and viscous to thin and watery. If benign (not harmful), the discharge usually comes from both breasts. The fluid may leak spontaneously or only when the breasts are squeezed or stimulated.

During pregnancy, a milky discharge is normal as the breasts are preparing to produce milk. Sometimes, certain stages of the menstrual cycle can cause discharge.

Other causes of nipple discharge include:

• Mammary duct ectasia: Clogged or swollen milk ducts
• Galactorrhea: Discharge that is similar to breastmilk but occurs when not lactating
  
• Intraductal papilloma: Benign tumors called fibroadenomas

See a healthcare provider about nipple discharge if:

• The discharge happens spontaneously
• The discharge is bloody or clear
• The fluid only comes out of one nipple
  
• You have other symptoms like a lump, nipple pain, or changes in skin texture

Though there are other possibilities, these are all signs that the nipple discharge is more likely to be related to breast cancer.

Nipple Pain 

Some nipple pain is normal or expected. For example, it's common for your breasts and nipples to be sore just before menstruation. In addition, breastfeeding can cause raw, cracked, and bleeding nipples.

Several benign and treatable conditions associated with nipple pain include:

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

Raynaud's phenomenon can cause nipple vasoconstriction, resulting in episodes of pain, burning, and/or tingling. This can occur with:

• Breastfeeding
• Exposure to the cold
• Nipple trauma

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

See a healthcare provider about nipple pain if you have:

• Persistent nipple tenderness
• Itchiness
• Pain without an obvious cause
  

Inverted Nipples

Nipple variations are usually something people are born with. They include inverted nipples, also called retracted nipples. Inverted nipples look sunken or indented. They can also occur as part of the normal aging process, typically on both sides.

See a healthcare provider about inverted nipples if:

• Your nipples used to stick out and have suddenly become flattened
• You suddenly have an inverted nipple on just one side

In some cases, this can be a sign of breast cancer.

Summary

Nipples and areolas vary in size, shape, color, and texture. Becoming familiar with how your nipples and areolas look is important. Sudden changes in their appearance should be reported to your healthcare provider immediately.

Other issues like excessive hair growth, leaking nipples, sudden retraction, or inversion of the nipples also need to be evaluated. Although these changes may be normal depending on hormonal changes, pregnancy, or aging, they could also be signs of serious conditions or illnesses.