Types of Nipples

Normal variations and what may be cause for concern

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Just as breasts come in all shapes and sizes, there are different nipple types that result in women having significant variations in the appearance of their nipples.

Most women (90%) have what are known as common nipples, which are those that protrude at rest and, because they're loaded with nerve endings, become erect due to stimuli like cold, touch, and sexual activity. The remaining 10% of women have flat or inverted nipples.

There are even differences among these nipple types. Some face front, while others point sideways. Many women have a mismatched pair—for instance, maybe one nipple is higher than the other, or only one is inverted or flat.

Knowing this may come as a relief if you are concerned that your nipples are not "normal." That said, there are some nipple differences that signal a potential problem, and they, too, are worth learning more about.

About 1% to 5% of people have an extra nipple or nipples, which are known as supernumerary nipples. These extra nipples don't cause any problems, though they may lactate if you breastfeed.

Common Nipples

There is variation among nipples even among those considered "common." Protruding nipples stick out from the areola, and the amount they protrude varies. Other nipples are "puffy," with an areola that rounds outward.

All nipples have small bumps on the areola called Montgomery glands, or areolar glands. These glands secrete a fluid called lipoid fluid to help keep the entire areola and nipple area lubricated.

In addition to varying in size, nipples also vary in color; the areola can range from very pale to a deep brown, depending on your skin color, and often gets darker during pregnancy.

nipple variations
Verywell / JR Bee

Inverted Nipples

Inverted nipples are those that are withdrawn below the surface of the skin and lack the normal protrusion. Nipple inversion is a condition you're born with.

It usually occurs when breast tissue adheres tightly to the base of the nipple, enough to prevent it from sticking out, or due to shortening of the milk ducts themselves, which pass through the breast and open into the top of the nipples.

In mild cases, the nipples are occasionally inverted, but will spontaneously become erect with stimulation. In more severe cases, the nipple cannot be made to protrude manually.

If you've had them all your life, inverted nipples are usually harmless, though they can sometimes make breastfeeding more difficult.

However, if they occur later in life or are a change from your normal protruding nipples (known as acquired nipple retraction), they can sometimes be a sign of a medical condition like breast cancer and should be checked out by your healthcare provider.

Nipple sensitivity varies from person to person, but inverted nipples should be as sensitive as nipples that point outward.

Some women find the appearance of inverted nipples very distressing. There are several options for reversing the direction of these nipples.

For mild inversion, various devices for self-retraction and vacuum approaches have been used. The results of these treatments, however, are usually modest at best and are not usually a long-term solution.

Plastic surgery can be done to reverse inverted nipples. A number of different procedures have been used. If you're considering this, find a plastic surgeon who has experience in treating nipple inversion.

Ask if you can see any before and after pictures of other women who've had the procedure done. You may want to get a second opinion as well.

Flat Nipples

Flat nipples are not raised. They appear to lay even with the areola, the ring of pigmented skin surrounding the nipple, and the skin on the rest of your breast. They don't respond to cold or arousal.

Many women have nipples that appear flat most of the time, but then become erect when they're exposed to cold temperature or sexual stimulation. These are not truly flat nipples.

Women with flat nipples who plan to breastfeed should not have any issues, as their nipples will likely protrude outward during pregnancy. If women with flat nipples don't like how they look, they can try the same remedies that are used to reverse inverted nipples.

Retracted Nipples

When your nipple starts out as raised tissue but begins to pull inward, change position, or fold itself into a narrow crease, it's called an acquired retracted nipple. A retracted nipple, unlike an inverted nipple, will not come back out when stimulated.

Nipple retraction may be caused by aging, duct ectasia (when milk ducts become swollen and clogged), or breast cancer. A mammogram. breast ultrasound, or breast magnetic resonance imaging (MRI) will help determine the cause of the nipple change and enable you to get the proper treatment.

See your healthcare provider if you notice nipple retraction, especially if only one nipple is affected. This can be an early sign of cancer and should be investigated.

Hairy Nipples

There are hair follicles surrounding your nipples, so it's normal to have at least a little hair around them. And yes, it's safe to remove unwanted hair by tweezing, waxing, shaving, or getting laser treatments.

That said, if the hair growth is excessive, you're also experiencing hair growth in other areas (for instance, on your face), or you also have other symptoms like irregular periods, acne, and obesity, see your healthcare provider.

These can be signs of an underlying problem like polycystic ovary syndrome (PCOS), a common medical condition caused by hormonal imbalance, or Cushing's syndrome, a disorder that occurs when the body is exposed to too much of the stress hormone cortisol.

A Word From Verywell

Nipples, like the rest of our bodies, change as we grow and age. It's important that you are familiar with your nipples, so you have a sense of what's normal for you and can report changes.

Though breast cancer is often not associated with any nipple changes, it's important to tell your healthcare provider if you notice physical changes, such as a nipple turned permanently inward or a sore in the nipple area.

Keep an eye out, too, for discharge that occurs suddenly, is bloody, or occurs in only one nipple. These can be signs of breast cancer.

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Article Sources
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