Cancer Breast Cancer Symptoms Print Changes of the Nipple and Areola What's Normal—and What's Not By Pam Stephan Updated August 13, 2019 Medically reviewed by Richard N. Fogoros, MD More in Breast Cancer Symptoms Causes & Risk Factors Diagnosis Treatment More Subtypes Living With Support & Coping Prevention Hormone Receptor Positive Breast Cancer Metastatic Breast Cancer Triple Negative Breast Cancer HER2 Positive Breast Cancer Survivorship Benign Breast Conditions View All There are a number of things that can alter the appearance, shape, or texture of your nipple or areola. Sometimes these are quick and temporary changes, such as a reaction to touch or cold temperature. Hormonal fluctuations (e.g., during pregnancy) and even age can induce perfectly normal changes in the nipples as well. But when the nipple or areola suddenly or unexpectedly change, it may be a sign of a medical issue. Knowing how to spot a problem can help you determine whether it's time to see a doctor. Illustration by Emily Roberts, Verywell Inverted or Retracted Nipples Nipple variations, such as inverted nipples, retracted nipples, or other alterations can be congenital features that you were simply born with. However, you should always see your doctor if one or both of them differ from how they used to be. It is a change in your nipples that is of greatest concern. 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 were elevated and have become flattened, you should talk to your doctor, especially if the change only affects one side. Retracted nipples, by contrast, start out raised and then pull inward. This is not normal and may be an indication of a medical condition. Breast cancer is the primary concern, especially if the retraction results in a change in a nipple's position or only affects one side. If stimulation doesn't affect the nipple or areola in any way, this is a sign of a problem as well. Abnormal Nipple Discharge Nipple discharge can be the sign of a problem. 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 also vary from thick and viscous to thin and watery. Nipple discharge can be caused by a normal menstrual cycle, benign tumors called fibroadenomas or lumps known intraductal papillomas (which are typically noncancerous). An infection can cause a discharge with a pus-like appearance and a greenish-yellow tinge. Mammary duct ectasia is another cause of nipple discharge and is most common around the time of menopause. The discharge is usually thick and sticky, grey appearing, and may have a green tint. This is a benign condition that occurs as milk ducts become swollen and clogged around the time of menopause. Nipple discharge caused by breast cancer can often be tinged with blood and usually occurs in one breast rather than both. Nipple Discharge: Types and Causes Nipple Lumps and Bumps Your nipple and areola can suddenly get 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) engorge in preparation for breastfeeding. However, if you develop bumps or lumps on or just beneath your nipple or areola when you aren't pregnant, you should have them checked out. This may be the sign of something as simple as a clogged milk duct, an intraductal papilloma, a blister, or a treatable infection such as an abscess. But it may also be the sign of ductal carcinoma in situ (DCIS), a treatable form of early-stage breast cancer. To determine the cause, your doctor may opt to perform either a fine needle biopsy or an imaging test called ductography to evaluate the true nature of the lump. Changes in Nipple and Areola Size It is normal for your breasts and nipples to swell in response to your menstrual cycle or when you are pregnant or breastfeeding. The same can happen when using oral contraceptives. However, if one breast grows noticeably larger, it is something you'll definitely want looked at. It may also be associated with mastitis, an infection of the breast tissue. Breast cancer can cause asymmetrical changes in breast size, either suddenly or gradually. If, on the other hand, your breasts have always been asymmetric, don't worry—few women are perfectly balanced. It is only a change in size that is concerning. The easiest way to determine whether you are experiencing actual breast enlargement or you're just going through your monthly cycle is to see how your bras fit. Do they suddenly fit tighter on one side or cause pressure or discomfort that hasn't been there before? If so, see a doctor. Changes in Skin Texture and Color During pregnancy, your nipples and areola may become darker in color; your areola itself may also become visibly larger. When these changes are either unilateral (occurring on one side), unevenly distributed on both sides, or occur outside of pregnancy, they are generally not considered normal. This can include thickening of the skin, visible swelling or inflammation, an "orange peel" texture, a change of nipple direction, or noticeably warmer skin temperature. Causes may include: Eczema: An itchy skin rashInflammatory breast cancer: This is a rare cancer that causes the swelling of the breasts. At first, this may appear to be eczema, but can rapidly spread and cause skin to become red and tender.Squamous cell carcinoma: A common skin cancer associated with overexposure to the sunPaget's disease of the nipple: A rare type of breast cancer that starts on the nipple and extends to the areola, but does not cause breast lumps or tumorsBowen's disease: A very early form of skin cancer that is easily treatable Nipple Pain Outside of pregnancy or your menstrual cycle, there is no such thing as normal nipple pain. If you have persistent nipple tenderness, itchiness, or pain that was not caused by an injury, you need to get it looked at. Nipple pain is an uncommon symptom of breast cancer, but it can be the first symptom of a developing malignancy. It may also be a sign of mastitis, fibroadenoma, or a benign cyst. Causes of Nipple Pain 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 manifest in this way. While you may end up with a clean bill of health, if there is a concern, you stand a far better chance of successful treatment if the problem is spotted, diagnosed, and treated early. A Complete Guide to Areola and Nipple Health Was this page helpful? Thanks for your feedback! Get honest information, the latest research, and support for you or a loved one with breast cancer right to your inbox. Email Address Sign Up There was an error. Please try again. Thank you, , for signing up. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Puapornpong P, Paritakul P, Suksamarnwong M, Srisuwan S, Ketsuwan S.Nipple Pain Incidence, the Predisposing Factors, the Recovery Period After Care Management, and the Exclusive Breastfeeding Outcome.Breastfeed Med. 2017 Apr;12:169-173. doi: 10.1089/bfm.2016.0194. Epub 2017 Mar 9. Shaheed SU, Tait C, Kyriacou K, Linforth R, Salhab M, Sutton C.Evaluation of nipple aspirate fluid as a diagnostic tool for early detection of breast cancer.Clin Proteomics. 2018 Jan 11;15:3. doi: 10.1186/s12014-017-9179-4. eCollection 2018. Yılmaz R, Bender Ö, Çelik Yabul F, Dursun M, Tunacı M, Acunas G1.Diagnosis of Nipple Discharge: Value of Magnetic Resonance Imaging and Ultrasonography in Comparison with Ductoscopy. Balkan Med J. 2017 Apr 5;34(2):119-126. doi: 10.4274/balkanmedj.2016.0184.