All About Areola and Nipple Health

Understand the Ins and Outs, Leaks and Bumps, Pains and Pleasures of Nipples

Female anatomy, computer artwork.
What do you need to know about nipple and areola health?. SHUBHANGI GANESHRAO KENE / Getty Images

Your nipple and areola are the focal points of each breast. They are a source of milk for your baby, and of pleasure for you and your partner. Nipples and areolas are complex—they deserve your care and attention to keep them healthy.

Nipples: Purpose, Shape, and Changes

Nipples are a working piece of the female body, not just a decorative afterthought on the swell of your breast. Nipples and areolas are connected to your milk production glands, and they have a fascinating anatomy.

There has always been debate over what is considered normal when it comes to nipples. "Normal" nipples are the ones you were given at birth, and they can certainly vary from person to person. Nipples may change as you age, or they may need some surgical remodeling if you have trouble breastfeeding.

Nipples changes occur in response to medications, hormones, a baby's cry, or stimulation of other kinds. But medical conditions may also cause nipple changes, so you need to know what to watch out for and how to deal with nipple problems.

Be sure to check your nipples every month when you do your breast self-exam.

Breast Milk and Nipple Discharge

Breast tissue develops during pregnancy, and milk production starts after birth. Babies will root around for your nipple and have the ability to suckle as soon as two hours after birth.

But breast milk is not the only fluid that may come out of your nipple.

Nipples may leak fluid that can vary in thickness, color, and texture from thin and watery to thick and bloody. Most nipple discharge is benign and can be cleared up with help from your doctor. Sometimes nipple discharge is a sign of cancer, however, so be sure to see your doctor if you notice it. A  ductogram (galactogram) is a test sometimes used to help diagnose nipple discharge.

Nipples, Rock Stars, and Witches?

Nipples, like ears, noses, and other body parts, can be pierced for jewelry wearing. (We may never forget when a wardrobe malfunction displayed a pop singer's pierced nipple on television.) Any hole in your skin can leave you vulnerable to infection, but piercing your nipple should not raise your risk of breast cancer.

As if celebrity stories about nipple exposure didn't give this body part enough attention, stories say that witches, villains, and ancient gods may have had extra nipples, along with special powers. The possibility of an extra nipple (third nipple) is quite real, actually, but some many people have one of which they are unaware. Not all look like the standard-issue model, and often they are dismissed as a mole or other skin change. Third nipples occur along the "nipple line" which extends from your nipples inward towards your pubic bone.

Nipple Discomforts and Diseases

Your nipples and areolas can be sensitive to heat, cold, stimulation, and pressure.

If you have nipple pain while breastfeeding, there are several ways to get relief.

If you aren't breastfeeding and you feel pain or swelling beneath your nipple and areola, it may be a subareolar abscess, which will need some medical attention.

Anyone's nipple may itch, but if the itch persists and the skin reddens, becomes flaky, or tingles, or if you have nipple retraction, get it checked out. It may be Paget's disease of the nipple, an uncommon type of breast cancer.

Some people who have had a mastectomy  (without nipple sparing) also experience itching or aching from a breast or nipple that is no longer there. This isn't your imagination if you experience it but rather the sensation is phantom pain, and is very real. As your body adjusts to being without a nipple and/or breast, the phantom pain will usually fade.

New Nipples?

After the first stage of breast reconstruction, your new breast has no nipple unless you underwent a nipple sparing mastectomy.

You may consider nipple creation after a reconstruction, which includes a tattoo to recreate your areola. If you aren't ready for nipple reconstruction surgery, you might try a self-adhesive nipple prosthesis as these come in a variety of sizes and colors. Or, like Geralyn Lucas wrote in her book "Why I Wore Lipstick to My Mastectomy," you may skip nipple reconstruction and have a heart tattooed over your nipple area as a mark of survival.

Keep in mind that you do not have to do nipple reconstruction after your breast reconstruction. Some women enjoy the freedom of not having to wear a bra after their reconstruction, and having a nipple constructed often means applying band-aids or tape to cover a reconstructed nipple, which doesn't retract like your original nipple (so you may simply appear always cold.)

Sources:

Staradub, V. Patient Education: Common Breast Problems (Beyond the Basics). UpToDate. Updated 06/08/17.

U.S. National Library of Medicine. Nipple Discharge. Updated 08/16/17. https://medlineplus.gov/ency/article/001515.htm

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