It’s funny, isn’t it? We all have them, but we probably don’t give our nipples much thought. Not until something feels… off. Maybe it’s a new ache, a change in how they look, or perhaps you’re a new parent navigating the world of breastfeeding. Suddenly, this small part of our body is front and center in our minds. And that’s okay! It’s good to be aware, because understanding your nipples is a key part of your overall breast health, and being informed about your nipple health is empowering.
So, what exactly are we talking about? Your nipple is that small, usually raised, nub at the center of your breast. Everyone typically has one on each side. Surrounding it is a circle of skin that’s often a bit darker – that’s called the areola. Together, we doctors call this whole area the nipple-areolar complex, or NAC for short. Think of them as a team.
What Do Our Nipples Actually Do?
Now, these little structures are pretty important. For mothers, the nipple is absolutely central to breastfeeding. It’s where your baby latches on, and tiny openings in the nipple release milk. It’s quite an amazing design, really. Beyond that, for many people, nipples can also be a source of sensation and play a role in sexual pleasure.
A Closer Look: Nipple Anatomy
Nipples come in all sorts of shapes and sizes, and that’s perfectly normal. On average, they might be about 10 to 12 millimeters wide – that’s roughly the width of a standard pen – and stick out about 9 to 10 millimeters.
Inside, your nipple is a clever mix of smooth muscle fibers (which help it become erect), supportive connective tissue, and, crucially, milk ducts. These are the tiny tubes that carry milk, and each nipple has around nine small openings for milk to pass through. They’re also packed with hundreds of nerves, which is why they’re so sensitive.
The Many Faces of Nipples: Types and Variations
Just like the rest of us, nipples have their own personalities!
Nipple Appearance
When we talk about how they look, your nipples might be:
- Protruding: These stick outward from the areola, kind of like little cylinders. This is the most common type.
- Flat: These don’t really stick out or go inward; they’re pretty much level with the skin of your areola.
- Inverted: These point inward, looking a bit tucked into the areola.
Often, having flat or inverted nipples is just how you were born, and it’s usually nothing to worry about. However – and this is important – if your nipples have always been protruding and you suddenly notice one or both becoming flat or inverted, that’s a sign to come see us. It could still be harmless, but it’s something we’d want to check, as it can sometimes be a sign of breast cancer or another issue needing attention.
Number of Nipples
Most of us have two nipples, one on each breast. But sometimes, there are variations:
- Supernumerary nipples: This means having three or more nipples. Usually, it’s just one extra (a third nipple), but believe it or not, some folks can have up to eight! They often look like small moles or birthmarks along the “milk line” on the body.
- Athelia: This is a rare situation where someone is born without any nipples at all. It can happen due to how things develop before birth and is sometimes linked with genetic conditions like Poland syndrome, which affects chest muscle development.
When Nipples Need Attention: Conditions and Disorders
Alright, let’s talk about when things might need a closer look. Your nipple health is an important part of your overall breast health, and a few conditions can affect this area.
Breast cancer is, of course, a major concern. Some types can start in or involve the nipple:
- Ductal Carcinoma in Situ (DCIS): This is an early form of breast cancer where abnormal cells are found in the lining of a milk duct but haven’t spread outside it. Often, there aren’t any symptoms, and we usually find it during routine screening like a mammogram.
- Invasive Ductal Carcinoma (IDC): This is the most common type of invasive breast cancer. It starts in a milk duct, breaks through the wall of that duct, and begins to invade nearby breast tissue. You might notice symptoms like dimpled, puckered, scaly, or inflamed skin on your breast or nipple. A lump or changes to breast size or shape can also occur.
- Paget’s disease of the breast: This is a rarer type of breast cancer that affects the skin of the nipple and usually the areola. It can cause symptoms like itching, burning, nipple discharge (that isn’t milk), and a red, scaly rash on the nipple or areola. It can sometimes look a bit like eczema.
Speaking of eczema, another condition we see is nipple eczema. This can cause an itchy, red, scaly rash on your nipples and areola, and sometimes elsewhere. The tricky part? It can sometimes be hard to tell the difference between eczema and the early signs of Paget’s disease or another form of breast cancer. That’s why it’s so, so important to get any changes checked out by a doctor. Don’t try to diagnose it yourself.
Checking Nipple Health and General Care
So, how do we keep an eye on your nipple health and your breasts in general? Regular check-ups and screenings are key.
- Mammograms are a fantastic tool. We generally recommend starting annual mammograms at age 40, but if you have a higher risk of breast cancer (like a strong family history), we might suggest starting sooner. And yes, men can get breast cancer too, though it’s rare. If you’re male and have certain risk factors, we might discuss screenings for you.
- Sometimes, we might also use a breast ultrasound or a breast MRI to get a clearer picture, especially if a mammogram shows something that needs more investigation or if you have dense breast tissue.
What can you do?
- Get to know your own body. Doing a monthly breast self-exam helps you become familiar with how your breasts normally look and feel. If you notice any changes – any at all – please let your doctor know.
- Keep up with your regular doctor’s appointments and recommended screenings. We’re here to help guide you on what’s appropriate for your age and risk factors.
When to Contact Your Doctor
It’s always better to be safe than sorry. Please give us a call if you notice any of these things:
- Nipple pain or soreness that hangs around for more than a few days or doesn’t have an obvious cause (like recent friction or breastfeeding challenges).
- Any changes to the color or texture of your nipple or the skin around it.
- Cracks in the skin of your nipple (we call this a nipple fissure).
- A rash on your nipple or any part of your breast.
- Any fluid leaking out of your nipple that isn’t breast milk (nipple discharge). This could be clear, bloody, greenish, or milky if you’re not breastfeeding.
- A nipple that suddenly becomes flat or inverted when it wasn’t before.
- If you’re breastfeeding and notice a small, painful white, clear, or yellow dot on your nipple – this could be a milk bleb (a blocked nipple pore).
Catching things early often makes a huge difference. So please, don’t wait if something feels wrong.
A Note on Nipple Piercings
If you have a nipple piercing, or are thinking about one, it’s a good idea to chat with your doctor about how to care for it properly to avoid infections. And if you become pregnant or plan to breastfeed, we definitely need to discuss any precautions.
Key Takeaways for Your Nipple Health
Here’s what I really want you to remember about your nipple health:
- Know Your Normal: Your nipples are unique. Pay attention to their usual appearance and feel.
- Changes Matter: Sudden nipple changes in shape (like new inversion), skin texture, color, or any nipple discharge (if not breastfeeding) warrant a doctor’s visit.
- Screening is Crucial: Regular mammograms, as recommended by your doctor, are vital for early detection of issues like breast cancer involving the nipple.
- Don’t Ignore Symptoms: Nipple pain, itching, rashes, or cracks on the nipple shouldn’t be dismissed. It’s always best to get them checked.
- Breastfeeding Support: If you’re breastfeeding and experience issues like milk blebs or pain, seek advice. We can help!
Your body is remarkable, and even small parts like your nipples play their roles. Taking a moment to understand them and listen to what they might be telling you is a wonderful act of self-care. You’re never bothering us by asking questions or getting something checked out. We’re in this together.
