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Know Your Nipples: 5 Changes to Watch For

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Heather Rupe, DO - Blogs
By Heather Rupe, DOBoard-certified OB/GYNApril 21, 2016
From the WebMD Archives

As someone who looks at nipples all day long, I can tell you that there is a wide range of what is considered “normal.” Much like other parts of the body, nipples come in variety of shapes, sizes and colors. And nipples can change. Many women find that their nipples enlarge and darken in color with age, weight changes, and pregnancy – these changes are normal. There are other kinds of changes, though, that warrant closer attention because they could be signs of trouble.

Here are 5 to watch for (and, if noticed, discuss with your doctor):

Rashy Nipples
Nipples are not a common place to get a rash. If you develop a rash on the nipple that doesn’t resolve within a week with simple treatments like cortisone, it should definitely prompt a visit to your doctor. There is a rare form of breast cancer called Paget’s disease that will often first present as a rash on the nipple that looks crusty and similar to eczema.

Leaky Nipples 
Clear, white or milky discharge that comes from multiple ducts is normal when you are pregnant or nursing. Nipple leaking or discharge outside pregnancy and breastfeeding is not normal.

Nipple discharge can sometimes be obvious, squirting out when you perform your breast exam. Other times it’s sneaky, appearing as discoloration on a bra or night shirt. Nipple discharge can be clear, green, red or brown. Medication, tumors and rarely cancer can all cause nipple discharge; so any discharge not associated with childbirth should prompt a visit to your provider. Your provider will usually perform an exam, a slide of the discharge and a mammogram to help figure out if it is concerning or not.

Inverted Nipples
Inverted nipples, where one or both nipples are “inside out,” are common. Nipples that invert around the time of puberty are normal.

Newly inverted nipples, though, are not normal.  If your nipple was previous an “outie” and then becomes an “in-ie” this is concerning. It could be a signal of a new mass or cancer, and you should see your doctor.

Tender Nipples
Your nipples contain a bazillion nerve fibers and are extremely sensitive. Breast and nipple pain is common, especially in the week before your period. Tenderness that resolves with your cycle is likely normal and can often be minimized by reducing caffeine and wearing a supportive, properly fitting bra. But if your pain is persistent and severe or if it is accompanied by fever or other symptoms, you should go in to be evaluated by your doctor.

(Extra) Hairy Nipples 
The majority of women have sparse dark hairs that grow around their areola. Most of these women will never admit it to anyone other than their trusty gynecologist, but it is true. For those of you who have them (don’t worry, you’re secret is safe with me), it is safe to trim or pluck these annoying hairs.

While a few sparse hairs around the nipple are fine, hair on the chest between the breasts is not normal and could be a sign of a hormonal imbalance. If your chest is starting to look “Tom Selleck- esque”, you should probably see your doctor.

Because nipples are such a sensitive, private part of the body, many woman are not comfortable discussing them with their girlfriends or even their doctors. But sometimes you need to. Changes in our nipples can give us a glimpse of what is going on deeper in the breast, so if you see any of the changes discussed above, be sure to check with your doctor.

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About the Author
Heather Rupe, DO

Heather Rupe, DO, is a board-certified OB/GYN in private practice in Franklin, TN, and serves as the vice chief of staff at Williamson Medical Center. She is the co-author of The Pregnancy Companion: A Faith-Filled Guide for Your Journey to Motherhood and The Baby Companion: A Faith-Filled Guide for Your Journey through Baby’s First Year.

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