Image: Unsplash Little hair here, little bump there? Here’s what’s normal when it comes to your nips—and when you should seek out the doctor.
If you’ve ever found yourself googling something “ weird” you’ve noticed about your nipples (like “bumps on nipple” or “third nipple”), you’re not alone. There is so much variation when it comes to nipples—like the look, shape, texture, colour, and size—that you’ve likely wondered at least once whether or not yours are “normal.”
And while the many differences you spot may give you pause, fear not: Chances are, you have totally normal nipples and whatever you’re noticing is a natural variation. That said, there’s a small chance your nipples might be trying to tell you something about your health. Keep reading to learn which seemingly weird nipple things are actually pretty run-of-the-mill and which are a sign you should check with your doctor.
First, a word about your nipples.
Before we start talking about “normal nipples,” let’s get some definitions out of the way. Sometimes people think the entire pink or brown part of your boobs is your nipples but actually, your nipples are just the centre part of the dark area—yep, where milk comes out if you breastfeed, according to the Cleveland Clinic. The dark skin surrounding the nipples, on the other hand, is called the areola, and it has glands (called Montgomery glands) that secrete fluid to aid in breastfeeding.
But if you’re searching around about something your nipples are doing, you’re probably wondering about your literal nipples, your areolas, or both. So keep in mind that we’ll be going by the anatomical definitions in this article.
Now that you know exactly what we mean by “nipples,” here are those “weird” issues that are actually just part of having normal nipples:
1. Your nipples are big or small
The size of your nipples means nothing. Like really, nothing. There are all different sizes and shapes. And if you had any kind of worry about your nipple size having any association with your health, don’t. “The size of your nipple has no relevance to cancer risk, for example,” Maggie DiNome, M.D., director of the Margie Peterson Breast Center at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, CA tells SELF.
Likewise, Debra Patt, M.D., a medical oncologist and breast cancer specialist with Texas Oncology, a practice in the U.S. Oncology Network, agrees: “Generally the size variability in the nipple and nipple-areolar complex is not a medical condition, just physiologic variability."
2. You think you’ve got the “wrong” nipple colour
Whether your nipples are so pale you can see your blue veins (oh, hey) or they’re a rich shade of brown, you needn’t worry—they’re totally normal. “Nipple colour is not indicative of health in any way,” Patt tells SELF. “There’s natural variability in nipple colour, just as there is in skintone variability with—and within—different ethnicities,” she adds. DiNome agrees that colour is not usually indicative of breast pathology but, “a rash, crusting or a lesion on the nipple or areolae may (be),” she says.
The exception here is if your nipples have suddenly turned red. Now, if you know why they’re red—for example, you went running and they chafed against your sports bra—then you’re good. Otherwise, head to the doc and let them know how your nipple color has changed. It could be a potential sign of breast cancer—specifically, Paget’s disease of the breast, a rare type of breast cancer that also comes with scaliness, itching, and yellow or bloody discharge, Kecia Gaither, M.D., an ob/gyn and women’s health expert in New York City, tells SELF. “With any major nipple changes, seek evaluation from your health provider,” she adds.
3. Your nipples don’t stick out—they stick in.
“Inverted nipples can be congenital, but they can also be acquired during one’s lifetime,” DiNome tells SELF. And they’re not that uncommon. In fact, it’s estimated that 10 to 20 percent of people with breasts have inverted nipples, which is when the nipples indent in the areola instead of standing above the surface of the breast, explains Gaither. Inverted nipples are totally safe and can happen with one or both breasts.
Generally, most women with inverted nipples can breastfeed normally, though they may pose some challenges, notes Patt. In some cases, inverted nipples can be altered surgically. If the inversion occurs as an adult, you may want to seek medical attention as it could be a sign of breast cancer, Patt adds.
4. There’s discharge coming out of your nipples.
“All ducts in the breast coalesce into the nipple, which is why [people with breasts] can breastfeed,” DiNome says. But for that same reason, those who are not breastfeeding can also have nipple discharge. “Most of the time it is physiologic, meaning it’s a result of normal processes,” DiNome explains. In up to 20 percent of people with breasts of reproductive age, having their breasts squeezed can elicit nip spillage. According to the National Institutes of Health, it can even happen from your bra or t-shirt rubbing against your boobs. So it can be totally normal.
That said, let’s talk about times when it might be a sign of something else. If it's coming out of both breasts, or happens when you squeeze the nipple, it could be due to something benign (meaning noncancerous) such as certain medications or herbs (like fennel), an injury, inflammation clogging the breast ducts, or an infection. In some cases, discharge can signal thyroid disease or be a sign of breast cancer. If the discharge is painful, bloody or green in hue, head to the doctor ASAP, Gaither suggests.
If you’re not pregnant or breastfeeding, it’s best to see your health provider if you notice discharge of any type just to make sure nothing is going on.
5. Your nipples are really sensitive—or not sensitive at all.
Nipples can have all sorts of feelings (and not the emotional kind). While some people find nipple play to be a snooze, others “can achieve orgasm through nipple stimulation alone,” Patt tells SELF. If you’ve had your boobs surgically altered (#nojudgment, I’ve got a reduction in my future), the effect on nipple sensitivity varies. “In a breast reduction, generally the nerves which supply the nipples—specifically, the fourth intercostal nerve—are preserved, so there shouldn’t be any decrease in nipple sensation,” Gaither tells SELF. Similarly, a standard augmentation procedure won’t likely have an effect on sensation, either, says Patt, unless you have the nipples cosmetically altered or moved.
If your nipples are sensitive to the point where it’s painful, see the doctor. This could be a sign of breast cancer or mastitis, infection of the breast.
6. You’ve got hair on your nips.
Really, it’s fine. “[Hair around the nipples] is generally linked to hormonal changes,” says Gaither. “Secondary to puberty, pregnancy, menstruation or menopause, birth control pills may also stimulate hair growth there,” she says. So a few strands shouldn’t freak you out.
In certain situations, though, a condition known as hirsutism can occur where a wealth of hair grows because there’s excessive production of male hormones. “This can stem from medical diagnoses like polycystic ovarian syndrome (PCOS) and Cushing syndrome,” Gaither says. So while a few hairs isn’t anything to stress about, a whole lot of 'em might be a sign you’ve got something else going on.
7. There are little bumps on your nipples and areolas—known as Montgomery glands, FYI.
Yes, those little bumps have a name! Quick anatomy lesson: The areola, the hyper-pigmented area surrounding the nipple, has these tubercles called Montgomery glands, which are normal sebaceous glands that surround the nipple, Patt tells SELF. And although they can vary in number (I’m talking as little as a few and as many as dozens), they’re just little benign bumps on the areolae surrounding the nipple. While the jury’s still out on their actual function (besides a bit of sebum secretion), theories have suggested that they exist to help guide infants to the nipple to breastfeed. That’s pretty cute, so we’re into it.
Speaking of Montgomery glands, just like oil glands on your face and the rest of your body, your Montgomery glands can get plugged and cause zits to form. But as SELF previously reported, it’s rarely of any significance and you can typically soothe irritation with a warm compress. However, if the bumps are red, have pus coming out of them, or come with a hard mass that suddenly forms and sticks around for a few weeks, see a doctor.
8. You experienced nipple growth or a change in nipple color during and after pregnancy.
Anyone who’s been pregnant can anecdotally attest to big nipples, but doctors too note the nipple growth. “The nipple usually darkens during pregnancy and after delivery,” says Patt. “And initially—and frequently—after childbirth, the nipples change in preparation for nursing, where cracking and bleeding can be common,” she adds. Likewise, Gaither tells SELF that “the areolae become larger and the Montgomery’s glands may become more pronounced.”
A 2013 study in The Journal of Human Lactation found that over the course of pregnancy, women’s nipples got about 20 percent longer and 17 percent wider, while the whole areola widened anywhere from half a centimeter to 1.8 centimeters. Discharge is also common—specifically, the clear, milky kind, that progresses in its opacity throughout the gestational period.
9. You have an extra nipple.
It wasn’t only Chandler Bing: “Third” nipples do exist. Another little nipple is totally safe, and total NBD. “This is called a supernumerary, or accessory nipple,” Gaither tells SELF. “During the embryonic period of development, the breasts develop along ‘milk lines,’ which are the precursor to mammary glands and nipples.” And while the milk lines generally degenerate as the embryo ages, in some people they persist, producing the extra (you might say bonus) nipple.\
Here’s when to check with a doctor:
We touched on this throughout the article, but it bears repeating: While most of this stuff is perfectly normal and not cause for concern, there are exceptions. Here are some signs you should talk to your healthcare provider about your nipples or areolas, according to the Mayo Clinic:
You have flaky or scaly skin on your nipple
You have crusty, oozing or hardened skin resembling eczema on the nipple, areola or both
Your nipples turn red without an obvious cause
You have yellow or bloody nipple discharge
You have any kind of nipple discharge that doesn’t resolve on its own after one menstrual cycle
Your nipple is inverted or flattened when it didn’t used to be
Your nipples have changed notably in any way
This article originally appeared on SELF
