Introduction:
The nipple is a projection of tissue found on the breast, from which milk oozes during breastfeeding. The nipple may have different shapes, sizes, and colors. The nipples can point forward, down, or to the side. These differences are normal; understanding the difference between normal and abnormal can help avoid any medical complications.
What Are the Different Types of Nipples?
Nipples are broadly divided into four types:
Protruded Nipples:
Protruding nipples are the most common type of nipple, and their exact shape will vary from person to person. When stimulated by touch, if exposed to the cold, or during sexual arousal, there may be the erection of protruded nipples. It is essential to become aware of the usual shape and size of the nipples so if there is a sudden change in color or one-sided modifications; it can be consulted with the healthcare provider.
Inverted Nipple:
When the nipples indent in the areola instead of protruding out, the surface of the breast is called an inverted nipple. As a result, they can appear sucked in or dented. It can be congenital or can also be acquired during a lifetime. Inverted nipples result from shortened milk ducts that usually pull the nipple tissue inward. An inverted nipple protrusion can still occur, especially when being stimulated. But, some inverted nipples will never protrude. Women with inverted nipples can do breastfeeding normally, even though they may face some challenges, and inverted nipples tend to go away after breastfeeding a baby.
Some women are very conscious about their inverted nipples look. These are some options for reversing inverted nipples:
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Vacuum approaches and self-retraction devices can be used for mild inversion. The results are often modest and are long-term.
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Plastic surgery is the best option to reverse inverted nipples. However, several different approaches are available.
Flat Nipples:
Flat nipples are neither raised nor inverted but lie even with the areola. Some flat nipples will erect when stimulation during cold temperatures, or sexual arousal, while few flat nipples often remain flat. Women with flat nipples may experience some difficulty during breastfeeding. For example, gently pulling the nipple outward and rolling the nipple in between the fingers causes the nipple to protrude during breastfeeding.
Retracted Nipples:
When the protruded nipples begin to pull inward, fold into a narrow crease, or change position, it is called acquired retracted nipples. Protrusion during stimulation does not occur in a retracted nipple, like an inverted nipple. Nipple retraction can be due to aging, breast cancer, or duct ectasia (when milk ducts become clogged and swollen). An ultrasound or MRI of the breast or a mammogram can help diagnose the cause of the nipple change.
Is Hair Growth Around the Nipple Normal?
Hairy nipples are usually linked to hormonal changes; they can occur due to puberty, menstruation, pregnancy, or menopause. Even birth control pills might also stimulate hair growth. These are hair follicles that both women and men have. These hairs might look wirier and darker than other hairs on the body. It can be plucked, trimmed, waxed, or shaved in the same way as other hairs if it bothers. However, tweezing or plucking around the nipple can sometimes cause infected follicles and ingrown hair.
Few other causes of hair growth in nipples may be due to the following:
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Polycystic ovarian syndrome (PCOS).
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Cushing's syndrome.
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Overproduction of male hormones.
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Medications such as testosterone and glucocorticosteroids.
Is Nipple Discharge a Concern?
When any fluid leaks out of the nipple of the breast, it is referred to as nipple discharge. It is considered a normal process. In about 20 percent of females of reproductive age, when their breasts are squeezed, they can produce nipple discharge; it can even occur during stimuli, such as when the bra or t-shirt rubs against the breast.
A normal nipple discharge maybe due to the following:
Pregnancy - In the early and late stages of pregnancy, watery and milky discharge from the nipple occurs.
Stopping Breastfeeding- After nursing the baby, some women may experience milk-like breast discharge that persists for a while.
Stimulation- During stimulation or when squeezed, the nipples may secrete fluid.
Suppose it is coming out of both breasts and without any stimulation. It could be due to something benign (noncancerous) such as certain herbs (like fennel), medications, an injury, inflammation of the breast ducts, or any infection. In some cases, discharge may be due to thyroid diseases or be a sign of breast cancer. If the discharge is painful, green in hue, or bloody, consult the doctor immediately.
What Do Changes in the Color of the Nipple Indicate?
The nipples can be so pale or a rich shade of brown; both are completely normal. There are natural variations in nipple color, just as in skin tone. Nipple color is not indicative of any breast pathology. But if the nipples have suddenly turned red, or there is a rash, a lesion, or crusting on the nipple or areola, it may indicate some issues, consult a doctor. It can be an indication of breast cancer. Paget's breast disease is a rare type of breast cancer that causes a sudden color change in the nipple, itching, scaliness, and yellow or bloody discharge.
What Changes in the Nipple Require Medical Consultation?
The breast should be self-examined daily during the shower or at least once a month. Other than breast lumps, some signs in the nipples or areolas that should be consulted with the healthcare provider include:
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The scaly or flaky skin on the nipple.
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Crusty or hardened skin resembling eczema on the areola, nipple, or both.
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Nipples are turning red without an obvious reason.
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Bloody or yellow nipple discharge.
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Any nipple discharge that does not resolve on its own after one menstrual cycle.
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The nipple is flattened or inverted, which is usually not common.
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Any other noticeable changes in the nipples.
What Are the Changes in the Nipple During and After Pregnancy?
The nipples will become larger and more pronounced and also change shape. The color of the nipples and areola will continue to darken significantly during pregnancy and after delivery. As the skin on the breasts stretches to accommodate their growing size, there may be itching or dryness. Nipple discharge is also common during the gestation period; it may be transparent or milky.
After childbirth, there are changes in nipples for nursing, where cracking and bleeding are normal signs, Montgomery's glands become more pronounced, and the areola become larger.
The nipples become about 17 % wider and 20 % longer throughout pregnancy. In addition, the areola is widened from half a centimeter to 1.8 centimeters.
What Are the Tiny Bumps on the Nipple?
There are tiny bumps on the nipple called areola glands of Montgomery glands. They are a normal part of all-female breasts. There are multiple glands visible for some women, while in others, less and not noticeable. These glands secrete protective skin oils, which are essential during lactation. Consult the doctor immediately if these glands become reddened, inflamed, or release a strange fluid.
Conclusion:
Most women have protruded nipples, which vary in color and size. Some women even have flat and inverted nipples which are normal. Due to the hormonal change during puberty, pregnancy, and menopause, there may be nipple appearance and sensitivity changes. Any sudden, noticeable changes in the nipple should be consulted as soon as possible.
