Nipple Bump: Causes and Solutions
Lumps on the areola, the pigmented area around the nipple, can be a cause for concern for both males and females. Here's a comprehensive guide to the common causes, symptoms, and treatment options for lumps on the areola.
Common Causes
Montgomery's Tubercles, small, harmless bumps that appear as oil-producing glands on the areola, are more prominent during pregnancy and lactation. Ingrown hair can also cause red, swollen bumps if the hair becomes infected. Milk blisters occur when breast milk is trapped in ducts, often seen in breastfeeding women. Mastitis, an inflammation of breast tissue, can cause lumps and tenderness in the breast area. Paget Disease of the Breast, a rare form of breast cancer affecting the nipple and areola, is associated with symptoms like redness, scaling, and nipple discharge. Benign breast conditions such as cysts or fibroadenomas are more common within the breast tissue rather than on the areola itself.
Symptoms
Montgomery's Tubercles are typically painless, small, and multiple. Ingrown hair may be painful, itchy, and red. Milk blisters are painful but not usually dangerous. Mastitis presents with pain, swelling, and redness. Paget Disease causes a red, scaly, and crusty appearance on the nipple and areola; may have nipple discharge or inversion.
Treatment Options
No treatment is needed for Montgomery's Tubercles as they are benign and normal. Ingrown hair can be treated with the application of warm compresses or topical treatments to prevent infection. Milk blisters resolve on their own but may require gentle expression of trapped milk. Mastitis is managed with antibiotics if bacterial, warm compresses, and continued breastfeeding if applicable. Paget Disease treatment involves surgery (such as mastectomy or breast-conserving surgery) followed by radiation therapy.
It's essential to consult a healthcare provider if symptoms persist or worsen over time, especially if they are associated with other concerning signs like nipple discharge or inversion. Regular self-examinations and check-ups can help identify any changes early. When doctors diagnose a lump on the areola, they will drain fluid from the lump and may perform a biopsy to rule out breast cancer.
Larger lumps on the areola or signs of severe infection may require hospitalization and treatment in the operating room with intravenous antibiotics. Applying a warm compress and moisturizing the nipple can help prevent the areola from cracking. Lumps on the areola that develop during breastfeeding tend to respond well to treatment and are less likely to recur when managed appropriately with drainage and antibiotics.
Methicillin-resistant S. aureus (MRSA) infections are more challenging for doctors to treat and require different antibiotics. Breastfeeding is the most common cause of breast infections, affecting between 2% to 3% of lactating people, of which 5% to 11% may develop an abscess. Consulting a multi-professional team, including a radiologist, general surgeon, infectious disease specialist, pharmacist, and lactation nurse, can reduce healthcare costs, improve recurrence rates, and reduce the need for unnecessary operations.
Recurrence rates are high in people who are not breastfeeding, especially in females. People who are breastfeeding might consider consulting a lactation nurse to learn how to prevent inflammation of the breasts. A 2014 article suggests that as many as one-third of people with lumps on the areola develop fistulas, a tract that forms between the milk duct or the opening of the abscess in the breast and the areola.
If a fluid sample from a lump on the areola is taken, the doctor can identify the bacteria and prescribe an antibiotic targeting those specific bacteria. A specific strain of S. aureus that is resistant to the antibiotic methicillin is sometimes found in lumps on the areola. Doctors may prescribe antibiotics like clindamycin, dicloxacillin, or trimethoprim-sulfamethoxazole for lumps on the areola.
Younger people who are not lactating tend to report more breast pain and have thinner discharge than older people with lumps on the areola. People with nipple piercings should ensure they keep the area clean. Sebaceous hyperplasia is a condition where the oil-producing glands in a person's skin grow more than usual, causing small bumps on the skin, including the nipple. Smoking, obesity, diabetes, and nipple piercings can also cause non-lactational breast abscesses.
Bacterial infections in breast abscesses are often caused by Staphylococcus aureus (S. aureus) and Streptococcus species. Paget's disease of the nipple is a rare condition associated with breast cancer, causing eczema-like changes to the skin of the nipple and areola. A person with a lump on the areola may experience breast pain, discoloration of the skin, warmth, fluid accumulation, fever, nausea, vomiting, and fluid drainage from the nipple or site of discoloration. Breast hematoma is a collection of blood within the breast tissue that can cause a lump near the nipple or areola area.
Males can develop fistulas in the breast, but this is very rare. More than 95% of people with a lump on the areola are females. There are two types of lumps on the areola: nonpuerperal subareolar abscesses (in people who are not breastfeeding) and puerperal abscesses (in breastfeeding females). Males can develop fistulas in the breast, but this is very rare.
- Paget Disease, a rare form of breast cancer, can affect both males and females, causing symptoms such as redness, scaling, and crusty appearance on the nipple and areola, which may be accompanied by nipple discharge or inversion.
- Alongside skin-care, it's crucial for women to prioritize their health-and-wellness, including regular self-examinations and check-ups that can help identify early signs of breast cancer, such as lumps on the areola.
- Besides Montgomery's Tubercles, other medical-conditions like cysts or fibroadenomas can cause lumps within the breast tissue, rather than on the areola itself, and should be evaluated by a healthcare provider.
- Mastitis, an inflammation of breast tissue, can also lead to lumps and tenderness in the breast area, and may affect breastfeeding women, necessitating treatment with antibiotics, warm compresses, and continued breastfeeding if applicable.
- In addition to breast cancer, mental-health is an essential aspect of women's health, and women experiencing anxiety or depression related to breast issues should seek support from mental-health professionals.
