We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions will remain anonymous. Please send your questions to firstname.lastname@example.org. This week’s topic: areola changes that have nothing to do with pregnancy.
Q: I’ve noticed some weird changes happening in my areola lately. Like sometimes the little glands in my areola et clogged, is that normal? And I just got montgomery tubercles and flipped the f**k out because I thought you only get those when you’re pregnant, but I took multiple pregnancy tests and am not pregnant. But why do I still have them? Is there anything else I should be checking my areola for, since clearly I’m super focused on them and worried about them right now? Like what indicates that I might have cancer? Anything else I should know?
A: Most of us don’t spend much time considering our areola (plural: areolae, because who doesn’t love a good diphthong), which is the technical name for that darker colored skin around your nipples. At least, not until they are trying to get pregnant, because most discussion around areola changes have to do with signs of early pregnancy. And yes, it’s true that along with all the other bodily changes that go along with pregnancy, your areola can get darker, larger, thicker, and you can start to notice surprising new bumps as your milk glands prepare themselves to feed a tiny human. But what about when things like that happen but you’re not pregnant? What else might your areola be trying to tell you about your health? Here are the main areola changes to look out for, and what they might mean.
Your Areola Color Is Changing
The color of your areola changes naturally over time, which you might have noticed because your areolae darkened when you hit puberty. However, your areolae can change color in adulthood, and not just when you get pregnant (although this is the most common time for it to happen). The primary reason for color changes is high levels of progesterone and estrogen, because these hormones cause your body to increase its pigment development. Darker areolae might be a sign of a hormone imbalance — or just the normal fluctuation of your body as it travels through the menstrual cycle.
When To See The Doctor: If your darker areolae is accompanied by other symptoms, such as flaking or peeling, or you notice that only one of your areola has changed in color, there might be something more medically serious going on. Paget’s Disease is a rare cancer that starts specifically in the nipple and areola area, and one of the first signs is discoloration of the nipple. This cancer is most often found in people over age 50, but if you notice sustained color changes as well as other symptoms including scaly, flaky, or thicker skin, itchiness or redness, or lumps, definitely schedule a visit to your doctor to get checked out.
Your Areola Is Expanding In Size
Breasts change size throughout your menstrual cycle, dictated by your hormone levels. This is totally natural, and as your breasts change size in this normal manner, so may your areolae.
Your areolae may also swell when you’re turned on. When you’re getting in the mood, your breasts actually swell with blood as your heart rate and blood pressure are both raised. This can cause your areolae to get a bit expanded.
When To Go To The Doctor: This is going to become something of a refrain but really the only time to worry is if only one of your areola becomes larger. This breast asymmetry could be a sign of breast cancer, so if this is happening to you, go see your doctor to get checked out.
You Have New Hair On Your Areola
Did you know that your areolae and nipples have hair follicles on them, just like the rest of your body? It’s true! It’s therefore totally natural to have some hair growing out of your areola skin. Body hair in this area is triggered by hormonal changes, and is therefore most common in puberty or menopause, but can also be due to taking the birth control pill.
When To Go To The Doctor: If you notice that suddenly you have lots of chest hair (not just a few hairs around your nipples but a lot on your chest region) this could be a sign of a medical condition. The main culprits are polycystic ovary syndrome, which is a hormonal imbalance that can cause irregular periods and ovarian cysts, and Cushing syndrome, which is a rare hormonal issue that occurs when your body has high levels of cortisol (the stress hormone) for a long time. Other symptoms of Cushing syndrome include getting a hump between your shoulders and stretch marks. If you have any of these additional symptoms, visit your doctor to get your hormone levels checked out. Otherwise, if you just don’t like your areola hair, you can safely remove them by plucking or lasering them off.
Your Areolae Are Puffy
Some people notice that their areolae gets puffy or raised. This is most common during puberty and pregnancy, but can also happen at other times during your life. This is completely normal and is not indicative of anything worrisome.
When To Go To The Doctor: If this is the only change your areolae are experiencing, this is nothing to worry about!
Your Areolae Are Itchy
Itchiness on your areola is rarely a sign of anything medically stressful on its own — more likely it’s because your skin is dry, your bra is rubbing you, or you’re allergic to your detergent or soap.
When To Go To The Doctor: If you notice that your itching persists even after you change your detergents and moisturize, ask your doctor about it. Certain skin cancers include itchy skin in their symptoms, although in these cases you would also have more visible signs (such as flaky or scaly skin).
Your Areola Skin Is Flaking & Peeling
All skin has the potential to get dry and flaky, and areola skin is not exempt from this situation. Peeling or flaking skin could be due to weather changes (skin often gets dryer in the winter), if you were suntanning topless and got a sunburn, or if you had a sexy romp that included rough nipple play and your nipples and areolae got chafed.
When To Go To The Doctor: If you notice that your areola or nipple skin is flaking or peeling, and particularly if this is happening to just one areola or nipple, make an appointment to see your doctor. It’s possible that you could have eczema, a chronic skin condition that causes itchiness and flaky skin. Eczema runs in families, so look for this in particular if you know someone else in your family has it.
These skin changes could also be a sign of skin cancer. A number of skin cancers present with scaly, flaky, red patches on the skin and can show up on the areola and nipple area, and Paget’s Disease starts in this area.
Your Areola Is Bumpy
It’s totally natural for your areola skin to get bumpy when you’re cold, so if you notice bumps after you’ve been walking outside during winter, don’t worry — they will go away once you warm up. Another reason for areola bumps is what are called montgomery tubercles, which is the technical name for when your areolar or montgomery glands get clogged. These glands are designed to lubricate your breasts during breastfeeding — people have an average of nine of these little glands per areola, although some people can have over 30, and some none at all. Clogged montgomery glands can get sore, change color to be red or yellow, and grow in size a bit.
When To Go To The Doctor: While montgomery tubercles show up mostly during pregnancy (they’re actually a sign of early pregnancy), they can also be triggered by hormone imbalance or stress, as well as physical changes such as significant weight change. So if you notice you have these bumps and you know you’re not pregnant or stressed, you might want to talk to your doctor about getting your hormone levels tested. They could be an indication that something else is going on.
Your Areolae Are Lumpy
There are many potential culprits for lumps under your areola, and most of them are not cancer. The most common option is that you have fibrocystic breasts, which is a really normal change many breasts go through, often right before you get your period. If your breasts are fibrocystic, it means your breast tissue changes to feel more ropey and lumpy. This often goes away on its own. Lumps can also be due to clogged milk ducts (which you have even if you’re not lactating); an infection; or an intraductal papilloma, which is a fancy name for a benign (aka non-cancerous) tumor in your milk ducts.
Sometimes, a lump could be what’s called ductal carcinoma in situ, which is the name for the earliest form of breast cancer. At this stage, the cancer is very treatable, but you do have to get it treated so the cells don’t spread to other parts of your breast.
When To Go To The Doctor: If you feel a lump in your areola, just as with any other part of your breast, it’s definitely worth visiting your doctor to figure out what’s going on and take action as needed. If you have a tumor or the beginnings of breast cancer, you will likely want to get that treated. Infection should be treated as well.
You Have Pimples On Your Areolae
Because your areolae have both sweat and sebaceous (oil-producing) glands as well as hair follicles, it’s possible for these glands to get clogged, giving you … nipple pimples! This can happen in particular right before menstruation.
When To Go To The Doctor: Most areola pimples are not medically stressful and will go away if you clean the area with warm water and a gentle (non-perfumed, chemical-heavy) cleanser. If you are struggling with these pimples, you can always go see a dermatologist to get more help and prevention tips based on the specific reasons why your body is producing these pimples.
The Bottom Line
You know your breasts better than anyone else — they’re yours, after all! Because some medically scary things can happen in this area (mainly cancer) it’s a good idea to keep an eye on them and notice any changes. So pay attention to your areolae, but definitely don’t stress about them too much, either. Most of the potential changes are not medically worrisome.