Abnormal Nipples – Types and Causes of Nipple Abnormalities

Abnormalities in nipples could be of many different types. However, one may erroneously mistake a natural variation in the nipples to be an abnormality. For example, women may feel that their nipples are abnormal solely because the nipples on the breasts seem different from each other. However, it is normal to have variations in size, color, and shape of nipples, just like it is normal to have an asymmetry in the size and shape of the breasts. Therefore, slight variations in the appearance of the two nipples should not be taken as an abnormality.

The nipples are raised structures in the breast tissue. In females, the nipples are connected to the lactiferous ducts and provide an outlet for the milk produced in the mammary glands. The circular region of skin that immediately surrounds the nipple is darker in color than the skin color in the rest of the breast. This circular region of dark skin around the nipples is known as the areola.

Read more on female breast anatomy.

In most cultures of the world, the female breasts and nipples have sexual connotations. Therefore, any abnormality in the nipples can be a potential cause for significant psychological stress. Apart from the aesthetic and sexual repercussions, abnormalities in the nipples could also indicate the presence of serious pathological defects that affect the normal physiologic functions of the nipples. For example, breastfeeding may be affected, leading to nutrient deficiency in a baby.

Types and Causes of Nipple Abnormalities

Abnormalities in the nipples could arise due to various causes. Nipples can get deformed due to injurious acts such as nipple piercings or some other trauma. Disfigurement or loss of nipples can occur due to burns. In other cases, the cause of an abnormal nipple could be genetic or congenital. The following are some of the different types of nipple abnormalities and their potential causes.

Read more on breast nipple problems.

Inverted nipples

Normally, the nipples are raised structures that project outwards from the areola. Inverted nipples refer to a state in which the nipples are turned inwards into the areola instead of growing out of the areola. This can cause problems during breastfeeding as the nipple may become inaccessible to the baby. However, in many cases, the nipples are capable of being drawn out when the baby is able to latch on to them during attempts at breastfeeding.

Other ways to draw out an inverted nipple include the use of artificial suction devices such as the breast pump. Inversion of nipples may occur either in one nipple or both the nipples. Inversion of one nipple is referred to as unilateral inversion, whereas inversion of both the nipples is referred to as bilateral inversion. Inversion of nipples could occur in multiple conditions.

The most common cause is a congenital defect (present since birth). Genetic mutations could also result in this condition. Some of the potential causes of inverted nipples include deletion of chromosome 2q, Fryns-Aftimos syndrome, congenital disorder of glycosylation, Weaver syndrome, and Kennerknecht-Sorgo-Oberhoffer syndrome. Variations in the shape of the nipples may also be genetically determined.

Retracted nipples

Inverted nipples and retracted nipples are often confused with each other. However, these are different conditions with different causes. Inverted nipples have mostly genetic or congenital causes. The inversion of nipples in such cases is present since birth. However, retracted nipples refer to cases in which the individual was born with normally raised nipples, but had an inversion of nipples later on.

Unlike inverted nipples, retracted nipples do not come out on stimulation. The causes of retracted nipples are varied. Some of the potential causes of retracted nipples include age-related changes, breast cancer, abscess in the breast, tuberculosis, duct ectasia, sagging breast, mastitis, infection of the milk ducts, scars, fat necrosis, sudden weight loss, and postoperative complications.

Prominent nipples

As mentioned, there is a natural variation in the size and shape of nipples. However, in some cases, the nipples may have an unusually large size and may protrude further than normal. Protrusion of nipples makes them prominently visible. Such a change can be temporary and usually occurs during puberty. The hormonal changes during puberty are usually the cause of such prominent nipples that accompany the development of other secondary sexual characteristics.

Hormonal changes that occur during periods of pregnancy or lactation may also cause the nipples to become prominent. Another potential cause of prominent nipples is deformity of the tubules in the breast tissue. The protrusion caused by the breast tissue in such cases leads to puffy nipples.

Polythelia

Normally, humans have two nipples. However, in certain abnormal cases, extra nipples may also be present. These extra nipples are referred to as accessory nipples or supernumerary nipples. Polythelia is a condition in which a third accessory nipple is present. The accessory nipple in polythelia may be located either below or above the normally placed nipple.

It is also possible for the accessory nipple to appear elsewhere on the body, typically along the line that extends from the axilla to the inguinal area. This region is sometimes referred to as the “milk line”. Polythelia is caused by congenital defects that are present since birth. Polythelia may sometimes be confused with other nipple abnormalities like bifid nipples, dysplastic divided nipples, and intra-areolar polythelia.

However, these conditions are caused by an anatomical variation of the nipples that are normally present, rather than the appearance of an accessory or supernumerary nipple.

Athelia

Athelia refers to a condition in which one or both of the nipples are absent. It is a rare congenital disorder. Most cases of athelia are unilateral in nature, in which only one nipple is absent. A potential cause of unilateral athelia is the Poland syndrome. Cases of bilateral athelia, in which both the nipples are absent, may be caused by some kinds of ectodermal dysplasia.

Other causes

Nipples can also develop other kinds of abnormalities due to various diseases. For examples, Paget’s disease, irritant dermatitis, eczema, psoriasis, and even lactation, can cause the nipples to develop scales, cracks, and fissures. Trauma may cause the nipples to lose their openings, which can prevent the outflow of milk. Changes in the size of the nipples and the areola are not usually considered to be abnormal, unless such changes are painful and arise suddenly.

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