Nipple problems Health Article

Definition

Nipple problems can include tenderness, skin changes, changes in shape, or discharge from the nipple portion of the breast.

This article is about nipple problems or changes in women who are not breast-feeding or who have not just had a baby (postpartum).

Alternative Names

Discharge from breasts; Milk secretions; Lactation - abnormal; Witch's milk; Galactorrhea; Inverted nipple; Nipple discharge

Causes, incidence, and risk factors

Nipple tenderness or skin changes may be caused by:

• Bacterial or fungal infections
• Dry skin in the areolar region (the darker area surrounding the nipple) of the breast
• Injury to or friction over the nipple area
• Paget's disease.

The likelihood of nipple discharge increases with age. It is somewhat common in women who have had at least one pregnancy or during the final weeks of pregnancy.

A milky nipple discharge is rare in men or women, but it does occur. When it occurs in men or in women who have never been pregnant, it is likely to be caused by an underlying disease. However, even then nipple discharge has many other causes that are NOT breast cancer, including:

• A tumor in the brain called a prolactinoma or microadenoma
• A small, noncancerous growth in the breast called an intraductal papilloma
• Breast abscess located underneath the areola (most commonly seen in women during breast-feeding)
• Injury to the breast or chest wall (milky discharge)
• Pregnancy, usually during the second trimester
• Severe hypothyroidism
• Use of certain drugs, including birth control pills, cimetidine, methyldopa, metoclopramide, phenothiazines, reserpine, tricyclic antidepressants, or verapamil
• Widening of the milk ducts (called ductal ectasia), normally not a cancerous problem
• "Witch's milk," a term used to describe nipple discharge in a newborn. The discharge is a response to hormones from the mother before birth, and should disappear within 2 weeks.

Nipple inversion is a condition that you are born with. Nipple retraction may be caused by aging, duct ectasia, infections in the milk duct, or breast cancer.