Nipple

What is a nipple?

Your nipple is the tiny structure that marks the center of your breast. You typically have one nipple on each side of your chest. Nipples usually stick out a bit, but they may also be flat or point inward. A round, darker-colored area of skin, called your areola, surrounds your nipple. Together, your nipple and areola make up what healthcare providers call your nipple-areolar complex (NAC).

What is the nipple’s function?

Your nipple plays a vital role in breastfeeding (chestfeeding). Your baby latches onto your nipple and areola, and tiny openings in your nipple release milk to nourish your baby.

Nipples can also play a role in sexual pleasure for people of all gender identities.

How big are nipples?

On average, nipples are 10 to 12 millimeters wide and stick out 9 to 10 millimeters from surrounding skin.

What is the anatomy of a nipple?

Your nipple is made up of smooth muscle fibers, connective tissue and milk ducts (tubes that carry milk). Each nipple has about nine small openings (orifices) where milk comes out. It also has hundreds of nerves, which provide sensation.

What are the different types of nipples?

We can group the types of nipples according to how they look and how many you have.

Nipple appearance

When it comes to appearance, your nipples may be:

• Protruding. Your nipples stick outward from your areola and look a bit like tiny cylinders. This is the most common type.
• Flat. Your nipples don’t stick outward or inward. They’re even with the skin of your areola.
• Inverted. Your nipples point inward so they look like they’re tucked inside your areola.

Flat or inverted nipples are often harmless variations that you’re born with. But if you have protruding nipples and suddenly notice they’re flat or inverted, tell a healthcare provider. This change can still be harmless, but it’s sometimes a sign of cancer or another condition that needs treatment.

Number of nipples

Most people have two nipples — one on each breast. But it’s possible to have:

• Three or more nipples (supernumerary nipples). Most people with this condition have just one extra nipple (a third nipple), but some people have as many as eight.
• No nipples (athelia). Some people are born without any nipples. This happens due to changes during fetal development. It’s sometimes associated with a genetic disorder like Poland syndrome (which causes underdeveloped chest muscles and other anomalies).

What conditions and disorders can affect the nipple?

Breast cancer can threaten the health of your entire breast, including your nipple. Here are a few types of breast cancer that start in your nipple area:

• Ductal carcinoma in situ (DCIS). Cancer starts in your milk ducts but typically doesn’t spread beyond them. There usually aren’t symptoms, and providers find most cases through imaging tests.
• Invasive ductal carcinoma (IDC). Cancer starts in your milk ducts and spreads to nearby tissues. Symptoms may include dimpled, puckered, scaly or inflamed skin on your breast or nipple. You may feel a lump in your breast or notice changes to breast size or shape.
• Paget’s disease of the breast. Cancer develops in the skin of your nipple. It causes symptoms that affect your nipple and/or areola, including itching, burning, discharge and a rash.

Besides cancer, another condition that can affect your nipples is nipple eczema. This is when an itchy, red, scaly rash develops on your nipples and areola (and possibly elsewhere on your body). It’s not always easy to tell the difference between eczema and signs of breast cancer. This is why it’s vital to call a provider if you notice any changes to your breasts.

How can I check the health of my nipples?

Providers routinely use mammograms to check the health of your entire breast, including your nipple. They also use breast ultrasound and breast MRI in certain situations.

People assigned female at birth (AFAB) should start getting annual mammograms at age 40. Your provider may recommend you start screenings sooner depending on your personal risk of breast cancer. If you’re assigned male at birth (AMAB), your provider may recommend screenings if you have certain risk factors. Although rare, breast cancer can and does affect people AMAB.

How can I care for my nipples?

You can care for your nipples by:

• Seeing a healthcare provider regularly for breast exams and doing recommended screening tests, like mammograms. Your provider will tell you how often you need exams and tests.
• Doing a monthly breast self-exam to become familiar with how your breasts look and feel. If you notice any changes, alert a provider.

When should I contact a healthcare provider?

Contact a provider if you experience any of the following signs or symptoms:

• Nipple pain or soreness that persists for several days or doesn’t have a known cause
• Changes to the color or texture of your nipple or surrounding skin
• Cracks in the surface of your nipple (nipple fissure)
• A rash on your nipple or any part of your breast
• Fluid leaking out (nipple discharge)
• A flat or inverted nipple when you didn’t have one before
• A small white, clear or yellow dot on your nipple when you’re breastfeeding (milk bleb)

Seeking care at the first sign of nipple changes can help your provider diagnose issues and recommend treatment. It’s better to call and find out it’s nothing serious than to delay care that could be lifesaving.

If you have a nipple piercing, ask your provider how to care for it. This includes asking about any precautions you should take when pregnant or breastfeeding.