Noticing a pimple on your face can be annoying. But nipple pimples? That can be anxiety-inducing. You may start thinking of the worst-case scenario: do I have breast cancer?
You would be relieved to know that nipple pimple is not always a cause for concern. Acne or even a simple hygiene issue are some of the more common reasons for nipple pimples. Nonetheless, depending on the persistence and accompanying symptoms, these tiny bumps can be a warning sign of health conditions, including breast cancer. But how do we tell what is considered normal or abnormal? When should you be concerned? Here, we will break down the various causes of nipple pimples, when you should see a doctor and the treatment options available.
What is a Nipple Pimple?
A nipple pimple appears as a small, raised bump on the nipple or areola, an area of dark-coloured skin surrounding the nipple. Nipple pimples are usually benign, largely due to conditions including:
Acne
Just like acne on other parts of the body, nipple acne is caused by the excess secretion of sebum (oil), which clogs the skin surrounding the nipple. This can be from many reasons such as hormonal changes or chafing with a tight bra or shirt. They appear as whiteheads and can be painful on touch.
Ingrown hair
Hair around the nipple is normal. Just like hair on other parts of the body, they can grow inwards back into the skin rather than outwards. This creates pimple-like bumps along the areolas, which can become itchy and inflamed overtime. Frequent shaving or waxing around the region stimulates hair regrowth, increasing the risk of hair ingrowths.
Areolar glands
Also known as Montgomery glands, these are tiny bumps on the pigmented skin around the nipples (areolas). They secrete oil to lubricate and protect the nipples from infection, especially during breastfeeding. It is normal for them to be slightly enlarged during hormonal changes such as puberty, menstrual cycle, or pregnancy. However, infected areolar glands may also present as red, inflamed, and painful bumps on the skin.
Milk blisters
For breastfeeding mothers, an overproduction of milk or improper latching can cause clogging in the milk ducts. The milk-filled bumps can look like a pimple, though they are painful and should be treated as soon as possible.
In some cases, nipple pimples could be a warning sign of a more serious health condition. These are distinguished by accompanying symptoms like pain and nipple discharge:
Yeast infection
Accompanied by rash and flaky skin, yeast infection typically results from frequent rubbing of dead skin cells, sebum, and sweat with the nipple areas. Poor hygiene e.g. not showering or washing your clothes, or an oral infection from the baby during breastfeeding are common causes.
Subareolar abscesses
They are abnormal growths on the areolar glands typically caused by infection of the milk ducts (mastitis). If left untreated, the infection can cause redness, swelling, and pus discharge that appears greenish or bloody. These cases can be painful and require treatment as soon as possible.
Is a Nipple Pimple a Warning Sign of Breast Cancer?
In most cases, a nipple pimple is not indicative of breast cancer. However, nipple pimples that persist for more than a month, or become painful can be associated with breast cancer. Do note that such cases are typically accompanied by other signs such as a lump in the breast, unusual nipple discharge, nipple inversion, or changes in the skin texture of the breast (such as dimpling). However, any persistent or unusual changes in the breast or nipple should be evaluated by a healthcare professional to rule out any serious conditions.
Nipple pimples are more common in a rare form of breast cancer called Paget’s disease of the nipple, where cancer cells begin in the nipple or areolas. It may spread to the milk ducts, also known as ductal carcinoma in situ (DCIS). It is rare for patients to only have nipple pimples as an isolated symptom. More defining signs of Paget’s disease include:
- Flaky skin around the nipple
- Ulceration
- Bloody nipple discharge
- Burning sensation on the nipples
When Should You Be Concerned About a Nipple Pimple?
Nipple pimple is a cause for concern if it is persistent for more than a month or is accompanied by other symptoms such as:
- Breast lump or changes in the size and shape of the breast
- Nipple inversion
- Persistent rash or skin dimpling
Early opportunities to treat any underlying health conditions are often missed because people downplay their concerns as mere overthinking. Remember that a false alarm is always better than a late diagnosis. If you experience any of the above symptoms, consult a doctor as soon as possible. At the Centre for Screening & Surgery, every concern will be addressed properly.
How is a Suspicious Nipple Pimple Diagnosed?
The cause of nipple pimples can be confirmed through various diagnostic procedures. The physician will first inquire of your medical history followed by a physical examination, where the physician will feel for any lumps or nipple discharge. Following that, various imaging tools are used to look for signs within the breast tissues that may have been missed during physical examination. The more common imaging tools include:
Mammograms
A mammogram is an X-ray examination of the breast to detect signs of lumps, masses, or other abnormalities that could be indicative of breast cancer or benign tumours. During the screening, you will be asked to remove your clothing and other jewellery. Two compression plates will be placed on either side of the breast at various angles to spread out the breast tissues. This will capture a more accurate X-ray image. While you may feel some discomfort from the compression of the plates, it is generally painless.
Ultrasound
An ultrasound is a scan that uses sound waves to produce images. Without using radiation, this is a relatively safe process and a good alternative for pregnant women. A breast ultrasound is commonly used to determine the characteristics of a lump found in a mammogram e.g. a tumour or a cyst.
Biopsy
If a lump is detected during a mammogram, a small sample of the breast tissue will be extracted for further laboratory testing. This will identify the presence of any cancer cells or infections.
Treatment for Nipple Pimples and Breast Cancer
The type and duration of treatment will differ based on the cause of your nipple pimples.
In general, good hygiene is vital to prevent acne or infections. Wash your breast daily with soap and warm water. After a sweaty workout, change out of your sports bra and try to clean off any sweat with a shower or wet towel. If you have sensitive skin, avoid using detergents or fragranced lotions.
For acne-related causes, discuss with your doctor to determine the best type of antibiotics for you. While every skin is different, salicylic acid is generally used for removing whiteheads and blackheads.
Subareolar abscesses need to be drained. Doctors will apply a numbing cream around the affected region, and a sterile needle will be injected to drain the abscess. Antibiotics are prescribed afterwards to prevent further infection. For breastfeeding mothers, you may also want to get your infant checked for an oral yeast infection.
If nipple pimple is caused by breast cancer, various therapies will be performed depending on the type, stage, and other individual factors. Common treatment options include:
- Radiation Therapy: High-energy waves are used to target and destroy cancer cells.
- Chemotherapy: The use of drugs to kill or slow the growth of cancer cells.
- Hormonal Therapy: Treatments that block cancer cells from getting the hormones they need to grow.
- Targeted Therapy: Drugs that target specific characteristics of cancer cells, such as a protein that allows cancer cells to grow in a rapid or abnormal way.
- Immunotherapy: This approach helps the immune system recognise and attack cancer cells.
- Surgery: Typically as a last resort, this can range from lumpectomy (removal of the tumour and a small margin of surrounding tissue) to mastectomy (removal of one or both breasts).
How to Prevent Breast Cancer and Monitor Your Health
Breast cancer is like a silent assailant – most do not notice any visible symptoms until cancer has reached its later stages. While late-stage cancer is not always a lost cause, early detection is always optimal in optimising treatment. Hence routine breast examinations are vital in detecting early signs of cancer.
Currently, a mammogram is one of the most effective and commonly used imaging tools. Even if you don’t notice any warning signs of breast cancer and other changes, you are still recommended to take it once per year for those aged 40 to 49, and twice per year for 50-year-olds and above.
Of course, breast examination can be performed on your own as well. It is a quick 5-minute check at least once a month, preferably a week after the end of your menstruation. You can either lie down or stand in front of a mirror. Observe your breasts and underarms for:
- Rashes, redness, or lumps on your skin
- Changes in the shape and size of your breasts
- Nipple inversion
- Any bulging or puckered areas around the outline of your breast
Next, using your finger pads, apply different pressure in a circular motion from your collarbone to your cleavage and armpits to check for any lumps or distortions around your breasts. Gently squeeze your nipple to check for abnormal nipple discharge such as blood, yellow, or watery fluid.
While these self-monitoring exercises may seem insignificant, they are often key to an early diagnosis. They don’t take much time – there are no excuses for not doing them! After all, there are no shortcuts to protecting your health.
Safeguard Your Health Today
While nipple pimples are generally harmless and not a sign of breast cancer, any persistent or unusual breast changes should be evaluated by a healthcare provider. Breast cancer diagnosis and treatment are multifaceted processes that involve various medical interventions to ensure the best possible outcomes.
At Centre for Screening and Surgery, we prioritise delivering quality and comfortable early cancer screening and treatment using minimally invasive procedures. If you notice pimples or other abnormalities on your breasts, call us to book an appointment today! A false alarm is always better than a late diagnosis.
