Bumps found on the areola, the dark skin surrounding the nipple, often cause concern, leading many to wonder if they are pimples. While new or unusual bumps can be worrying, the structures in this area are frequently normal anatomical features. These small, raised spots are often benign, but they can resemble acne. Understanding the function and typical appearance of the areola’s structures helps distinguish between a normal bump and a true skin condition.
Understanding the Normal Bumps on the Areola
The areola contains specialized structures called Montgomery glands, which are the most common source of the small, raised bumps seen in this area. These glands are modified sebaceous, or oil, glands, and they are a completely normal feature of the breast anatomy. They appear as small, flesh-colored or pale elevations on the areola and sometimes on the nipple itself. The number of these glands can vary significantly from person to person, ranging from none to more than 40 on each areola.
The primary function of Montgomery glands is to secrete a lipid-rich, oily substance called sebum. This sebum lubricates and protects the skin of the areola and nipple, helping to prevent drying out or cracking. The secretions also contain volatile compounds that may act as an olfactory stimulus, helping newborns locate the nipple during breastfeeding.
These normal bumps, also referred to as Montgomery tubercles, can become more prominent due to hormonal shifts. Fluctuations during the menstrual cycle, puberty, and especially pregnancy can cause the glands to swell. Stimulation, stress, or wearing tight-fitting clothing can temporarily make them appear more raised. Since these glands are not clogged pores, do not squeeze or pick at them, as this can lead to irritation or infection.
True Acne and Other Skin Conditions
True acne, or pimples, can technically occur on the areola, although it is far less common than the normal anatomical bumps. The skin surrounding the areola, and sometimes the areola itself, contains hair follicles and sebaceous glands, which are the biological requirements for acne formation. A true pimple develops when dead skin cells and oil clog a hair follicle, leading to inflammation that results in a whitehead or pustule.
Acne in this specific location is often triggered by factors like friction from tight clothing, such as a sports bra, or poor hygiene after sweating. The irritation and blockage of the pores can result in the typical red, inflamed, and sometimes painful pustules associated with acne.
Conditions Mimicking Acne
Another common condition that mimics a pimple is folliculitis, which is an inflammation or infection of the hair follicles around the areola. Folliculitis typically presents as small, red bumps that may contain pus and are often caused by bacteria.
Other conditions can also cause lumps in this area, such as sebaceous cysts, which are small, firm lumps that develop under the skin due to a blocked gland duct. For women who are breastfeeding, a lump resembling a pimple may be a milk blister, caused when a milk duct is blocked near the nipple surface. Differentiating pathological bumps from normal Montgomery glands involves looking for signs of active inflammation, such as pain, warmth, or persistent redness.
Signs That Require a Doctor Visit
While most bumps on the areola are benign, certain signs suggest the need for a medical evaluation to rule out infection or other underlying conditions. Any bump that rapidly changes in size or shape, or one accompanied by persistent, localized pain or warmth, should be checked by a healthcare provider. These symptoms can indicate an infection, such as an abscess, which is a collection of pus that may require drainage and antibiotics.
A doctor’s visit is also warranted if the bump is associated with any unusual discharge from the nipple, especially if the discharge is bloody or contains pus. Other red flag signs include changes to the surrounding breast tissue, such as skin that appears scaly, crusty, or has a texture resembling an orange peel.
Additionally, a nipple that suddenly becomes inverted or retracted, or a lump that feels hard, irregular, and does not move easily under the skin, requires prompt attention. If a bump does not resolve on its own within a few weeks, or if you have any significant concern about its appearance, seeking professional advice ensures an accurate diagnosis.