The areola is the pigmented area of skin surrounding the nipple. Changes to the areola, including swelling, are common experiences. Understanding the potential reasons behind areolar swelling is helpful, as not every change signals a serious problem.
Expected Areola Changes
The areola can undergo natural, temporary changes that result in swelling or tenderness, often linked to hormonal fluctuations.
During puberty, as ovaries begin to produce estrogen, the breasts develop, and the areola may enlarge. These hormonal shifts contribute to the growth of milk ducts and the accumulation of fat in the breast connective tissue.
Throughout the menstrual cycle, hormonal changes can also affect the areola. Estrogen and progesterone levels fluctuate, stimulating the growth of glandular tissue, which can lead to premenstrual tenderness and a feeling of fullness or slight swelling in the breasts and areola.
During pregnancy, the areola often becomes larger and darker as the body prepares for breastfeeding. This is due to increased levels of hormones like progesterone, which promote the proliferation of secretory tissue within the breasts. Breastfeeding itself can also cause the areola to appear fuller due to milk production and glandular activity.
Common Benign Causes
Beyond typical physiological changes, several other non-serious factors can cause areola swelling.
Skin irritation is a frequent culprit, possibly from friction caused by tight clothing or reactions to hygiene products like soaps and detergents. Minor injuries to the area can also lead to temporary swelling as the body responds to trauma.
Fluid retention in the body, which can occur due to various factors, may also manifest as slight swelling in the areola.
The small bumps on the areola, known as Montgomery glands or areolar glands, are sebaceous glands that lubricate the nipple and surrounding skin. These glands can become more prominent or appear swollen if they become blocked or irritated, or in response to hormonal changes unrelated to pregnancy. While generally harmless, a clogged Montgomery gland can sometimes develop into a small, fluid-filled cyst that may cause minor swelling.
When to Be Concerned
While many instances of areola swelling are benign, certain signs and symptoms warrant prompt medical attention.
Swelling accompanied by signs of infection, such as significant redness, warmth, increasing pain, or the presence of pus, could indicate a bacterial infection like mastitis. Mastitis, while most common in breastfeeding individuals, can occur in anyone and may also present with flu-like symptoms, including fever and chills.
Other concerning symptoms include:
- Persistent or worsening swelling that does not resolve within a few weeks.
- Nipple discharge, especially if bloody, clear, or unusual in color, and not related to pregnancy or breastfeeding.
- Skin changes like dimpling, puckering, a rash, or an orange peel texture (“peau d’orange”).
- A new, firm lump in the breast or areola, or a suddenly inverted nipple.
Seeking Medical Advice
If you experience concerning symptoms related to areola swelling, especially if new, persistent, or worsening, seek medical advice for an accurate diagnosis. Your healthcare provider will typically perform a physical examination of your breasts, armpits, and neck, and ask about your symptoms and medical history, including duration, pain, recent injuries, medication use, and family health history.
Further evaluation often involves imaging tests like a diagnostic mammogram, which uses X-rays, or a breast ultrasound, which uses sound waves to determine if a lump is solid or fluid-filled. A breast MRI might also be recommended for a more detailed view.
If imaging results are inconclusive or suggest an abnormality, a biopsy may be performed. This involves removing a small tissue sample for laboratory analysis to confirm a diagnosis and guide further treatment.