Nipples turning white can be concerning, but this symptom is often linked to common and manageable conditions. This article explores the frequent causes of nipple blanching.
Nipple Vasospasm
Nipple vasospasm occurs when the tiny blood vessels supplying the nipple temporarily constrict, reducing blood flow. This causes the nipple to appear white or blanched. As blood flow returns, the nipple may transition through colors like blue, purple, or red before returning to its usual hue.
The pain associated with nipple vasospasm is often described as burning, throbbing, or stinging, ranging from mild discomfort to severe. It can occur before, during, or after feeds, lasting seconds to minutes or longer. Cold temperatures, emotional stress, and certain medications are common triggers.
Nipple vasospasm is frequently associated with Raynaud’s phenomenon, a condition where blood vessels in the extremities, like fingers and toes, constrict in response to cold or stress. Individuals with a history of Raynaud’s, cold hands and feet, or a family history of the condition are more susceptible.
During breastfeeding, nipple trauma or a poor latch can also trigger vasospasm. If a baby does not latch deeply enough, the nipple can be compressed, restricting blood flow. The nipple may appear misshapen, flattened, or pointed, resembling a new lipstick tip, immediately after a feed. Addressing these latch issues is often a primary step in managing breastfeeding-related nipple vasospasm.
Nipple Infections and Physical Factors
Beyond vasospasm, nipple whiteness can also stem from infections or physical factors. A common infectious cause is thrush, a fungal infection from an overgrowth of Candida albicans yeast, often due to antibiotic use or nipple damage. Thrush often causes intense burning, itching, or stinging pain in the nipples and breasts, which may persist for up to an hour after feeding.
While visual signs of thrush can be subtle, they may include bright pink nipples, dry or flaky areolas, a fine white rash, or shiny skin. In breastfeeding individuals, thrush can transmit between parent and baby, potentially causing oral thrush or a stubborn diaper rash in the infant. If pain does not improve with breastfeeding adjustments, thrush becomes a stronger possibility.
Physical factors can also contribute to temporary nipple blanching. Poor latch or nipple compression during breastfeeding can directly reduce blood flow to the nipple due to pressure. Trauma from incorrect breastfeeding techniques, infant sucking issues, or ill-fitting clothing can cause temporary ischemia (lack of blood flow) or irritation, leading to changes in appearance.
Montgomery glands, small bumps on the nipple and areola, can also appear as white spots, particularly during pregnancy and breastfeeding, due to hormonal changes or blocked pores. These glands produce an oily substance that keeps nipples soft. A blocked pore can sometimes lead to a painful white spot or milk blister.
When to Seek Professional Guidance
Changes in nipple color, such as turning white, can be concerning. While many causes are benign, persistent or worrying symptoms warrant medical evaluation. A healthcare professional can provide an accurate diagnosis and recommend appropriate management. Self-diagnosis is not recommended; professional medical advice is crucial for personalized care.
Seek prompt medical attention if nipple whiteness is accompanied by severe, persistent pain that does not improve, or if it interferes significantly with daily life or breastfeeding. Other warning signs include new breast lumps, nipple discharge (especially bloody or pus-like), or changes in breast skin texture. These changes include dimpling, redness, warmth, peeling, crusting, or flaking, all requiring immediate assessment.
If you experience a fever alongside nipple changes, or if previous treatments for suspected conditions like thrush have not provided relief, consult a doctor. During an evaluation, a healthcare provider will typically take a detailed medical history and perform a physical examination. Depending on findings, they may recommend further tests, such as cultures for infection or imaging studies, to determine the underlying cause and ensure proper treatment.