Finding a black dot on your nipple can understandably cause concern. While many instances are harmless and common skin variations, some may warrant medical attention. Understanding the potential reasons behind such a change is important for your peace of mind and health.
Common Harmless Explanations
The nipple and areola contain pores and glands that can lead to various benign appearances, including dark spots. A common cause is a clogged pore or blackhead, where oil and dead skin cells accumulate, resulting in a small dark bump.
An ingrown hair is another possibility, occurring when a hair follicle on the areola grows inward, appearing as a dark spot beneath the skin’s surface. Moles or freckles can also develop on the nipple or areola. These pigmented spots are typically harmless unless they exhibit changes in appearance.
Fordyce spots are small, raised, yellowish or white bumps that are visible sebaceous (oil) glands without hair follicles. These are normal and can appear more prominent or darker on the nipple or areola. Minor irritation or injury to the nipple area can also result in a small scab or dried blood, which might appear as a black dot.
Potential Medical Concerns
While most black dots on the nipple are harmless, some conditions require medical evaluation. A blood blister or hematoma can form due to trauma or a ruptured blood vessel, appearing as a dark, blood-filled spot. These can sometimes be caused by friction or a poor latch during breastfeeding. Over time, the blood in a blister may become darker, eventually appearing black.
Skin cancer, such as melanoma, can occur on the nipple and areola. Melanoma presents with irregular shapes, uneven borders, color variations (including black, brown, or pink), and changes in size or elevation. Paget’s disease of the nipple is a rare breast cancer affecting the skin of the nipple and areola. It often appears as a red, scaly rash similar to eczema, which can be sore, inflamed, itchy, or cause a burning sensation, and may have dark or crusted areas.
Infections or abscesses in the breast or nipple area can sometimes lead to dark spots if there is pus or tissue damage. A breast abscess is a buildup of pus from a bacterial infection, which can enter through cracks in the nipple, causing pain, swelling, warmth, and redness. Severe infections can involve tissue necrosis that might present as a dark area.
When to See a Doctor
Consult a healthcare provider if a black dot on your nipple is new, changes in size, shape, or color, or if it bleeds. Any persistent skin changes on the nipple or areola that do not resolve on their own should also be evaluated.
Seek medical attention if the dot is accompanied by symptoms like pain, itching, redness, swelling, or a persistent rash. Nipple discharge that is not breast milk, especially if bloody, spontaneous, or from only one duct, warrants prompt evaluation. A new lump or thickening in the breast, or any dimpling or puckering of the breast skin, also requires medical assessment.
What to Expect at a Medical Appointment
When you consult a doctor about a black dot on your nipple, they will begin with a thorough physical examination. They will visually inspect the nipple and areola, and gently feel your breast for any lumps or thickening. The doctor will also ask about the spot’s history, including its appearance, changes, and any associated symptoms.
Depending on initial findings, further diagnostic tests may be recommended. A dermoscopy, which uses a specialized magnifying tool with a light, can help examine the spot’s characteristics in more detail. If an underlying issue is suspected, a biopsy may be performed, involving the removal of a small tissue sample for laboratory analysis. Imaging tests such as a mammogram, ultrasound, or magnetic resonance imaging (MRI) of the breast may also be used to assess for deeper abnormalities.