It’s common for nipples to appear lighter or more pale than the surrounding breast skin. In many cases, white nipples are totally normal and nothing to worry about. But sometimes white or pale nipples can indicate an underlying medical condition. Here’s an overview of the possible causes of white nipples and when to see your doctor.
Normal causes of white nipples
In many cases, lighter nipples are just part of a person’s normal anatomy. Some of the common reasons why nipples may appear lighter or white include:
- Genetics. Some people naturally have lighter nipples compared to the rest of their breast skin. This is simply due to normal variations in skin pigmentation.
- Areola size. People with larger areolas (the circular area around the nipple) tend to have lighter-colored nipples since the pigment is spread over a wider area.
- Aging. Nipples and areolas often fade a bit and become paler as people get older.
- Pregnancy and breastfeeding. Hormonal changes during pregnancy and breastfeeding can make nipples appear lighter for some time.
- Temperature changes. Some people’s nipples become paler when exposed to cold temperatures or stress. This is due to temporary changes in blood flow.
If lighter nipples run in your family or you’ve always had pale nipples, they are likely just part of your normal appearance. It’s also common for nipples to change over time due to aging, hormones, or temperature changes.
Medical causes of white nipples
In some cases, whitening of the nipples can be a sign of an underlying medical condition that needs treatment. Some possible medical causes of white or pale nipples include:
Raynaud’s phenomenon
Raynaud’s phenomenon causes reduced blood flow to the nipples and other extremities in response to cold temperatures or stress. This can temporarily make the nipples appear lighter. Raynaud’s affects the color of fingers and toes too. The nipple color should return to normal after warming up.
Eczema
Eczema is a skin condition that can affect the nipple and areola area. The flaky, itchy rash of eczema can cause whitening and discoloration of the nipples.
Paget’s disease of the nipple
This rare type of breast cancer affects the nipple area. One of the early signs is redness, scaling, and discharge from the nipple. As Paget’s disease advances, it can cause white, raw-looking nipples.
Periductal mastitis
An infection of the milk ducts, called periductal mastitis, often causes inflammation and whitening of the nipple. The nipples may also appear cracked or flaky. Periductal mastitis usually affects women who are breastfeeding.
Nipple eczema
Eczema occurring specifically on the nipple is called nipple eczema. It’s a common cause of itchy, flaky, pale nipples and areolas. Nipple eczema is especially common in breastfeeding women.
Other symptoms that may accompany white nipples
Depending on the underlying cause, you may notice other changes in the nipple and breast in addition to lighter nipple color. Some associated symptoms can include:
- Flaking, peeling, cracking or scaling of the nipple skin
- Redness or a rash on the nipple or areola
- Discharge from the nipples
- Itching or burning pain in the nipple area
- Swollen, tender breasts
- Lumps or changes in breast shape or texture
Make sure to notify your doctor if you have any nipple changes along with other worrisome symptoms affecting the breast.
When to see a doctor
In most cases, lighter nipples are not concerning. But it’s a good idea to make an appointment with your doctor or dermatologist if you notice any of the following:
- One nipple is suddenly much lighter than the other
- Your nipples have recently changed color or lightened
- Whitening is only affecting one nipple
- Your nipples are lighter and also itchy, painful, flaky, swollen, or oozing
- The skin around the nipple looks abnormal – for example, scaly, bumpy, or warty
- You have nipple changes along with a new breast lump or unusual breast pain
Sudden nipple changes or nipple symptoms in only one breast warrant a quick evaluation to identify the underlying cause.
Diagnosing the causes of white nipples
To diagnose the cause of whitened nipples, your doctor will typically:
- Ask about your symptoms and medical history
- Examine your breasts and nipples
- Order tests like a skin biopsy or milk duct imaging if infection or cancer is suspected
In many cases, a physical exam is enough to reassure that white nipples are normal. But additional tests can help diagnose diseases like eczema, Paget’s disease, or periductal mastitis.
Can white nipples be prevented?
It’s not possible to prevent your nipples from lightening due to normal causes like aging, hormones, or genetics. But you can lower the risk of medical causes of white nipples in some cases:
- Avoid smoking – Smoking raises the risk of nipple eczema and some breast infections.
- Practice nipple care during breastfeeding – Use lanolin cream and properly fitting flanges to minimize nipple irritation.
- Moisturize nipples – Use gentle moisturizers to prevent drying and cracking.
- Control eczema – Reduce flare-ups with medications and by avoiding triggers.
- Get checked for breast cancer – Have regular exams and mammograms to catch any signs of Paget’s disease early.
Medical treatments for white nipples
The treatment for white nipples depends on the underlying cause:
- Normal causes – No treatment needed for temporary or hereditary nipple lightening.
- Raynaud’s phenomenon – Treat the Raynaud’s itself with lifestyle changes, medicines, and avoiding triggers.
- Eczema – Prescription steroid creams, moisturizers, and anti-itch creams provide relief.
- Paget’s disease – Treated with chemotherapy, radiation, hormonal therapy, or mastectomy.
- Periductal mastitis – Antibiotics, warm compresses, and massage to drain clogged milk ducts.
- Nipple eczema – Over-the-counter hydrocortisone cream and reducing nipple irritation and allergens.
See your doctor promptly if OTC eczema treatments don’t improve whitened nipples within 1-2 weeks. For Paget’s disease, early treatment is critical.
Home remedies and lifestyle changes
You can try these home remedies and tips to help improve nipple irritation and whitening:
- Gentle cleansing. Wash nipples daily with a mild, fragrance-free soap and water. Avoid harsh scrubbing.
- Moisturize. Apply a gentle, hydrating moisturizer like lanolin or shea butter after breastfeeding or washing.
- Avoid triggers. Stop using products, fabrics, or behaviors that seem to irritate your nipples.
- Cool compresses. Apply cool compresses or chilled gel packs to sore nipples for pain and swelling relief.
- Wear breathable fabrics. Opt for soft, breathable fabrics like cotton when possible to prevent nipple irritation.
- Consider nipple shields. Nipple shields can protect sensitive nipples during breastfeeding.
- Improve latch. Consult a lactation consultant to improve baby’s latch and prevent nipple damage when breastfeeding.
OTC hydrocortisone cream can also help reduce nipple irritation and inflammation. But see your doctor if symptoms don’t start to improve within a week.
When to see a doctor
Schedule an appointment with your doctor if:
- Your nipples are persistently itchy, painful, scaly, or discharging fluid
- OTC treatments aren’t helping with nipple irritation
- You have nipple changes only on one side
- Your nipple color change is accompanied by a breast lump or swelling
- You have risk factors for breast cancer like family history or a prior biopsy
While white nipples are often normal, it’s important to make sure an underlying condition isn’t causing the changes. Seek medical advice if you have any concerns about your nipple health.
Takeaway
It’s very common for nipples to be a lighter, paler shade compared to your regular breast skin tone. In many cases, genetics, aging, hormonal fluctuations or temperature changes are responsible for white or pale nipples. But sometimes whitening can be a sign of a medical condition like Raynaud’s, eczema, infection, or very rarely, breast cancer. See your doctor if your nipples are accompanied by symptoms like itching, pain, discharge, or lumps. They can help determine if treatment is needed based on an exam and your health history.
