nipple

Synonyms in a broader sense

Mammary gland, mamma, mastos, mastodynia, mastopathy, mammary carcinoma, breast cancer

English: female breast, mamma

Anatomy of the nipple

The nipple (Mamilla, Mamille) is a circular structure in the middle of the breast region that is more pigmented, i.e. darker than the surrounding skin. It consists of the actual nipple, i.e. the part that bulges outwards and is darkest, and the areola surrounding it (Areola), which also has increased pigmentation, but is located at the level of the skin. The size and color of this areola can vary greatly from person to person, so there is actually no standard value here.

Illustration of a nipple

Illustration of the nipple: vertical section through the nipple

Nipple (nipple)
Papilla mammaria

  1. Milk duct -
    Lactiferous duct
  2. Milk sachets -
    Lactiferous sinus
  3. Sphincter muscle of the nipple -
    Papillae sphincter muscle
  4. Vein - Vena
  5. Elastic tendons to the skin -
    Fibrae elasticae
  6. Areola -
    Areola mammae
  7. Areola glands -
    Glandulae areolar
  8. Longitudinal muscle pull
  9. Adipose tissue -
    Corpus adiposum mammae

You can find an overview of all Dr-Gumpert images at: medical illustrations

Figure female breast

Illustration of the mammary gland of a young woman: vertical section through the nipple (A) and muscles of the anterior chest wall from the left (B)
  1. Nipple -
    Papilla mammaria
  2. Areola -
    Areola mammae
  3. Milk duct -
    Lactiferous duct
  4. Lobule of the mammary gland -
    Lobuli glandulae mammariae
  5. Adipose tissue -
    Corpus adiposum mammae
  6. Ribs - Costas
  7. Pectoralis major -
    Pectoralis major muscle
  8. Anterior saw muscle -
    M. serratus anterior
  9. Outer weird
    Abdominal muscles -
    Obliquus muscle
    externus abdominis
  10. Chest wall - thorax
  11. Skin - Cutis

You can find an overview of all Dr-Gumpert images at: medical illustrations

development

You can find nipples in both man as well as the woman. This is because they are in the womb already at a very early stage Embryonic development arise in which it is not yet possible to distinguish between male and female characteristics. Therefore, what many do not even know, men also have the facility for mammary glands, which is why it is even possible nowadays through the administration of hormones for men to Breastfeeding become capable.
Normally, however, the mammary glands and warts in men have no function, except that, as in women, they do so through theirs erection represent a state of sexual arousal. However, this erection cannot be compared with the erection of the sexual organs. It does not happen with the help of special erectile tissue, but is caused by the contraction of smooth musclestriggered by the autonomic nervous systemcaused. This is similar to the principle by which our body hair grows cold or strong emotions straighten up and one goose bumps arises because a reflex of the hair follicle muscle is triggered. The erection is caused by the release of the hormone Oxytocinwhich can be caused by cold, Touches or others sexual stimuli or that too Breastfeeding of an infant.

Please also read our topic on this 'Why do men have nipples?'

Structure and function of the nipple

Women have around 15 to 20 mammary glands embedded in adipose tissue in their breasts, the ducts of which all open into the nipple. These mammary glands are only formed by the influence of female hormones during puberty from the previously existing sebum tissue. During the menopause, there is another change in the female hormone balance, which is why the mammary glands in many women recede more or less at this point. The function of the nipples is to release the breast milk produced by the mammary glands, which the baby feeds.

The nipple and the surrounding areola are a very sensitive area. They react very strongly to external stimuli and are therefore also referred to as the erogenous zone. If the infant wants to drink and is looking for the nipple, it is easier to find this structure on the one hand by erecting it and on the other by the presence of many scent and sebum glands within the areola. When he sucks on the nipple, the breast milk empties.

Appearance

Depending on the person, nipples can look very different, so there is a large framework within which everything is still considered "normal", because every person is different.However, there are also some anatomical peculiarities that occur frequently and deserve special consideration.
These include, for example, the so-called Inverted warts (also: Inverted nipples). These are nipples that practically do not face outward, but are permanently turned inward. Usually, if any, this is a cosmetic problem. For some women, that Breastfeeding however, this can lead to difficulties.

Nipple disorders

Some people have more than two nipples. This state is called Polythelia designated. The extra nipple (s) can be anywhere along the milk ridges that the Armpit to inguinal region pull.
Pain in the nipple can have various causes. Sometimes just wearing certain clothes leads to Pain or itch of the nipple or nipples. In most cases, however, the discomfort is hormonal conditionally, come especially in women in the puberty, pregnancy (read also our topic pregnancy nipples) or the Lactation in front.
The mammary glands can also become inflamed, which usually leads to pain as well as pain Redness, swelling and overheat of the nipple area.
Inflammation of the nipple occurs mainly during breastfeeding, but can also be caused by other factors such as Thyroid dysfunction caused. Whenever there are externally visible changes in the nipples and / or liquid (no matter if clear, milky or bloody secretion) emerges from them (except of course in breastfeeding mothers), one should pay attention and, as a precaution, consult a doctor about a malignant disease such as one tumor to exclude, which is partly associated with these symptoms.

Burning / itchy nipple

There are numerous causes, the A itch or Burn of the nipple cause. An irritation to the Mamille by various things is a frequent trigger of these complaints.

Here, for example, the dress - especially the bra - have an irritating effect on the skin. The skin of the wart reacts to the constant irritation and it comes to Burn and or itching.
Also Cosmetic products can be a cause. If the itching occurs shortly after using a new skin care product, then there is an obvious connection. All products are eligible, from body lotions to soaps and perfumes.
In this case a Pause in application of the cosmetic product clarify the question of whether this is the trigger for the complaints. If this is actually the case, a different product to be switched.
It is the same when a bra causes itching or burning. Here the fabric, but also the unfavorable fit of the bra, can be the cause.

Also one mechanical overstimulation the nipple breastfeeding mothers can cause discomfort that may appear as itching or burning. In this case you can cooling and the Skin soothing ointments Provide relief.

Itchy nipples can also be less common Inflammation of the mammary glands to lead. This is known as mastitis. This is usually part of the breast reddened, overheated, swollen and clear pressure painful. These symptoms should guide you to see a doctor. If it is actually a question of mastitis - depending on the cause - a treatment comes with Antibiotics, Drugs that The lactating hormone prolactin inhibit or use small surgical procedures.
Often times a Cool the affected breast relief.

Also a Rash on the skin, a eczema, can be excruciating itching to lead. The skin can then reddened and dry be and have various changes. With such symptoms there is an idea Dermatologist useful, this can possibly with an ointment Cortisone or contains a similar active ingredient.

Also one Fungal infection the skin can itching and burning of the nipple, a dermatologist may also be able to help in this case Anoint Provide relief.

Another relatively common cause of nipple itching or burning is Phases of hormonal changes As part of the puberty and the pregnancy and Lactation as well as the menopause.

Another very important albeit rare cause of one-sided itchy nipple is Breast cancer. There are usually other symptoms like palpable knots, milky or bloody discharge from the nipple, swollen lymph nodes, Skin changes the chest and others in front.
But even if the persistent itching is the only symptom, it should definitely be one doctor a possible one will be visited Breast cancer through the physical exam and one X-ray image the chest (Mammography) can recognize. Because the sooner one Breast cancer is recognized, the better the treatment options.

Pain in the nipple

There are numerous causes of sore nipples. Often they can be triggered by mechanical irritation of the nipple. Such irritation can be caused by items of clothing, especially the bra.
If this is the case, the bra should be changed and it should be seen whether the pain subsides. Both the fabric and the fit of a bra can cause chest irritation.
Another cause of mechanical irritation to the nipple is breastfeeding. Therefore, breastfeeding mothers often suffer from itchy, burning or sore nipples. Ointments that soothe the skin can often provide relief here.
Cooling the nipple is also usually good for these symptoms.

Another cause of nipple pain can be inflammation of the mammary glands. This condition is known as mastitis. It is common in nursing mothers, but is also becoming more common in non-nursing and non-pregnant women.
Usually the breast is clearly reddened, overheated, swollen and tender on pressure in a limited area.

In addition to cooling measures - depending on the cause - antibiotics or drugs that inhibit the hormone prolactin, which causes an increased flow of milk, are used. If an abscess has already formed after the mastitis has persisted for a long time, minor surgical procedures may be necessary.

Frequently, phases of hormonal changes can also cause chest pain. Girls in puberty and women during and after pregnancy but also during menopause are particularly affected.
Skin disorders can also trigger chest pain. In this case, skin changes and symptoms such as itching or burning are usually also present. In this case it can be useful to see a dermatologist.

It should never be forgotten that breast cancer can manifest itself in a wide variety of symptoms. That is why unilateral chest pain should not be taken lightly. Pain alone is rarely an indication of breast cancer; other symptoms such as discharge from the nipple, palpable lumps, skin changes in the breast or swelling of the lymph nodes are often added.
However, this is not always the case. Therefore, in the case of chest pain that persists for more than a few days, a visit to the gynecologist should always be considered. This can use a palpation examination and an x-ray examination of the breast (mammography) as well as possibly other examinations such as blood tests to find out whether it is breast cancer or another cause of the pain.

Read more on the topic: Pain in the nipple

Retracted nipple

A Retraction of the nipple is called Nipple retraction designated. It can occur on one or both sides and congenital or acquired be. In itself, a harmless cause of nipple retraction is the image of the Inverted nipple or Nipple. Here the nipple of one or both breasts is pulled inwards. This usually develops to its full extent in the course of breast development during puberty. Inverted warts are a pure cosmetic problemMany women with inverted nipples are bothered by the appearance of their breasts.
It can also be after a pregnancy at the Breastfeeding difficulties arise when the infant the Not gripping the nipple properly can.

Please also read: Changes in the nipples during pregnancy

There are both conservative as well as operational opportunities for treatment.
Come conservatively Massage techniques or a Nipple shaper in question. In the field of Cosmetic surgery the inverted nipples can be erected by means of small surgical interventions.

A second important cause of nipple retraction and therefore one essential differential diagnosis to the nipple is that Breast cancer (Breast cancer). Next to one palpable knot A retracted nipple in the breast can be an indication of cancer. Therefore, a one-sided retraction of the nipple that has not existed before should always be a reminder to be more attentive. Other possible symptoms of breast cancer can be Orange peel in the breast area, unilateral bloody secretion from the nipple and one permanent eczematous changed nipple.
It should be timely if such symptoms occur gynecologist to be visited. This can go through Inspect and Keys Draw initial conclusions and, if necessary, make a diagnosis by taking a chest x-ray (Mammography) enclose. Even if it ultimately turns out to be a harmless finding, a healthy dose of caution with changes in the breast area is never wrong.

Nipple inflammation

A Inflammation of the nipple rarely occurs in isolation. Mostly there is one Inflammation of the chest in itself, more precisely the Glandular body inside the chest. Such an inflammation of the glandular body is known as mastitis. A distinction is made here between two types.

The Puerperal mastitis only occurs in women the days or a few weeks before Child born have is a Disease of the puerperium.
The Non-puerperal mastitis however comes independently from Puerperium in front.

Postpartum mastitis most commonly occurs in the second week after giving birth. The pathogen that triggers the inflammation is mostly Staphylococcus aureus and will at Breastfeeding transfer. Most of the time, the inflammation is only present in part of the breast, and often it is upper outer quadrant the chest. The area is reddened, overheated, painful and swollen.
The breastfeeding function is restricted. There is a pronounced Feeling sick With fever and swollen lymph nodes in the field of Armpit the affected side.
If the inflammation is left untreated, a abscess arise, which must then be treated surgically.

Come therapeutically - depending on the stage of the disease - Cooling, immobilization through a tight bra and Expressing the milk in question. Pumping happens to one Prevent milk congestion, the milk is then discarded because it contains germs.
The gift of Antibiotics makes sense in the early stages. Milk production may also be inhibited with medication. Already exists abscess, this must - depending on the size - punctured or split and be emptied.

The Non-puerperal mastitis is a disease of sexually mature but not pregnant woman mostly before the menopause. She can get through bacteria staphylococci are the most common causative pathogens.
But also non-bacterial mastitis occur. Reasons for this can include Milk flow (Galactorrhea), one Mastopathy or Inverted nipples (Inverted warts). The increased milk flow can hormonal or medicinal be triggered or by stress arise.

The symptoms of Non-puerperal mastitis resemble those of Puerperal mastitis, it occurs in a circumscribed area of ​​the chest too Redness, overheating, tenderness to pressure and swelling. A very important differential diagnosis is that inflammatory breast cancer, kind of Breast cancer. Here too is that Chest often reddened and overheated.
If the therapy does not respond or if there is any other uncertainty about the diagnosis, this is one Sampling (Biopsy) for exact differentiation conceivable. Non-puerperal mastitis is the main therapeutic option Prolactin inhibitors in question, as the milk flow often caused by too much of the hormone Prolactin comes about. One drug from this group is Bromocriptine.

Therapy should be up to 6 weeks be continued because otherwise it quickly becomes one Relapse can come. Furthermore causes cooling a symptom relief. Non-puerperal mastitis caused by bacteria can occur Antibiotics for use.