The sebum glands of the nipple

definition

A sebum gland is a special type of gland located in the dermis, which uses a holocrine mechanism to secrete fatty secretions (sebum or sebum) onto the surface of the body. A holocrine mechanism describes a form of gland that release secretions and perish themselves in the process.

Sebum glands are found in varying concentrations all over the body except on the inside of the hands and feet. The majority of the sebum glands in the body are closely associated with the hair, but there are so-called free sebum glands unrelated to the hair roots at the transition from skin to mucous membrane (eyelids, lips, genitals, anus, nipples, nostrils and ear openings). Around the nipple there are usually 10-15 particularly large free sebum glands, arranged in a circle, which are called areolar glands or Montgomery glands.

Anatomy of the sebaceous gland

Sebum glands are the only holocrine glands in the human body and therefore have a characteristic structure. Holocrine is a gland that completely dies when the secretion is released. One speaks of apoptosis, a form of programmed cell death.

The end pieces of the glands are pear-shaped or piston-shaped and usually occur in groups that share a short common duct. In contrast to all other forms of gland, these end pieces are completely filled with gland cells, the sebocytes, and have no cavity. This is because the cells themselves “become secretions” by migrating from the outermost edge of the end piece to the duct, changing their shape and ultimately dying off.
At the base, i.e. on the very outside, there are basal cells, from which new gland cells repeatedly arise through cell division.

The maturation of the sebocytes consists of two microscopically clearly visible changes: On the one hand, the cell stores fats, which makes it grow and become lighter. In addition, the initially quite coarse-spotted, oval cell nucleus initially becomes round and then shrinks through compression and finally disintegrates. The other cell organelles also perish. This process is typical for apoptotic (= controlled dying) cells and is called pycnosis.
When the cell reaches the apical end (Latin: apex = point), i.e. the interface with the duct, it is expelled from the cell structure and disintegrates. The duct consists of another particularly flat cell shape and, in most sebum glands, flows into the hair follicle with which it shares an outlet after a short time.

New studies have found that some cells of the Montgomery glands are able to secrete a chemical fragrance (called pheromone). The mechanism differs from the sebum secretion, however, as the corresponding cells do not perish completely, but secrete the fragrance in the form of larger bubbles.

The sebum itself is a yellowish, thin-bodied mixture and consists largely of triglycerides (approx. 43%), i.e. of glycerine-bound fatty acids, free fatty acids (approx. 15%), waxes (approx. 23%), squalene (approx. 15%) and cholesterol (approx. 4%), so all in all very fat-loving compounds. In addition, there are also proteins, as well as other cell debris and skin flakes that are carried away when they are secreted onto the skin.

Find out all about the topic here: The sebum glands.

Function of the sebum gland

The sebum glands of the skin primarily have a protective function, as they protect the skin from drying out. The Montgomery glands also play an important role in the breastfeeding process, as they help to seal the baby's mouth with the nipple airtight and thus facilitate the sucking process. In addition, the sebum provides additional protection for the sensitive nipple, which is exposed to high stress from repeated breastfeeding. Many mothers still complain of swollen nipples while breastfeeding, which can be due to the anatomical peculiarities of the very individual breast, but also to an incorrect breastfeeding technique.

Recent research also suggests that the secretion from the Montgomery glands contains pheromones, chemical fragrances, which make it easier for babies to find the nipple. This is particularly important in the initial phase of breastfeeding, as the baby first has to learn the relationship between breast and food. This is why the Montgomery glands are sometimes referred to as "the particularly differentiated scent glands of the skin".
Another experiment suggests that the fragrances encourage infants to drink more. The number of Montgomery glands present probably also plays a role here, since the infants of mothers with a higher number of these glands also gained weight more quickly.

The amount and consistency of sebum produced is largely regulated by the sex hormones, whereby testosterone tends to increase both and estrogens tend to have an inhibitory effect. In this respect, gender plays a major role.
In addition, age, disposition, nutritional status and environmental influences also play a role. In the case of fragrances, the influencing factors are still quite speculative, as this is still a comparatively young research topic. Here, too, it is assumed that the sex hormones have a great influence.

Also read the topic: Woman's hormones.

Disorders of the sebum glands on the nipple

Clogged sebum glands on the nipple

Clogged sebum glands are an issue that everyone should have dealt with at some point. Constipation can cause blackheads and pimples. Since the skin is particularly sensitive in this area and the sebum glands are correspondingly large, this can be particularly painful. Especially if the constipation keeps recurring despite treatment, this level of suffering is increased. In addition, the swollen area can also pose an aesthetic problem at this point. It is also considered whether such a clogged sebum gland can impede the flow of milk when breastfeeding.

Basically, the development process here is very similar to the development of a pimple: At the beginning there is often an increase in the horn-forming cells, which is referred to as microcomedo. This can be accompanied by a slight inflammation, especially in acne patients, even in the early stages. However, both developments are usually not yet visible to the eye at this early stage and are considered preliminary stages. If, in addition to hyperkeratosis, the increased formation of horns, there is also increased sebum production (seborrhea), a real comedo can form. This leads to a plug-like blockage of the duct due to the excessive keratinization and the sebum.
This comedo can be either open or closed. In an open comedo, the obstruction is far on the surface due to the melanin in the skin and reactions with the oxygen in the air make the plug turn black. It is easy to see from the outside and is known as a blackhead or blackhead. In the closed comedo, the constipation is a little deeper and manifests itself from the outside as a small white bump, which is why one speaks here of whiteheads. This sealed-off fatty secretion is an ideal breeding ground for certain bacteria. The subsequent inflammation of the surrounding tissue as part of the immune reaction, which fights the bacterial growth, can then be recognized from the outside as a red, swollen pimple. All of these processes can take place in a very similar way on the nipple.

Read more about the topic here: Clogged sebum- what to do?

Lump on the nipple

If you notice a lump near the areola, you should always consult a doctor for clarification, especially if this lump remains constant over a long period of time or even grows. In most cases it will be an atheroma, a so-called groats bag. Nevertheless, the possibility of a malignant tissue change must be excluded.
To do this, the doctor first tests whether the knot can be moved and how it reacts to pressure. Sometimes a reliable determination that it is actually an atheroma can only be made through a histological examination. Such an atheroma is basically harmless, but should still be removed, otherwise it can develop into an abscess.

Basically, atheroma is also a blocked sebum gland, which has not yet become inflamed. The pressure inside the gland has ensured that an encapsulated bag has formed. From the outside you can only see a small bump, which sometimes has a small black or gray point. The person concerned often reports a feeling of tension around the atheroma.
The size can vary widely: most atheromas are not noticed until they are about the size of a pea and can swell up to the size of a chicken egg. Under no circumstances should you remove such an atheroma yourself by squeezing it, as there is an increased risk of inflammation. In addition, the capsule of the atheroma should also be removed to prevent it from simply developing again.

Find out more about the topic here: Breast lump.

Abscess on the nipple

An abscess can develop from an atheroma due to inflammation, but it can also develop independently of the sebum glands anywhere in the body, especially in frequently stressed areas such as the inner thighs or buttocks. In the case of the breast, an abscess can, in a very unfavorable and rare case, also develop from a simple inflammation of the nipple caused by breastfeeding (puerperal mastitis).

As with atheroma, the corresponding area is surrounded by a capsule, which in this case is not filled with fatty secretion, but with pus. Pus or pus is a yellowish, viscous secretion that is caused by the death of immune cells. Most often this reaction is triggered by staphylococci, streptococci or E. coli.
In the case of the breast, the abscess is usually very close to the skin surface and can be recognized from the outside based on the typical signs of inflammation. A smear of the pus can provide information about the responsible pathogen. Again, it is absolutely not advisable to prick the boil yourself. The abscess is best removed cleanly and completely. In the worst case, the pathogen can get into the bloodstream and cause blood poisoning (sepsis) there, especially if the immune system is weakened anyway.

If the abscess was removed properly and on time, it will usually heal completely within a few weeks. It is important that the remaining open wound is regularly cleaned and the bandage changed.

You might also be interested in this topic: Sebum hyperplasia

How to express the sebum glands on the nipple

In principle, it is not advisable to express the blocked sebum glands yourself, as there is an increased risk of infections and scarring. However, if you really want to do it yourself, you should observe a few hygienic guidelines: First of all, you should wash the affected area thoroughly, preferably with an antibacterial washing lotion. Then it is advisable to treat the skin in a steam bath with chamomile or with clean cotton cloths soaked in warm water. This will enlarge the pores and make them easier to express later. Then the skin is gently patted dry.

Immediately before you actually get to the expression, you should thoroughly disinfect your hands to prevent inflammation. It is best to press carefully from both sides without fingernails, as this distributes the pressure relatively evenly. This process is made a little easier if you carefully prick the area beforehand with a needle sterilized over a lighter. Sucking off with a 50mm syringe and of course a sterile needle is better than squeezing it out. If clear fluid or blood escapes instead of pus, you should stop immediately. Finally, the affected area should be disinfected a second time with a skin-friendly agent.

More about this topic can be found: Remove sebum glands.