Areola

The areola is the pigmented circular area of skin surrounding the nipple on the breast. It is part of the nipple-areolar complex, which also includes the nipple itself and the openings of the lactiferous ducts at its center.

Anatomy and histology: The areola’s coloration varies with pigmentation of the epidermis and can range from pink to brown. The skin may contain sebaceous (Montgomery) glands, which secrete oily secretions that help lubricate and protect the area, especially during lactation. The surface may have small hair follicles in some individuals. Beneath the surface, smooth muscle fibers can cause the nipple-areolar region to become erect in response to temperature, touch, or arousal.

Development and variation: Areola size, shape, and color differ widely among individuals and can change with hormones. Puberty, pregnancy, lactation, and aging commonly alter pigmentation and size. In many people, the areola darkens during puberty and again during pregnancy; lactation can enlarge the area and intensify pigmentation. In infants the areola can appear lighter or bluish at birth.

Function: The areola helps protect and lubricate the nipple area during breastfeeding. Montgomery glands secrete lubricants and antimicrobial substances that may aid infant latch and skin protection. The coloration and texture can also serve as tactile cues during nursing.

Clinical notes: Changes in the areola are usually benign, but new or changing pigmentation, asymmetry, a lump, or crusting should be evaluated by a clinician to rule out dermatologic or breast conditions, including cancer or melanoma. Surgical procedures may aim to preserve, reconstruct, or reduce the size of the areola as part of breast surgery.