White Bumps on Nipples: Causes and Concerns - Obstetrics and Gynecology

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When it comes to white bumps on the nipples, there are several potential causes that can lead to discomfort and the appearance of these lesions. Based on your description of a painful white bump on the nipple that resembles a pimple and has blood when squeezed, it is important to consider a few common conditions that could be responsible for your symptoms.

1. Montgomery Glands: The nipples have small glands known as Montgomery glands, which can sometimes become enlarged or clogged. These glands are normal anatomical structures that help lubricate the nipple during breastfeeding. If they become blocked or inflamed, they can appear as white bumps and may cause discomfort. This is usually not a cause for concern and can resolve on its own.

2. Folliculitis: This condition occurs when hair follicles become inflamed, often due to infection or irritation. If there is hair growth around the nipple area, it is possible for folliculitis to develop, leading to the formation of painful, pus-filled bumps. Squeezing these bumps can sometimes lead to bleeding, especially if the skin is irritated.

3. Sebaceous Cysts: These are non-cancerous lumps that can form when sebaceous glands become blocked. They can appear as white or yellowish bumps and may be tender to the touch. While they are generally harmless, they can become infected, leading to pain and discharge.

4. Infection: An infection in the nipple area, such as a bacterial infection or a condition like mastitis (which is more common in breastfeeding women), can cause pain and the formation of bumps. If the area is red, swollen, or warm to the touch, this could indicate an infection that may require medical treatment.

5. Dermatitis: Skin conditions such as eczema or contact dermatitis can also affect the nipple area, leading to irritation, redness, and the formation of bumps. If you have recently changed soaps, lotions, or laundry detergents, this could be a contributing factor.

6. Paget's Disease of the Nipple: Although less common, Paget's disease is a type of breast cancer that can manifest as changes in the skin of the nipple, including redness, scaling, and the formation of bumps. If the white bump persists or is accompanied by other symptoms such as discharge, changes in the appearance of the nipple, or a lump in the breast, it is crucial to seek medical evaluation.

Given your symptoms, it is advisable to avoid squeezing the bump further, as this can exacerbate irritation or lead to infection. Instead, consider the following steps for self-care:
- Keep the Area Clean: Gently wash the area with mild soap and water to prevent infection.

- Avoid Irritants: Refrain from using harsh soaps, lotions, or other products that may irritate the skin.

- Warm Compresses: Applying a warm compress can help soothe discomfort and may promote drainage if there is an underlying infection.

- Monitor Symptoms: Keep an eye on the bump and any associated symptoms. If it does not improve within a few days, worsens, or if you develop additional symptoms such as fever, increased pain, or discharge, it is important to consult a healthcare provider.

In summary, while many causes of white bumps on the nipples are benign, it is essential to monitor your symptoms closely. If you have any concerns or if the bump persists, seeking medical advice is the best course of action to ensure proper diagnosis and treatment.