Brown Spots on Areola: Causes, Itching, and When to See a Doctor

Brown spots on the areola that occasionally itch?

I experience unbearable itching in my chest every winter.
When I lived in the northern part of Taiwan, I would apply petroleum jelly every night for moisturizing, which provided some relief, but the itching persisted, and I often scratched until it bled.
After moving to the southern part, the condition improved significantly, and the itching decreased.
However, I noticed a brown spot on my right nipple areola during high school, about the size of my index finger, which is slightly raised.
Recently, over the past two weeks, it has been intermittently itchy.
Initially, I would scratch it, leading to some peeling, and now there is a small scab.
After researching, I discovered that there are many bacteria under my nails, so I have refrained from scratching, and the itching has improved a lot.
I am curious about what this brown spot is; it does not ooze or have any white fluid, just a brown patch.
I check my chest every day while showering, and there have been no changes.
Could you please tell me what this might be? Thank you! Also, which specialist should I see for this issue?

Yú ér, 10~19 year old female. Ask Date: 2017/05/13

Dr. Wu Jianting reply Breast and Thyroid

For spots on the areola skin, it is recommended to rely on actual observation.
It is advisable to visit a dermatologist for an examination, and treatment can be provided based on the symptoms.
Thank you for your inquiry.

Reply Date: 2017/05/13

More Info

Brown spots on the areola can be concerning, especially when accompanied by itching and discomfort. Based on your description, it seems that you have experienced a persistent brown spot on your right areola, which has recently started to itch and has led to some skin irritation from scratching. Let’s explore the potential causes of these symptoms, when to seek medical attention, and what kind of doctor you should consult.

Possible Causes of Brown Spots on the Areola
1. Hyperpigmentation: This is a common cause of brown spots on the skin, including the areola. It can occur due to various factors such as hormonal changes, sun exposure, or skin irritation. In women, hormonal fluctuations during menstrual cycles, pregnancy, or menopause can lead to increased melanin production, resulting in darker spots.

2. Seborrheic Keratosis: This benign skin growth can appear as a brown or black spot and is often slightly raised. They are common in older adults and are generally harmless.

3. Moles or Nevi: Moles can develop on any part of the body, including the areola. While most moles are benign, any changes in size, color, or shape should be evaluated by a healthcare professional.

4. Dermatitis: Skin conditions such as eczema or contact dermatitis can cause itching and irritation. If you have been using products that irritate your skin or if you have a history of allergies, this could be a contributing factor.

5. Fungal Infections: Sometimes, fungal infections can cause discoloration and itching. These infections can thrive in warm, moist areas of the body.

6. Paget's Disease of the Nipple: Though rare, this condition can present with changes in the skin of the nipple and areola, including brown spots, and is often associated with underlying breast cancer.

When to See a Doctor
You should consider seeing a doctor if:
- The brown spot changes in size, shape, or color.

- You experience persistent itching that does not improve with home care.

- There is any bleeding, oozing, or crusting that develops.

- You notice any new symptoms, such as swelling or changes in the surrounding skin.

Which Doctor to Consult
For concerns regarding skin changes on the breast or areola, it is advisable to consult a dermatologist. They specialize in skin conditions and can provide a thorough examination and diagnosis. If there are concerns about breast health, a breast specialist or general practitioner can also be consulted, who may refer you to a specialist if necessary.

Management and Care
In the meantime, here are some tips to manage your symptoms:
- Moisturize: Continue using a gentle, fragrance-free moisturizer to keep the area hydrated. Vaseline can be effective, but ensure it does not irritate the skin further.

- Avoid Scratching: Try to avoid scratching the area to prevent further irritation and potential infection. Consider using cold compresses to soothe itching.

- Hygiene: Maintain good hygiene, especially if you have been scratching. Keeping the area clean can help prevent infections.

- Monitor Changes: Keep an eye on the spot and any changes in your symptoms. Documenting any changes can be helpful for your doctor.

In summary, while brown spots on the areola can arise from various benign causes, persistent symptoms warrant a medical evaluation to rule out any serious conditions. Consulting a dermatologist will provide you with the best course of action and peace of mind regarding your skin health.

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