Areola !
The areola is the ring of darker skin around the nipple; its small glands keep the nipple lubricated during breastfeeding.
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What it is
The pigmented ring of skin around the nipple, with small bumps: the areolar glands (Montgomery tubercles).
What it does
Its glands lubricate and protect the nipple during breastfeeding; it darkens in pregnancy.
Key facts
- Where
- Pigmented circular skin around the nipple
- Function
- Areolar (Montgomery) glands lubricate during lactation; subareolar lymphatic plexus drains toward the axilla
Relations
- Deep
- Lactiferous sinuses and smooth muscle fibres, with no layer of fat under the skin
- Contents
- Areolar (Montgomery) glands, sebaceous and sweat glands, smooth muscle and the subareolar lymphatic plexus
How to find it
The pigmented circle around the nipple, with small raised areolar glands near its edge. Many duct lesions lie just behind it, so a breast examination includes palpating under the areola, and its border guides periareolar incisions and tracer injection.
Examination
- Inspection of nipple and areola together: a red, scaly change that starts on the nipple and does not heal raises the question of Paget disease, while a change starting on the areola and sparing the nipple suggests eczema
On imaging
On mammography (craniocaudal and mediolateral oblique views) the nipple should be in profile; areolar skin is normally a little thicker than the rest. New retraction, thickening or a mass behind it needs workup. Ultrasound, angled under the nipple, shows the subareolar ducts in duct ectasia, abscess or fistula. MRI looks for an underlying cancer in Paget disease.
Common problems
- A blocked or infected areolar gland.
- A new change in colour or a rash that does not heal needs a check (Paget disease).
How it is diagnosed
Examination; a biopsy if a rash or change persists.
Treatment
- Surgeons often hide incisions at its edge (periareolar incision) for biopsies, breast lifts and reductions.
Clinical notes
- Periductal mastitis and subareolar abscess occur outside lactation, mostly in smokers; they recur and can open onto the skin at the areolar edge as a mammary duct fistula
- Its smooth muscle contracts with cold, touch and breastfeeding, wrinkling the skin and helping empty the sinuses
- Changes in sensation of the nipple and areola are a recognized risk of periareolar incisions and of breast surgery in general
Anatomical variants
- Size and colour vary widely between people, from about 2.5 to 10 cm across; the pigment deepens in pregnancy and often stays darker afterwards
Related conditions
Test yourself
Think of the answer, then tap the question to see it.
Why is tracer for sentinel node biopsy often injected around the areola?
The subareolar lymphatic plexus drains to the same axillary sentinel nodes as the rest of the breast.
How do the areola and its tubercles change in pregnancy?
The areolar (Montgomery) tubercles enlarge and the areola darkens, among the early visible signs of pregnancy.
Who typically gets periductal mastitis with subareolar abscess, and what can it lead to?
Mostly smokers, outside lactation; it recurs and can open at the areolar edge as a mammary duct fistula.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- areola mammae; glandulae areolares; tubercula areolae TA2 7106
- Official Spanish (DeCS)
- Areola mamaria
- English (TA2)
- Areola
Sources: Terminologia Anatomica (TA2); Anatomy, Thorax, Breast; Anatomy, Thorax: Mammary Gland; 27.2 Anatomy and Physiology of the Ovarian Reproductive System (OpenStax (Rice University), 2022) · adapted, CC BY 4.0.
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Representative model, for educational purposes only.