Visible white spots on the nipple and areola, also known as Montgomery tubercles, are an early sign of pregnancy. Still, the white spots can also indicate other conditions that may require medical attention.
Until there is 100% confirmation that you are indeed pregnant, all the “you must be pregnant” signs voiced by close friends or a loved one just add to the frustration of not knowing for sure if you’re pregnant or not.
Pregnancy indeed triggers hormone changes that can sometimes be pretty extreme with a tendency to affect your usual calm and friendly self.
Emotional swings are par for the course with hormone shifts, and they usually begin before the dreaded morning sickness comes knocking, if it knocks at all.
Somewhere in between, you may feel or notice physical changes, especially with your breasts.
Small white spots that look like pimples may begin appearing on your nipples and areola, and your breasts may feel a little more sensitive than usual. Chances are, you could be pregnant, but there could be other reasons for these strange white spots.
Let’s go through the different reasons for these white spots so you’ll have a good idea of how to deal with them.
The purpose of Montgomery tubercles
Montgomery tubercles, or glands as they are commonly known, appear as raised white bumps on your nipple and areola, the dark area surrounding your nipple.
When white spots appear on your nipples, the initial assumption is that you must be pregnant because these glands serve a specific function for both mother and breastfeeding baby.
We have sebaceous glands all over our bodies that lubricate and protect our skin.
These moisture-generating glands also lubricate your hair, keeping it soft and subtle but greasy if you neglect routinely washing your hair, especially during puberty when there is increased hormone activity.
The same glands are only known as Montgomery glands when they are on your nipples and areola, and the lubrication function provides a protective oily barrier to guard against infection.
The number of Montgomery glands will differ among women, much like the size and shape of nipples and areola do.
You may only notice a few, but the count can go up as far as 30 visible glands. The number of visible white spots is related to hormone changes in your body.
Montgomery glands serve to moisturize your nipples and areola, offering natural protection against damage and soreness during breastfeeding.
Oils released by the glands have natural antibacterial properties that protect against possible infection.
It also helps guide your baby to your nipple through the scent it creates in conjunction with the early production of colostrum mixed with the scent of your breast milk.
Visible white spots and pregnancy
Not every woman will experience white spots as an early sign of pregnancy, but between 30% and 50% will notice the sudden appearance of these white spots even before a missed first period.
This is not to say that pregnancy can be confirmed, but it is definitely a sign of increased hormone activity.
You will have to look out for more common signs of pregnancy like:
- A change in the sensitivity and physical appearance of your breasts. Your breasts will feel more tender, heavier, or may appear to be bigger than normal.
- You may experience mild cramps and light spotting before your period is due.
- You may experience bouts of morning sickness.
- Loss of energy, tiredness, and feeling fatigued toward the end of a normal day.
- Overpowering mood swings.
- Frequent need to urinate.
If the white spots you noticed are indeed an early sign of pregnancy, you can relax as this is part of your body’s normal process as it prepares for pregnancy and breastfeeding.
Hormonal changes will naturally result in your Montgomery glands becoming enlarged to ensure adequate moisturization and protection.
In most cases, visible Montgomery glands indicate a possible pregnancy which must still be confirmed with a pregnancy test; however, there are times when pregnancy is not the cause.
Visible white spots not related to pregnancy
Women do not have to be pregnant for changes in their Montgomery glands to occur.
Lifestyle choices and hormonal changes not brought on by pregnancy can also trigger increased Montgomery gland activity.
Below are a few examples that may cause white spots on your nipples and areola:
- White spots are fairly common when hormones become more active or change due to your menstrual cycle or as a response to your contraceptive pill. White spots also occur before or during menopause.
- Stress is another common cause as it affects the normal function of your hormones, creating a hormone imbalance.
- Hormones can be affected by some types of medication.
- A sudden change in your weight, either weight loss or weight gain.
- Nipple stimulation is often caused by chaffing or not wearing the appropriate bra size and wearing clothing that places undue pressure on your breasts.
- Glands can become blocked, inflamed, or infected, giving rise to a yeast infection that will present as an itchy rash.
As a word of encouragement, white spots appearing on your nipples and areola are pretty normal, but they should not be treated as your usual pimple is treated by popping them. This may lead to an infection setting in.
If you are concerned about the sudden appearance of white spots, a visit to your doctor will help to alleviate your worries.
Infections from white spots on your nipples and areola
White spots on your nipples and areola may also be caused by infection, and women with compromised immune systems are at a higher risk of infection.
A typical infection can be caused by fungus, viruses, or bacteria, which present as thrush, herpes, or subareolar abscesses.
Thrush is a yeast infection that mainly occurs in the vagina.
Newborn babies can also develop thrush in their mouth and infect their mother’s nipples when breastfeeding.
Thrush usually appears as a white rash that becomes an inflamed, red area of the tender skin around the nipple which can be treated with an antifungal medication.
Herpes is an STD and can be spread to the breasts through a breastfeeding infant who contracts it from the mother at birth.
Herpes presents as fluid-filled blisters that cause a scab when popped.
Both mother and child should urgently be treated for herpes with an antiviral medication to prevent more serious health issues.
Caused by a bacterial infection, subareolar abscesses are not very common but result from a build-up of pus in the breast tissue due to poorly treated mastitis.
Subareolar abscesses are not necessarily breastfeeding-related but can also be caused by nipple piercings or from a wound caused by acne.
There will be swelling and a tender red area around the infection which can be treated with a course of antibiotics or an operation to drain the infection.
There are two rare conditions that also present as white spots on the nipples and areola.
They are Vitiligo, an autoimmune disorder that destroys pigmented cells in the body, and Paget’s disease, a rare form of breast cancer with eczema-like symptoms that begin in the nipples and areola.
These conditions might be rare or may only become noticeable much later in pregnancy, but white spots on your nipples and areola should be monitored when first noticed.
If you experience pain, discomfort, or notice a rash developing, it’s advisable to discuss it with your doctor.
You need to have peace of mind about the changes your body is presenting.
What is the most common cause of white spots?
The most common cause of white spots on your nipples and areola can be attributed to hormonal changes in your body.
Pregnancy will initiate hormone changes that prepare your breasts for breastfeeding, and white spots are a visible sign of this.
When should I see my doctor about white spots on my nipples and areola?
If you notice a few white spots but no pain or signs of an infection, you could be pregnant, and a home pregnancy test may confirm this for you.
If you are pregnant, you can discuss the white spots with your doctor on one of your regular check-ups but if you suspect an infection, then see your as soon as possible to start treatment early.
Should I be concerned with changes in my breasts?
Yes, especially if there is no reason for sudden changes in your breasts, as in the case of pregnancy.
Breast cancer is a real threat and must be detected as early as possible, and any unusual change you may notice should be brought to your doctor’s attention as a matter of urgency.
White spots on the nipples and areola are usually an early sign of pregnancy, which should motivate you to do a pregnancy test if you are still within the childbearing age.
White spots are also fairly common during menopause and are triggered by stress and lifestyle choices.
Montgomery glands in your nipples and areola serve a specific function: lubricate and protect your nipples during pregnancy and breastfeeding.
You should never-the-less monitor your breast regularly. If you notice any changes that may be accompanied by pain or a rash, you should arrange an appointment to see your doctor to seek clarity and treatment if necessary.