A number of different conditions and medical problems can cause a puffy areola, but in most cases normal hormonal shifts are to blame. Breastfeeding moms may also notice increased puffiness and swelling when their babies are learning to latch, growing teeth, or weaning. Infected nipples or breast tissues can be a cause, as well, and in rare cases puffiness may be a symptom of breast cancer.
Puberty and Hormonal Changes
The breasts — including the nipples and areolae — are part of the female reproductive system, and as a result they are very closely impacted by hormonal shifts and changes that have to do with puberty, menstruation, and menopause. Girls often first notice swelling and tenderness as their bodies begin the transition from child to woman. This usually happens in response to estrogen and other hormones, and tends to subside once development is complete. Young women may experience puffiness on and off for months and sometimes years as the breast tissues expand, stretch, and grow.
Some women also notice swelling and minor inflammation in the days leading up to the start of their menstrual cycle. Hormone levels are often in a state of extreme flux during this time. Increased estrogen and progesterone counts can impact everything from mood swings to muscular cramps, and breast tenderness is frequently on the list as well. Most of the time any puffing will go away on its own once the woman’s period starts.
Older women who are going through menopause frequently see this symptom, too, and it is often one of the first signs that change is underway. Menopause is closely related to puberty, only instead of getting ready to reproduce the body is shutting down that capability. The outward experience is very different, but the hormones and internal chemistry behind both processes are usually quite similar.
Puffiness and swelling of the areoles is a common side effect of pregnancy, particularly in the last trimester as the breasts are preparing to produce and dispense milk. Puffiness is most common in both breasts simultaneously, but can happen one at a time. This is most common in women who have breasts of different sizes or who have had cosmetic or plastic surgery. Swelling is usually just a way for the body to prepare and test out the milk ducts. Some fluid seepage may occur during this process, and in some cases the puffing only increases once the baby is born and feeding begins. It will usually go away once the woman’s body adjusts to the baby’s needs, though this can sometimes take a few weeks.
Breastfeeding Irritations and Infections
Though breastfeeding is a natural process, it doesn’t always come easily to every new mom. Babies who have difficulty latching, swallowing, or sucking can irritate the areole as they try to eat, and engorgement of the breasts — an often painful condition that happens when a mother makes more milk than her baby is willing or able to eat — only makes things worse.
Infections are another common cause. Thrush, mastitis, and blocked ducts are just a few examples of breastfeeding problems that can lead to puffiness and swelling on or around the nipples, as well as fever, intense pain, and heightened sensitivity. These are generally considered somewhat serious and often require medical intervention to solve. Babies who bite their mothers may also cause puffiness, particularly if they puncture the nipple tissue.
Cysts and Growths
A cyst or other abnormal growth beneath the skin’s surface might also be to blame. This is very often the case when a woman has just one puffy areola. Small growths are often all but undetectable without a thorough exam, and a mammogram or other medical imaging scan may be required. Most abnormal growths are benign, which means that they aren’t harmful in and of themselves. Surgery or certain anti-inflammatory medications can often return a person to normal with little interruption to daily life.
Cancer is a rare, but serious, potential cause of a of puffy areola. Breast cancer happens when the tissues of the nipple, mammary glands, or lymph nodes regenerate endlessly, which causes devastating tumors to grow and spread throughout the body. Most women with breast cancer have many more symptoms than simple puffiness, though it is often one of the early warning signs that something just isn’t right.
When to Get Help
Puffiness or minor swelling isn’t usually anything to worry about, and most medical experts recommend a “wait and see” approach where patients are told to monitor their symptoms, making note of changes or pain. Puffiness that does not seem to go away on its own after a few days, that is painful, or that is accompanied by fever, rash, or liquid seepage should usually get medical attention to rule out any more serious conditions. Anyone who suspects an infection should also seek prompt care to keep things from spreading.