Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Asubareolarnippleabscessis a pus-filled sore found on the breast below the nipple or areola. Theareolais the ring of darker (pigmented) skin that circles the nipple.
An abscess forms when bacteria enter the skin, and the immune system sends white blood cells to fight the infection. The area becomes inflamed and swells, forming a pocket ofpus—a thick, whitish-yellow fluid made up of degenerating white blood cells, dead/living bacteria, and tissue debris.
A subareolar nipple abscess maycause pain, a small tender lump, and drainage of pus. While more common among younger or middle-aged women who are not breastfeeding, they can also form in men.
This article discusses the symptoms, causes, diagnosis, and treatment of subareolar nipple abscesses.
A subareolar nipple abscess can also be referred to as an areolar gland abscess, Zuska’s disease, or lactiferous fistula.
The Parts of the Outer Breast
Verywell / Emily Roberts
Subareolar Nipple Abscess Symptoms
The most common symptoms of a subareolar nipple abscess include:
Is a Breast Abscess Serious?A breast abscess can be serious and typically requires antibiotics. In more severe cases, needle aspiration, surgical drainage, a drainage tube, or surgical removal may be required.
Is a Breast Abscess Serious?
A breast abscess can be serious and typically requires antibiotics. In more severe cases, needle aspiration, surgical drainage, a drainage tube, or surgical removal may be required.
What Causes a Subareola Nipple Abscess?
An abscess occurs when bacteria that normally live on the skin enter the body through a hole in the skin. Theareolarglands of the breasts are modified sweat glands that open on the skin’s surface. Bacteria can enter through the glands and multiply underneath the skin, blocking the areolar gland.
As the bacteria multiply, the immune system is activated to fight the local infection.White blood cellsmove into the blocked-up areas. Then, pus forms when white blood cells, dead tissue, and bacteria build up in the abscess pocket.
Possible risk factors for subareolar abscess include:
How an Areola Abscess is Diagnosed
Breast ultrasound andfine-needle aspiration (FNA)are often used to diagnose subareolar abscesses.The material drained from the abscess is sent to the lab to identify the infectious bacteria to guide antibiotic medication choices.
Other tests used in diagnosing a subareolar nipple abscess may include:
Your healthcare provider may recommend further testing depending on what they see on your exam.
Differential Diagnoses
Treating a Subareolar Nipple Abscess
An abscess on the nipple or areola is commonly treated with a combination of antibiotics and draining the infection. In some cases, surgery may be required.
Antibiotics
Subareolar abscesses usually require antibiotic treatment for four to seven days.If breastfeeding or chestfeeding, ensure your healthcare provider is aware so they can choose an appropriate antibiotic.
Drainage
For small abscesses, the treatment of choice is aspiration (drawing out the fluid and pus with a syringe). Aspiration can be done with or without ultrasound guidance.
Somewhat larger abscesses—over 3 centimeters (cm) or roughly 1 inch and a half in diameter—may require the placement of apercutaneous catheter.This is a small tube that is inserted through the skin and into the abscess to allow for the continued drainage of any pus that develops.
After your abscess is drained, it is important to finish taking your antibiotics even if your symptoms have resolved. If all the bacteria in the abscess are not killed, your symptoms are more likely to recur.
Surgery
Some abscesses are more difficult to treat, and asurgical incision and drainage (I&D)may need to be done.
This might be the case if the abscess is larger than 5 centimeters, multiloculated (has several compartments separated from each other, making them difficult to drain), or has been present for a long time.
For persistent severe abscesses, it is sometimes necessary to surgically remove the abscess and the glands in which they occur. However, the abscess may persist or recur in some cases, necessitating further treatment.
Treatment in Men
Aggressive treatment with complete excision of the duct is recommended. If not completely removed, these abscesses commonly recur.
Home Remedies
While a subareola nipple abscess requires medical treatment, there are some things you can do at home to ease the discomfort and help it heal.
Keep the area clean and wash your hands before and after touching the area. Avoid pushing, popping, or squeezing the abscess. Doing so can cause the infection to spread.
Apply a warm compress or moist heating pad to the area for 10 to 15 minutes several times a day. This will help the abscess to drain more easily when you go to the doctor.
Over-the-counter (OTC) pain relievers, like Tylenol (acetaminophen) or Advil (ibuprofen) can help to ease the pain.
Can You Breastfeed with a Nipple Abscess?Yes, you can continue to breastfeed with a nipple abscess but, it may be very painful. If you are unable to nurse from the infected side, manually express or pump milk to prevent breast engorgement.
Can You Breastfeed with a Nipple Abscess?
Yes, you can continue to breastfeed with a nipple abscess but, it may be very painful. If you are unable to nurse from the infected side, manually express or pump milk to prevent breast engorgement.
Summary
A Word From Verywell
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kasales CJ, Han B, Smith JS Jr, Chetlen AL, Kaneda HJ, Shereef S.Nonpuerperal mastitis and subareolar abscess of the breast.AJR Am J Roentgenol. 2014;202(2):W133-139. doi:10.2214/AJR.13.10551Zhang Y, Zhou Y, Mao F, Guan J, Sun Q.Clinical characteristics, classification and surgical treatment of periductal mastitis.J Thorac Dis. 2018;10(4):2420-2427. doi:10.21037/jtd.2018.04.22Giess CS, Golshan M, Flaherty K, Birdwell RL.Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center.J Clin Ultrasound. 2014;42(9):513-521. doi:10.1002/jcu.22191Fahrni M, Schwarz EI, Stadlmann S, Singer G, Hauser N, Kubik-Huch RA.Breast abscesses: diagnosis, treatment and outcome.Breast Care. 2012;7(1):32-38. doi:10.1159/000336547Kazama T, Tabei I, Sekine C, et al.Subareolar breast abscess in male patients: a report of two patients with a literature review.Surgical Case Reports. 2017;3(1):128. doi:10.1186/s40792-017-0402-3Lam E, Chan T, Wiseman S.Breast abscess: evidence-based management recommendations.Expert Review in Anti Infective Therapy. 2014;12(7):753-762. doi:10.1586/14787210.2014.913982Mount Sinai.Subareolar abscess.Additional ReadingIrusen H, Rohwer A, Steyn D, and Young T.Treatments for breast abscesses in breastfeeding women.Cochrane Database of Systematic Reviews. 2015;(8):CD010490. doi:10.1002/14651858.CD010490.pub2Johnson SP, Kaoutzanis C, Schaub GA.Male Zuska’s disease.BMJ Case Reports.2014;2014:pii: bcr2013201922. doi:10.1136/bcr-2013-201922MedlinePlus.Subareolar abscess.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kasales CJ, Han B, Smith JS Jr, Chetlen AL, Kaneda HJ, Shereef S.Nonpuerperal mastitis and subareolar abscess of the breast.AJR Am J Roentgenol. 2014;202(2):W133-139. doi:10.2214/AJR.13.10551Zhang Y, Zhou Y, Mao F, Guan J, Sun Q.Clinical characteristics, classification and surgical treatment of periductal mastitis.J Thorac Dis. 2018;10(4):2420-2427. doi:10.21037/jtd.2018.04.22Giess CS, Golshan M, Flaherty K, Birdwell RL.Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center.J Clin Ultrasound. 2014;42(9):513-521. doi:10.1002/jcu.22191Fahrni M, Schwarz EI, Stadlmann S, Singer G, Hauser N, Kubik-Huch RA.Breast abscesses: diagnosis, treatment and outcome.Breast Care. 2012;7(1):32-38. doi:10.1159/000336547Kazama T, Tabei I, Sekine C, et al.Subareolar breast abscess in male patients: a report of two patients with a literature review.Surgical Case Reports. 2017;3(1):128. doi:10.1186/s40792-017-0402-3Lam E, Chan T, Wiseman S.Breast abscess: evidence-based management recommendations.Expert Review in Anti Infective Therapy. 2014;12(7):753-762. doi:10.1586/14787210.2014.913982Mount Sinai.Subareolar abscess.Additional ReadingIrusen H, Rohwer A, Steyn D, and Young T.Treatments for breast abscesses in breastfeeding women.Cochrane Database of Systematic Reviews. 2015;(8):CD010490. doi:10.1002/14651858.CD010490.pub2Johnson SP, Kaoutzanis C, Schaub GA.Male Zuska’s disease.BMJ Case Reports.2014;2014:pii: bcr2013201922. doi:10.1136/bcr-2013-201922MedlinePlus.Subareolar abscess.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kasales CJ, Han B, Smith JS Jr, Chetlen AL, Kaneda HJ, Shereef S.Nonpuerperal mastitis and subareolar abscess of the breast.AJR Am J Roentgenol. 2014;202(2):W133-139. doi:10.2214/AJR.13.10551Zhang Y, Zhou Y, Mao F, Guan J, Sun Q.Clinical characteristics, classification and surgical treatment of periductal mastitis.J Thorac Dis. 2018;10(4):2420-2427. doi:10.21037/jtd.2018.04.22Giess CS, Golshan M, Flaherty K, Birdwell RL.Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center.J Clin Ultrasound. 2014;42(9):513-521. doi:10.1002/jcu.22191Fahrni M, Schwarz EI, Stadlmann S, Singer G, Hauser N, Kubik-Huch RA.Breast abscesses: diagnosis, treatment and outcome.Breast Care. 2012;7(1):32-38. doi:10.1159/000336547Kazama T, Tabei I, Sekine C, et al.Subareolar breast abscess in male patients: a report of two patients with a literature review.Surgical Case Reports. 2017;3(1):128. doi:10.1186/s40792-017-0402-3Lam E, Chan T, Wiseman S.Breast abscess: evidence-based management recommendations.Expert Review in Anti Infective Therapy. 2014;12(7):753-762. doi:10.1586/14787210.2014.913982Mount Sinai.Subareolar abscess.
Kasales CJ, Han B, Smith JS Jr, Chetlen AL, Kaneda HJ, Shereef S.Nonpuerperal mastitis and subareolar abscess of the breast.AJR Am J Roentgenol. 2014;202(2):W133-139. doi:10.2214/AJR.13.10551
Zhang Y, Zhou Y, Mao F, Guan J, Sun Q.Clinical characteristics, classification and surgical treatment of periductal mastitis.J Thorac Dis. 2018;10(4):2420-2427. doi:10.21037/jtd.2018.04.22
Giess CS, Golshan M, Flaherty K, Birdwell RL.Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center.J Clin Ultrasound. 2014;42(9):513-521. doi:10.1002/jcu.22191
Fahrni M, Schwarz EI, Stadlmann S, Singer G, Hauser N, Kubik-Huch RA.Breast abscesses: diagnosis, treatment and outcome.Breast Care. 2012;7(1):32-38. doi:10.1159/000336547
Kazama T, Tabei I, Sekine C, et al.Subareolar breast abscess in male patients: a report of two patients with a literature review.Surgical Case Reports. 2017;3(1):128. doi:10.1186/s40792-017-0402-3
Lam E, Chan T, Wiseman S.Breast abscess: evidence-based management recommendations.Expert Review in Anti Infective Therapy. 2014;12(7):753-762. doi:10.1586/14787210.2014.913982
Mount Sinai.Subareolar abscess.
Irusen H, Rohwer A, Steyn D, and Young T.Treatments for breast abscesses in breastfeeding women.Cochrane Database of Systematic Reviews. 2015;(8):CD010490. doi:10.1002/14651858.CD010490.pub2Johnson SP, Kaoutzanis C, Schaub GA.Male Zuska’s disease.BMJ Case Reports.2014;2014:pii: bcr2013201922. doi:10.1136/bcr-2013-201922MedlinePlus.Subareolar abscess.
Irusen H, Rohwer A, Steyn D, and Young T.Treatments for breast abscesses in breastfeeding women.Cochrane Database of Systematic Reviews. 2015;(8):CD010490. doi:10.1002/14651858.CD010490.pub2
Johnson SP, Kaoutzanis C, Schaub GA.Male Zuska’s disease.BMJ Case Reports.2014;2014:pii: bcr2013201922. doi:10.1136/bcr-2013-201922
MedlinePlus.Subareolar abscess.
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