Is a Large Areola Normal or Not? (2024)

The size of an areola—the dark-colored skin on the breast that surrounds the nipple—can vary from one person to the next. Some people are simply born with big areolas, while others have smaller ones. Females tend to have larger areolas than males, averaging 2 inches in diameter versus 1 inch in diameter respectively.

Areolas can also change in size as you age, gain or lose weight, or experience hormonal changes during puberty, pregnancy, or menopause. While most of these changes are perfectly normal, some may be abnormal and warrant an investigation by a healthcare provider.

This article explains what areolas are, including why they can suddenly change in size, color, and texture. It also describes treatments that can change the size and appearance of areolas for cosmetic purposes or gender affirmation.

Average Size of Areolas

The average size of an areola varies substantially across individuals and life spans. The size tends to increase in relation to a person's breast size.

The average size of female and male areolas are quoted in medical literature as follows:

• Average female areola size: 67.1 millimeters, or just over 2.5 inches in diameter
• Average male areola size: 26.6 millimeters, or roughly 1 inch in diameter

In females, the size of the areola increases substantially during puberty. It may then increase again should a woman get pregnant and lactate (produce milk).

Males generally have smaller areolas than females. Even so, there is a substantial variation from one male to the next.

While the function of the areolas remains the same irrespective of size, larger areolas may be somewhat less sensitive to touch.

Other Areola Variations

In addition to size, areolas can vary in their shape, color, texture, and firmness:

• Shape: Areolas may be round or oval.
• Color: They can range from dark pink to dark brown, typically in relation to your skin tone.
• Texture: Areolas are peppered with small, pimple-like bumps called Montgomery's tubercles. These glands secrete an oil that lubricates and protects the nipples. They also secrete a small amount of milk during lactation.
  
• Firmness: Underlying the skin of the areolas is a network of nerves and smooth (involuntary) muscles that respond to touch, temperature, and sexual stimulation. These can cause the areolas and nipples to suddenly become erect. During breastfeeding, the stiffening of these structures helps a baby latch onto the nipple and aids with the flow of breast milk.
  

Why Areola Size Can Change

Areola size can change as a process of aging, in response to hormonal changes or fluctuations, and for other causes.

Aging

The areola changes significantly in size over a lifespan. The first noticeable change takes place around the time of puberty in both females and males.

As the breasts begin to grow, the areolas also get larger and eventually form a raised area with more prominent Montgomery's tubercles. Even so, the areolas may not always appear bigger in relation to the larger size of the breasts.

Weight Gain

Areolas can get bigger if you gain a significant amount of weight due to the stretching of the skin. The color may also lighten. If you then lose weight, the size may not change all that much (or at all), but the color may darken somewhat.

Hormonal Changes

Changes in the size of the areolas during adulthood are mainly due to the female sex hormones estrogen and progesterone which are also found in males.

Each hormone plays a specific role:

• Estrogen controls the growth of the ducts, which is why the areolas and nipples tend to get firmer and the ducts more prominent during the middle stages of the menstrual cycle (when estrogen levels are at their highest).
• Progesterone controls the growth of the areola, which is why they grow larger during pregnancy in tandem with steep, progressive increases in progesterone levels.

During pregnancy and lactation, the areola will also become darker as the breast increases in size. After lactation is completed, the breast size will decrease as the size and color of the areola will tend to remain the same.

During menopause, decreased hormone levels may not necessarily make the areolas and nipples smaller, but they make them less firm, prominent, and sensitive.

In males, areola sizes can change due to drops in the male hormone testosterone. Having low testosterone (hypogonadism) alters the normal balance of male and female sex hormones. The proportionate increase of estrogen and progesterone can lead to the abnormal enlargement of the breasts, called gynecomastia. The areola size may also change.

Hypogonadism may be a relatively normal part of aging in older males but may also occur due to genetics, liver cirrhosis, chronic kidney disease, and hyperthyroidism(overactive thyroid).

Changing Your Areola Size

Surgery can be used to adjust the size of the nipples and areolas. This surgery is most often done in the context of breast reduction, but it can also be performed for:

• Cosmetic purposes: This includes areola reduction (used when someone thinks that their areolas are too big) or the surgical correction of inverted (retracted) nipples.
• Gender confirmation: Transgender people may undergo top surgery, which includes reshaping the breasts and changing the size of the areola to align their physical characteristics with their gender identity.
• Post-mastectomy reconstruction: Individuals who have undergone breast reconstruction following mastectomy may also need nipple and areolar reconstruction. If the nipple and areola were removed, nipple tattooing can be performed to create a facsimile of the areola.

Surgery used to alter the size and shape of the areola can permanently reduce nipple sensitivity and may affect sexual sensation and pleasure. It may also impact a person’s ability to breastfeed.

When to See a Healthcare Provider

You should see a healthcare provider if the areola suddenly changes in size, color, texture, or shape or if there is unexplained pain, bleeding, or discharge. Possible causes include nipple eczema, Paget's disease of the nipple, and areola infection.

Nipple Eczema

Eczema, also known as atopic dermatitis, is a skin condition that can affect any part of the body. It commonly occurs during breastfeeding, causing thick, scaly skin with raised bumps on the nipples and areolas. Nipple eczema usually affects both breasts at the same time.

Paget’s Disease of the Nipple

Paget’s disease of the nipple is a rare type of breast cancer. It may first appear as a single bump or lesion that grows and spreads over time. This lesion may cause itching or ulcers.

Lumps and bumps that appear only on one areola and increase over time should be evaluated by a healthcare provider. Paget’s disease of the nipple may need to be treated with a lumpectomy (surgical removal of the tumor).

Subareolar/Periareolar Infection

Abscesses and infection can occur both beneath the areola (subareolar) and around it (periareolar). These are more common in people who are pregnant or lactating. Those that occur outside of pregnancy tend to take place closer to menopause.

These infections can sometimes cause a painful, swollen area or a hardened lump beneath the areola. An abscess may need to be drained and treated with antibiotics.

Summary

Areolas are the dark circles of skin around the nipples. They vary in size and color and can change over time due to aging, hormonal changes, and weight gain. Females generally have larger areolas than males.

People may choose to alter the size or appearance of their areolas with surgery. It may be for cosmetic reasons, gender affirmation, breast reduction, or post-mastectomy reconstruction.