Every one (boys, girls, men and, of course, women) has breast tissues, over which is an areola (a ring of skin, darker than the rest of the body) and a nipple.
Most people have 2 breasts with a nipple each. Some individuals, however, could have 1 or more extra nipples, in addition to the standard 2. Such individuals are said to have extra/supernumerary/accessory/vestigial/Witch’s nipples.
What are supernumerary nipples?
Extra nipples are classified under rare diseases, although its prevalence varies across different regions of the world.
In general, extra nipples are an uncommon occurrence. They seem to appear more frequently on the left side and are more common in men compared to women. Most supernumerary nipples appear along the milk line – an imaginary line starting from the armpit, cutting across the expected location of a nipple and terminating in the groin – but they can also be found in any part of the body, including the hands and back, these are called ectopic supernumerary nipples.
Most people with accessory nipples usually have just 1 extra nipple, making a ‘third nipple’, but some people may have as many as 6 or 8 extra nipples.
How can I identify an extra nipple?
As highlighted earlier, extra nipples are often located along the milk line. Many times, they are so underdeveloped and may be mistaken as moles or birthmarks. Extra nipples usually have bumps or ridges on them, unlike birthmarks and moles which are usually flat. Sometimes extra nipples may look like regular nipples, making them easy to identify.
In women, extra nipples may become tender at some points in the menstrual cycle, just like the regular 2 nipples. They may also secrete milk during lactation.
Depending on the type, extra nipples may have a surrounding areola and/or breast tissue.
Types of extra nipple
Supernumerary nipples are grouped into 6 different categories.
- Category 1 (polymastia): A third nipple and areola are present with underlying breast tissue.
- Category 2: The third nipple doesn’t have an areola, but underlying breast tissue is present.
- Category 3: Breast tissue and an areola are present, but a nipple is not.
- Category 4: Breast tissue is present, but there is no nipple or areola.
- Category 5 (pseudomamma): A nipple and areola are present with fatty tissue beneath, but not breast tissue.
- Category 6 (polythelia): A nipple is present without an areola or underlying breast tissue. This is the most common type.
How do extra nipples form?
At week 4 of embryonic development (the earliest stage of a baby’s development) in the womb, two strips of ectoderm (future skin) thicken, forming the milk or mammary line. In the following weeks and months, the strips become even thicker and become known as mammary ridges.
Eventually, the mammary ridges regress except for on the chest area, where the breasts and nipples continue to grow and develop. When the mammary ridge does not disappear completely, supernumerary nipples forms in the persistent areas.
Should I be worried about supernumerary nipples?
Supernumerary nipples are usually nothing more than a cosmetic mishap. However, in very rare cases, they may be associated with diseases, cancers or congenital anomalies of other organs , such as the kidneys and urinary tract.
Extra nipples or breasts can develop the same disease as the regular breast/nipple, including cancers. Development of lumps or changes in the skin or appearance of supernumerary nipples should not be ignored.
Extra nipples can be removed by a noninvasive outpatient surgery, for cosmetic or medical reasons.
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