Everything about the body changes with age. Gravity and hormones can cause the entire breast to stretch and reshape. Nipples and areolas — the darker skin around the nipple — are no exception. But as long as changes occur on both breasts, don’t fret too much about the variation in your breasts, says Dr. Marisa Weiss, a breast oncologist.

“All kinds of little things happen that you might notice,” says Dr. Weiss, the founder, director, and chief medical officer of BreastCancer.org. “If they’re happening on both breasts in a similar way, most likely it’s a benign, age-related thing.”

While things like pigment changes and small bumps around the nipple are perfectly normal, Weiss says, there are developments that can be worrisome.

Breast cancer signs aren’t always lumps
If you have a new type of discharge from the nipple — especially if it’s bloody — that’s something that needs to be evaluated, says Dr. Weiss. It could be no big deal, but it could also be a sign of cancer, she says. And if a nipple turns inward, enlarges, and hardens, get it checked. This could be an early warning sign.

A rash, scab, or rough patch that appears on the nipple and areola is another development worth a trip to the doctor. This could be a sign of Paget’s disease, a rare, early form of breast cancer that sometimes gets misdiagnosed as eczema.

And if one of your breasts suddenly becomes bigger, warmer, and redder — and you’ve ruled out a bacterial infection — seek out a surgeon or physician who specializes in breast diseases. This rare form of inflammatory cancer, which can make your breast look like the skin of a navel orange, can present without a mass, says Dr. Weiss.

Changes that are totally normal
Breasts continue to develop until you’re about 25, says Dr. Weiss. And when you get older, your whole body can get wider. So if breasts get bigger and the skin around the nipple gets darker (whether from pregnancy or not) the areolas can look like they’re expanding.
And since the breasts tend to droop with time, this can change the position of the nipple and areola.

Dr. Weiss encourages people to trust their instincts about their bodies, and make an appointment with your doctor, gynecologist, or a physician who specializes in breast diseases if you have a genetic predisposition to breast cancer and notice a change in only one breast, or experience discharge, rashes, or lumps that are new, don’t respond to treatment, and persist for more than a few weeks.

And make sure your nipple concerns aren’t just the result of foreplay. “You want to make sure it’s not a bite mark,” says Dr. Weiss. “Think about it a little bit before you get worried about it.”

Keri Wiginton is a writer and photographer focusing on issues related to women's health, mental well-being, and feminism. Her work has appeared in the Chicago Tribune, Washington Post, Austin-American Statesman, Tampa Bay Times and Houston Chronicle. Follow her work at www.keriwiginton.com or on Twitter at @keriphoto.