Hyperkeratosis of the Nipple and Areola Treatment & Management

Updated: Mar 17, 2022
  • Author: Rabindranath Nambi, MD; Chief Editor: Dirk M Elston, MD  more...
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Approach Considerations

Surgery should be considered in cases in which the response to medical therapy is inadequate, for cosmetic reasons, and if there is an indication for concomitant surgery of the breast. [43]

Reported treatments of nevoid hyperkeratosis of the nipple and/or areola include the following:

Therapeutic options for secondary hyperkeratosis of the nipple and/or areola consist of the treatment options for the underlying dermatologic condition. [59]


Long-Term Monitoring

The follow-up care for patients with primary hyperkeratosis of the nipple and/or areola (HNA) is based on the response to therapy and any change in the clinical presentation. A follow-up examination at 3-6 months after the initiation of therapy is reasonable. The patient should be instructed to return to the clinic immediately if any nipple discharge, nipple retraction, or palpable mass is present.

Monthly breast examinations are important for breast cancer surveillance, and they are mandatory for all patients with HNA, especially if the disease is unilateral. Patients should be cautioned and educated not to attribute any changes in their breasts to the associated HNA.