Subareolar abscess

Subareolar abscess is caused by a blockage of the small glands or ducts below the skin of the areola. This blockage leads to infection of the glands.

This is an uncommon problem. It affects younger or middle-aged women who are not breastfeeding. Risk factors include:

• Diabetes
• Nipple piercing
• Smoking

Symptoms of an areolar abscess are:

• Swollen, tender lump beneath the areolar area, with swelling and warmth of the skin over it
• Drainage and possible pus from this lump
• Fever and chills
• General ill feeling or fatigue

Your health care provider will perform a breast exam. Sometimes an ultrasound or other imaging test of the breast is recommended. A blood count and a culture of the abscess, if drained, may be ordered.

Subareolar abscesses are treated with antibiotics and by opening and draining the infected tissue. This can be done in a doctor's office with local numbing medicine. If the abscess returns, the affected glands should be surgically removed. The abscess can also be drained using a sterile needle. This is often done under ultrasound guidance.

The outlook is good after the abscess is drained.

Subareolar abscess may return until the affected gland is surgically removed. Any infection in a female who is not nursing has the potential to be due to a rare form of breast cancer. You may need to have a biopsy or other tests if standard treatment fails.

Contact your provider if you develop a painful lump under your nipple or areola. It is very important to have your provider evaluate any breast mass.

Abscess - areolar gland; Areolar gland abscess; Breast abscess - subareolar

Dabbs DJ, Weidner N. Infections of the breast. In: Dabbs DJ, ed. Breast Pathology. 2nd ed. Philadelphia, PA: Elsevier; 2017:chap 3.

Klimberg VS, Hunt KK. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 35.

Valente SA, Grobmyer SR. Mastitis and breast abscess. In: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, eds. The Breast: Comprehensive Management of Benign and Malignant Disorders. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 6.

Updated by: Jonas DeMuro, MD, Diplomate of the American Board of Surgery with added Qualifications in Surgical Critical Care, Assistant Professor of Surgery, Renaissance School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.