Looking closely at the areola, you may notice small bumps raised around the nipple. They can look like acne, or like milia on the skin, and the impulse is often to squeeze or remove them. These bumps may be Montgomery tubercles — structures related to sebaceous glands that exist naturally on the areola, where they help protect the skin of the nipple and areola.
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Why do Montgomery tubercles appear?
Montgomery tubercles are small bumps on the areola, the darker skin around the nipple. The areola contains specialised secretory glands called Montgomery glands, and the tubercles are these glands showing at the skin surface.
The glands have sebaceous characteristics: they produce an oily secretion around the nipple and areola that prevents the skin from drying and protects it. The nipple and areola are exposed to friction and external stimulation, so these glands help protect the skin.
The number and size of Montgomery tubercles differ between people, and the pattern on the two areolas need not be identical. Several tubercles are usually visible on one areola; some are barely noticeable while others are clearly raised. Montgomery tubercles are not a disease but normal breast anatomy, so if there is no pain or inflammation, no treatment is required.
In an experiment in which neonates were exposed to the secretion of Montgomery glands from lactating women, clear respiratory and sucking responses appeared — the tubercles are functional, normal structures.[1]
Why do they sometimes look more prominent?
Tubercles that are usually inconspicuous can suddenly look larger or more numerous. This does not necessarily mean disease; hormonal change and the condition of the skin around the areola can influence it.
Hormonal change with pregnancy and breastfeeding. During pregnancy the breasts develop and the size and colour of the nipple and areola can change. The Montgomery glands develop too, so the tubercles can look larger and clearer. This is a natural change in preparation for pregnancy and breastfeeding.
Breast changes across the menstrual cycle. Before and after menstruation, hormonal change can make the breasts swell or feel sensitive, and the tubercles may look more noticeable alongside it. Changes in the tubercles alone cannot indicate a particular hormonal state.
Blockage or inflammation of a gland. If the outlet of a Montgomery gland becomes blocked, secretions cannot drain and the tubercle may swell. With inflammation, the surrounding area may redden, with pain or tenderness. This should be distinguished from normal tubercles simply being prominent.
Individual skin and areolar structure. The number and size of tubercles vary widely. Depending on areolar area and skin characteristics, a tubercle of the same size can look more prominent, and slight differences between the two areolas can be natural.
| Cause of prominence | Possible change |
|---|---|
| Pregnancy and breastfeeding | Hormonal change makes tubercles larger and clearer |
| Menstrual cycle | Breast sensitivity and more noticeable tubercles |
| Gland blockage | A specific tubercle swells or feels firm |
| Inflammation | Redness, pain, tenderness |
| Individual skin structure | Differences in number and size |
In an analysis of photographs of 211 patients (399 breasts), Montgomery tubercles averaged 5.0 per breast, ranging from 0 to 25.[2]
How are Montgomery tubercles distinguished from acne?
When small bumps appear on the areola they are often assumed to be acne or a sebaceous cyst, but the cause and features differ. Montgomery tubercles are existing areolar glands becoming visible; acne or folliculitis is inflammation around a pore or hair follicle.
Montgomery tubercles: several are distributed on the areola, often skin-coloured or the colour of the areola. They are usually painless, relatively constant in size, and have often been present in the same form for a long time.
Acne or folliculitis: can appear suddenly or as a reddened swelling in one spot. With more inflammation there may be pain or heat, and pus can form. Other skin lesions such as epidermoid cysts can also occur around the areola, so appearance alone is not enough to distinguish them accurately.
| Feature | Montgomery tubercles | Acne / folliculitis |
|---|---|---|
| Cause | Normal glands present in the areola | Blockage and inflammation of pore or follicle |
| Location | Mainly the areola | Areola and surrounding skin |
| Colour | Skin colour or areola colour | May be red or show pus |
| Pain | Generally absent | Pain if inflamed |
| Change over time | Relatively constant | Sudden onset or size change |
| Treatment | Mostly unnecessary | Considered according to inflammation |
In particular, do not squeeze Montgomery tubercles or pierce them with a needle in the belief that they are acne. Forcing a normal gland can injure the skin or lead to bacterial infection.
When is removal actually necessary?
Because Montgomery tubercles are normal areolar structure, most do not need to be removed. Where a tubercle is unusually large or bothersome in appearance, cosmetic improvement can be discussed. What matters then is not simply removing the bump but first confirming whether it is a normal Montgomery gland or involves inflammation or another skin lesion.
When appearance is the concern. Large or prominent tubercles can make the areolar surface look uneven. If that is the concern, the state of the tubercles can be assessed and removal discussed. Since removing normal glands can leave scarring or pigment change, removal purely for cosmetic reasons is not recommended unconditionally.
When inflammation recurs. If a gland becomes blocked or inflamed, a specific tubercle can swell and become painful. In that case the cause of inflammation should be identified and treated. Inflammation does not automatically mean removal is needed; depending on the state, medication or other measures may be considered first.
When a tubercle suddenly enlarges or discharge appears. A tubercle that appears where none existed, or one that grows quickly, should be distinguished from other skin conditions. If there is blood-stained discharge from the nipple, or persistent eczematous change, ulceration or a firm lump in the nipple or areola, breast disease should be assessed.
Points to note about removal. The method depends on the size, position and skin condition of the tubercle. Local excision may be considered where appropriate, but scarring and pigment change can remain afterwards. The nipple and areola are sensitive and contain secretory glands, so unnecessary damage to surrounding tissue should be avoided. Montgomery tubercles are therefore best decided on by reviewing the current state and the need for cosmetic improvement together, rather than removing them as a matter of course.
Read alsoWhat counts as a normal range, and when removal is considered, is covered in “Montgomery tubercles after breast augmentation” (Korean).
Montgomery tubercles: common myths and facts
| You may think… | In practice |
|---|---|
| "Montgomery bumps are acne." | They are functioning sebaceous glands; squeezing does not remove them. |
| "Having many means something is wrong." | The normal range for the number is wide. |
| "They should all be removed." | The principle is to select only prominent ones for removal. |
In a Montgomery tubercle consultation I look at the speed of recent change rather than the count. If they have been unchanged for months, I observe; if one side changes quickly or there is discharge, examination comes first.
Montgomery tubercles are normal glands associated with the areola that help protect the skin of the nipple and areola. Having several, or having them visible, is not in itself a reason for removal. Where they are large and a cosmetic concern, or where inflammation recurs in one spot, options can be discussed. Avoid squeezing or irritating them as if they were acne, and have sudden size change or pain assessed.
🔬 The research behind this article
These are the international journal papers that support the content above. Select a title to open the abstract on PubMed.
- PLoS One 2009 — areolar (Montgomery) gland secretion in lactating womenDoucet S, Soussignan R, Sagot P, Schaal B. The secretion of areolar (Montgomery's) glands from lactating women elicits selective, unconditional responses in neonates. PLoS One. 2009;4(10):e7579.Key: elicited respiratory and sucking responses in neonatesText [1] · PMID 19851461 · DOI
- American Journal of Surgery 2023 — photographic analysis of 211 patients and 399 breastsKandi LA, Hammond JB, Thornburg DA, et al. Can Montgomery tubercles impact aesthetic 3D nipple-areolar complex tattooing? An anatomical, quantitative analysis of breast cancer patients. Am J Surg. 2023;225(1):99-102.Key: Montgomery tubercles averaged 5.0 per breast (0–25)Text [2] · PMID 36404166 · DOI
🎬 Watch: Dr. Park Seong-Soo on video
Korean-language videos from BongBong Plastic Surgery's official channel and Dr. Park's channel, “Seongsu-ro Doctor”. Titles are translated for reference; selecting one opens YouTube.
- Why you should not squeeze Montgomery tuberclesSeongsu-ro Doctor · 2026.06.11
- Prominent Montgomery tubercles after breast surgery and how they are removed at the rootSeongsu-ro Doctor · 2026.06.09
Frequently asked questions
Does everyone have Montgomery tubercles?
A. Montgomery glands are normal areolar anatomy present in most people. How clearly the tubercles show at the skin surface differs from person to person.
Do Montgomery tubercles go away over time?
A. Because they are normal glands, they may not disappear completely. If they became prominent temporarily through pregnancy or hormonal change, they may later become smaller or less noticeable.
Is it OK to squeeze Montgomery tubercles?
A. They are not acne, so squeezing is not recommended. Forcing pressure can injure the skin or cause inflammation.
Does having many Montgomery tubercles mean breast disease?
A. Breast disease cannot be judged from the number of tubercles. Several can be a normal individual variation, and without pain or rapid change they are usually not a problem.
Can Montgomery tubercles be removed for cosmetic reasons?
A. Cosmetic removal can be considered depending on the state of the tubercles. Because removing normal glands can leave scarring or pigment change, the need and the expected change should be reviewed carefully.
📖 References
Select a [number] in the text to jump to the source, and ↩ to return. Only papers whose title, journal and year were verified on PubMed are included.
- Doucet S, Soussignan R, Sagot P, Schaal B. The secretion of areolar (Montgomery's) glands from lactating women elicits selective, unconditional responses in neonates. PLoS One. 2009;4(10):e7579. — PLoS One 2009 — areolar (Montgomery) gland secretion in lactating women. ↩
- Kandi LA, Hammond JB, Thornburg DA, et al. Can Montgomery tubercles impact aesthetic 3D nipple-areolar complex tattooing? An anatomical, quantitative analysis of breast cancer patients. Am J Surg. 2023;225(1):99-102. — American Journal of Surgery 2023 — photographic analysis of 211 patients and 399 breasts. ↩
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