Nipple blebs are small white spots on the tip of the nipple. They are often associated with sharp and deep pain. They can also obstruct the flow of milk which can contribute to milk stasis. They can range from 1 mm to 3 mm in diameter, but can appear larger if aggravated.
Blebs are usually due to frequent plugged ducts, oversupply and/or subacute mastitis. The underlying cause of the bleb should be identified and treated as well. Here are some tips for bleb treatment:
1. Apply a cotton ball soaked in olive oil directly over the bleb. If the bleb opens on its own, apply a thin coating of an over the counter antibiotic ointment to the nipple after feeding to prevent the bleb from reforming.
2. If painful and not resolving with the above, a prescription steroid such as triamcinolone 0.1% can be applied over the nipple three times a day. The steroid can help to resolve the bleb by treating the inflammation. Cover the nipple with plastic wrap and continue for one week.
3. If plugged milk ducts are contributing to blebs, consider oral sunflower lecithin, 1200 mg, 3-4 times a day.
Things to avoid: Do not pick at the bleb to try to open it! This can lead to infection and cause scarring. Do not soak the nipple in saline water, as is frequently recommended. Soaking the nipple can cause the nipple tissue to break down, leading to further issues.