I too have seen a few women with hyperkeratosis of the nipple and/or the areola. This is typically defined as an overgrowth of melanocytes or a nevoid defect affecting women of childbearing age. One artcile believes there is a correlation between this type of hyperkeratosis and endogenous or exogenous estrogen levels. Lesions often appear and or worsen during pregnancy. The lesions are typically thickenings of the nipple/areola and show brown hyperpigmentation. This is sometimes treated during pregnancy and/or during lactation with such medications as salicylic acid gel, topical tretinoin (Retin-A), lactic acid lotion, or light cryotherapy. Mostly what I have seen is the thickened layers peeling off during the course of breastfeeding, leaving some very tender skin underneath. Proper positioning, latch, and suck are very important to these mothers. I have recommended using moisturizing lotions to prevent this overgrowth from adhering so tightly that bleeding occurs when it sloughs off. A dermatologist told me that he will sometimes recommend Retin-A because as the Hale book says, it stimulates epithelial cell turnover and reduces cell cohesiveness. A summary of this condition as well as other dermatologic conditions that affect the breast and nipple can be found in: Whitaker-Worth DL, et al. Dermatologic diseases of the breast and nipple. Journal of the American Academy of Dermatology 2000; 43:733-751 Marsha Walker, RN, IBCLC Weston, MA *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html