Jeanne, < After all, whether we see it or not, we lose layers of skin to babies while breastfeeding - some is just more visible than others.> I agree with your post. This is often seen on the flange/bell of the breastpump, more noticeable with mothers with darker areolar pigmentation. I recently saw a caucasion mom with light brown areolas one of which had a large, darker, leathery circular area on one side which had developed during pregnancy. Flakes could sometimes be seen on the baby's lips. The nipples were not involved and the slight damage to her nipple skin in early nursing was no more than commonly seen when mom and babe are struggling to learn to latch well. Increased melanocyte activity in the areolas and the linea negra and mask of pregnancy, etc. might be the reason for the darker color of the area. I have no idea why it was just in one circular area. It was gone by 2 weeks of nursing. One of my children, a redhead with pale skin, has congenital ichthyosis, I think it is called. By 2-3 y.o., in winter when heat and dry air were present, on certain areas of her body. the keratin (the outer dead layer of skin cells), would fail to desquamate regularly through bathing and toweling, and we started Keri lotion as necessary after baths and vigorous toweling. Now that she is an adult, loofas, buff puffs, bath gloves are the order of the day, and she tries out the latest cosmetic moisturizers like others try out lipstick and cologne! (She has glorious hair genes to compensate!) Years ago, when I once saw a mom with similar coloring and skin history for prenatal care, I had some familiarity with the condition. When I did a nipple assessment in the 3rd trimester, I was amazed to find, just on the end of the nipple, a 0.5 cm round buildup of many layers of thick keratin. Nipples were pale pink, but keratin had a yellow-gray tinge. (They were the only pair of "tough" nipples I have ever seen!) I could just imagine my reaction if I were a hospital nurse putting the baby to breast. Enough to freak one out over what to do at that stage of the game! So prenatally, I had her bathe as usual and put triple lanolin on the nipples after baths (the only lanolin preparation pleasant and easy to put on at that time). After two weeks of this, it was only slightly better, so I gave her some lab slides and had her use a q-tip to remove some cells after a bath, and we sent them to a pathologist. His report was essentially keratin, with some kind of yeast (he specified it was not candida), which if I remember his report did not make a big deal of. I reassured her it was just an extension of her past skin characteristics and probably of no consequence to the baby, but would be sure to create a wave of questions at the hospital if it was still so thick at delivery. I had her continue the routine with the addition of an extra little gentle friction with the towel over the areas, being sure not to be too vigorous or cause discomfort. By 36 weeks gestational age when she left our system to transfer to the hospital clinic, it was completely cleared, without any discomfort, and when I called her to follow up, she had a very satisfactory nursing experience. I took slides at all stages of the discovery and resolution of the condition. It may be that the old custom of having mom's "toughen" their nipples with towel friction years ago may have kept some keratin from accumulating heavily. But other than the esthetic effect, I don't think there is anything detrimental. Are there any dermatologists lurking? What say you? K. Jean Cotterman RNC, IBCLC Dayton, OH ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866]