Function of the sebaceous gland

The sebaceous glands of the skin have primarily a protective function, as they protect the skin from drying out. The Montgomery glands also play an important role in the breastfeeding process, as they help to seal the baby’s mouth with the nipple so that it is airtight and thus facilitate the sucking process. In addition, sebum provides additional protection for the sensitive nipple, which is exposed to a high level of stress during repeated breastfeeding.

Many mothers still complain about swollen nipples during the breastfeeding period, which may be due to anatomical peculiarities of the very individual breast, but also to incorrect breastfeeding technique. Recent research also suggests that the secretion of the Montgomery glands contains pheromones, i.e. chemical fragrances, which make it easier for babies to find their nipples. This is particularly important in the early stages of breastfeeding, as the infant has yet to learn the connection between breast and food.

For this reason, the Montgomery glands are sometimes referred to as “particularly differentiated scent glands of the skin”. A further experiment suggests that the scents encourage the infants to drink more.Probably also the quantity of the available Montgomery glands plays a role on that occasion, since the babies of mothers with a higher number of these glands also increased faster in weight. The amount and consistency of sebum produced is regulated to a large extent by the sex hormones, with testosterone tending to increase both and estrogens tending to inhibit them.

In this respect, gender plays a major role. But age, disposition, nutritional status and environmental influences also play a role. In the case of the fragrance, the influencing factors are still rather speculative, as this is still a comparatively young research topic. Here, too, a great influence of the sex hormones is assumed.

Diseases of the sebaceous glands on the nipple

Constipated sebaceous glands are a topic, with which everyone might have had to do already once. Blackheads and pimples can develop due to the constipation. Since the skin in this area is particularly sensitive and the sebaceous glands are correspondingly large, this can be particularly painful.

Especially if the constipation occurs again and again despite treatment, this pressure of suffering is even increased. In addition, the swollen area can also be an aesthetic problem, especially in this area. It is also considered whether such a blocked sebaceous gland can obstruct the flow of milk during breastfeeding.

Basically, the process of development here is very similar to the development of a pimple: In the beginning there is often a proliferation of horny cells, which is called microcomedo. Especially in acne patients, these can be accompanied by a slight inflammation even in the early stages. However, both developments are usually not yet visible to the eye in this early stage and are considered to be preliminary stages.

If, in addition to hyperkeratosis, the increased formation of horn, an increased sebum production (seborrhea) is added, a real comedo can develop. This is due to the excessive hornification and sebum secretion to a plug-like blockage of the excretory duct. This comedo can be either open or closed.

In an open comedo the blockage is located far at the surface due to melanin in the skin and reactions with oxygen in the air cause the plug to turn black. It can be easily recognized from the outside and is called blackhead. In a closed comedo the clog lies a bit deeper and shows itself from the outside as a small white elevation, which is why it is also called whitehead.

This blocked fat-containing secretion is an ideal breeding ground for certain bacteria. The subsequent inflammation of the surrounding tissue as part of the immune response that fights bacterial growth is then visible from the outside as a red, swollen pimple. All these processes can also take place in a very similar form on the nipple.

If a lump is found near the areola, a doctor should always be consulted for clarification, especially if this lump remains constant over a longer period of time or even grows. In most cases it will be an atheroma, i.e. a so-called grotto sac. Nevertheless, the possibility of malignant tissue changes must be excluded.

To do this, the doctor first tests whether the node can be moved and how it reacts to pressure. Sometimes it is possible to determine with certainty that it is indeed an atheroma, but this can only be done by a histological examination. Such an atheroma is basically harmless, but it should still be removed, otherwise it can develop into an abscess.

Basically, an atheroma is also a clogged sebaceous gland, which has not yet become inflamed. Therefore the pressure inside the gland has caused an encapsulated pouch to form. From the outside you can only see a small bump, which sometimes carries a small black or grey dot.

The affected person often reports a feeling of tension around the atheroma. The size can vary greatly: Mostly atheromas are only noticed when they are about the size of a pea and can swell up to the size of a chicken egg. Under no circumstances should such an atheroma itself be removed by squeezing, as there is an increased risk of inflammation.

In addition, the capsule of the atheroma should also be removed to prevent it from simply developing again.An abscess can develop from an atheroma due to inflammation, but it can also develop independently of sebaceous glands anywhere in the body, especially in places that are frequently affected, such as inner thighs or buttocks. In the case of the breast, an abscess can, in very unfavorable and rare cases, also develop from a simple inflammation of the nipple (mastitis puerperalis) caused by breast feeding. As in atheroma, the corresponding area is surrounded by a capsule, which in this case, however, is not filled with fatty secretion but with pus.

Pus, or pus in technical terms, is a yellowish, viscous secretion that is caused by the death of immune cells. This reaction is usually triggered by staphylococci, streptococci or E. coli. In the case of the breast, the abscess is usually quite close to the skin surface and can be recognized from the outside by the typical signs of inflammation.

A smear of the pus can provide information about the responsible pathogen. Here, too, it is absolutely not advisable to pierce even the boil. It is best to remove the abscess cleanly and completely.

In the worst case, the pathogen can enter the bloodstream and cause blood poisoning (sepsis), especially if there is a weakened immune system anyway. If the abscess was removed in time and properly, it usually heals completely within a few weeks. It is important that the remaining open wound is cleaned regularly and the dressing is changed.