What is athelia?

Athelia is a condition in which a person is born without one or both nipples. Although athelia is rare overall, it’s more common in children who are born with conditions such as Poland syndrome and ectodermal dysplasia.

Keep reading to learn more about how this condition presents, what causes it, and more.

What does this condition look like?

Athelia manifests differently, depending on the condition that caused it. Typically, people with athelia are missing both their nipple and areola—the colored circle around the nipple. The nipple may be missing on one or both sides of the body.

People with Poland syndrome may be born without an entire breast, nipple, and areola on one side. The absence of one or both breasts is called amastia.

What causes this condition?

Athelia is caused by conditions such as Poland syndrome and ectodermal dysplasia.

Poland syndrome

Poland syndrome affects about 1 out of every 20,000 newborns. It’s named after British surgeon Alfred Poland, who first described it in the 1800s.

Researchers don’t know exactly what causes this syndrome. They think it might be caused by a problem with blood flow in the womb during the baby’s sixth week of development.

Poland syndrome may affect arteries that provide blood to the growing baby’s chest. It’s thought that the lack of blood prevents the chest from developing normally.

Rarely, Poland syndrome is caused by a gene change that’s passed down through families.

Children who are born with this condition have missing or underdeveloped muscles on one side of their body. They’re usually missing part of the chest muscle, called the pectoralis major.

Other symptoms of Poland syndrome include:

  • missing or underdeveloped ribs on one side of the body
  • missing or underdeveloped breast and nipple on one side of the body
  • webbed fingers on one hand
  • short bones in the forearm
  • sparse underarm hair

Ectodermal dysplasias

Ectodermal dysplasias are a group of more than 180 different genetic syndromes. These syndromes affect the development of the skin, teeth, hair, nails, sweat glands, and other parts of the body.

They happen when the ectodermal layer in the embryo — which gives rise to skin, teeth, hair, and other organs — doesn’t develop properly.

People with ectodermal dysplasia may experience symptoms like:

  • thin hair
  • missing or malformed teeth
  • an inability to sweat (hypohidrosis)
  • vision or hearing loss
  • missing or underdeveloped fingers or toes
  • cleft lip or palate
  • unusual skin color
  • thin, brittle, cracked, or otherwise weakened nails
  • lack of breast development
  • difficulty breathing

Genetic mutations cause ectodermal dysplasia. These genes can pass from parents to children or can mutate (change) when the baby is conceived.

Other causes

Other causes of athelia include:

  • Progeria syndrome. This condition causes people to age very quickly.
  • Yunis Varon syndrome. This rare, inherited condition affects the face, chest, and other parts of the body.
  • Scalp-ear-nipple syndrome. This condition causes a hairless patch to form over the scalp, underdeveloped ears, and missing nipples or breasts on both sides.
  • Al-Awadi-Rass-Rothschild syndrome. This rare, inherited genetic condition occurs when the bones are poorly formed.

Who’s at risk for this condition?

A child is more likely to be born with athelia if one parent has a condition that causes it. Poland syndrome is more common in boys than girls, but ectodermal dysplasia affects males and females equally.

Does this condition increase your risk for others?

Athelia isn’t the same thing as amastia, which occurs when the whole breast is missing. However, it’s possible for the two conditions to occur together.

In rare cases, girls with Poland syndrome can have amastia: the entire breast and nipple on the affected side of the body are absent.

Are other complications possible?

The lack of nipples itself doesn’t cause complications. But some of the conditions that cause athelia may lead to health problems. For example, severe Poland syndrome can affect the lungs, kidneys, and other organs.

If you’re missing a nipple, you won’t be able to breastfeed your baby on that side.

Is treatment or management necessary?

You don’t have to treat athelia unless the appearance of the missing nipple bothers you.

If you’re missing the entire breast, you can have reconstruction surgery using tissue from your abdomen, buttocks, or back. The nipple and areola can then be created during another procedure.

To make the nipple, your surgeon molds a flap of tissue into the correct shape.

If desired, you can go on to have an areola shape tattooed on your skin. Newer 3-D tattoo procedures use oscillating needles coated in pigment to create a more realistic, three-dimensional–looking nipple.

What’s the outlook?

The individual outlook depends on which condition caused athelia. Mild Poland syndrome may not cause any health issues — or even be noticeable. More severe cases can affect organs like the lungs or kidneys, which can cause complications.

If you or your child was born with athelia, your doctor is your best resource for information about your overall health and potential complications.

How to cope

Athelia and the conditions that cause it can have an impact on your self-esteem. If you’re struggling to cope with the changes to your body, you may find it helpful to speak with a psychologist, therapist, or other mental health professional.

You can also join a support group for people who share the condition. Ask your doctor if they can recommend a support group online or in your area.