Cushing’s and Hairy Nipples

Hairy nipples are a common condition in women. The amount of hair on the nipples varies, but some women find that the hair becomes long, coarse, and dark, which can be distressing.

Hairy nipples are rarely a cause for concern and are usually not a sign of any underlying health issues. However, occasionally they can signify something more serious, in which case, it is essential to consult a doctor.

Almost every part of a person’s skin is covered in hair and hair follicles. On certain parts of the body, such as the top of the head, the hair usually grows longer and thicker, while on other parts, it is thin and transparent.

Fast facts on hairy nipples:

  • It is not known how common hairy nipples are or how many women have them.
  • Many women do not report the condition and instead manage it themselves.
  • It is possible for hair that used to be fine and light to turn coarse and dark with age.

Causes of hairy nipples in women

There are several underlying reasons that might cause nipple hairs to grow. These are:

Cushing’s syndrome

Cushing’s syndrome is another condition caused by hormonal imbalance. When it occurs, there is an excess of cortisol in the body. In this case, a person may experience several symptoms, such as:

  • increased hair growth
  • abnormal menstrual periods
  • high blood pressure
  • a buildup of fat on the chest and tummy, while arms and legs remain slim
  • a buildup of fat on the back of the neck and shoulders
  • a rounded and red, puffy face
  • bruising easily
  • big purple stretch marks
  • weakness in the upper arms and thighs
  • low libido
  • problems with fertility
  • mood swings
  • depression
  • high blood glucose level

Cushing’s syndrome is fairly rare, and the cause is usually associated with taking glucocorticosteroid medicine, rather than the body overproducing the hormone on its own.

It is possible, however, that a tumor in the lung, pituitary gland, or adrenal gland is the cause.


Hormonal changes and fluctuations

Hormonal changes in women can cause many different symptoms, one of which is changes in nipple hair growth and color.

Some common hormonal changes happen during pregnancy and menopause.

However, hormonal changes can also occur when a woman is in her 20s and 30s, which may cause nipple hair to change appearance or become noticeable for the first time.

Overproduction of male hormones

It is possible for hormonal imbalances to cause hairy nipples. Overproduction of male hormones, including testosterone, can cause hair growth, while other symptoms include:

  • oily skin that can lead to breakouts and acne
  • menstrual periods stopping
  • increase in skeletal muscle mass
  • male pattern baldness, leading to a woman losing hair on her head

If overproduction of male hormones is suspected, it is a good idea to make an appointment with a doctor who can confirm this with a simple test.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) occurs because of a hormonal imbalance. PCOS is a condition that affects the way the ovaries work.

Common symptoms of PCOS are:

  • infertility
  • irregular menstrual periods
  • ovarian cysts
  • excessive hair growth in unusual places, such as the nipples

PCOS is believed to affect around 1 in 5 women.


The side effects of particular medicines can cause unusual hair growth.

Medicines, such as testosterone, glucocorticosteroids, and certain other immunotherapy drugs may cause hairy nipples.

What are the treatment options?

Treatment for hairy nipples is not usually necessary for health reasons.

However, many women with the condition prefer to try and reduce or get rid of the appearance of hair on their nipples for cosmetic purposes.

There are several methods by which they can try and do this:

Trimming the nipple hair

Trimming the nipple hair may be enough to reduce its appearance. Small nail scissors are ideal, and hair can be cut close to the skin. It is essential to do this carefully and avoid catching the skin.

Trimming will need to be carried out regularly when the hair grows back.

Tweezing the nipple hair

Tweezing nipple hair is an effective way to get rid of unwanted nipple hair. However, this option can be painful as the skin around the nipple area is particularly soft and sensitive.

It is also important to bear in mind that the hair will return, and tweezing the hair increases the risk of infection and ingrown hairs.

Shaving the nipple hair

Shaving is another option to reduce the appearance of nipple hair. However, it is advisable to do so with caution to avoid nicking the sensitive skin.

This option also carries an increased risk of developing ingrown hairs and infection.


Sugaring or waxing is a good hair removal option, though either one is likely to be painful. A salon is the best place to get this treatment type, as doing this at home may cause damage to the skin. Infection and ingrown hairs are again a risk.

Laser hair removal

These popular treatments can help to reduce the hair growth and slow or even prevent regrowth for a while. However, they can be painful, too.

Laser treatment is by far the most expensive option, as it will need to be performed by a plastic surgeon or cosmetic dermatologist.

Hormonal treatment

If a hormonal imbalance is the cause of hairy nipples, a doctor may prescribe or adjust a woman’s medication therapy to restore a healthy hormonal balance.

Other treatments and how to choose

The above treatments are all commonly used to remove and reduce nipple hair and usually have minimal side effects.

Bleaching or using hair removal cream to treat the condition, however, is not advised as these methods are usually too harsh for this sensitive area and may cause irritation and damage.

At what point should you see a doctor?

Hairy nipples in women are quite common, and there is usually no need to see a doctor. However, if they are accompanied by any other unusual symptoms, it is a good idea to make an appointment.

A doctor will be able to perform tests to determine whether an underlying cause, such as PCOS, is causing the growth of nipple hair. If so, they will give advice and medication therapy to help manage the condition.

A doctor will also be able to advise how to remove nipple hair safely.


For the majority of women, nipple hair may seem unsightly, but it is not a cause for any concerns about their health.

However, because some medical conditions can cause nipple hair to darken and grow, it is important to see a doctor if any other symptoms are experienced.

Nipple hair can usually be easily treated and managed, should a woman choose to try to remove the hair for cosmetic reasons.

Adapted from


ACTH-producing Lung Tumors Hard to Detect, But May Be Cured with Surgery

Ectopic Cushing’s syndrome can be challenging to diagnose, especially when it comes identifying the problem source. But appropriate hormone management protocols, used in combination with advanced imaging methods, may help physicians identify ectopic ACTH-producing tumors.

The findings in a case report of a young man with ectopic Cushing’s syndrome were published in the International Journal of Surgery Case Reports, under the title “Case report: Ectopic Cushing’s syndrome in a young male with hidden lung carcinoid tumor.”

Cushing’s syndrome is caused by high amounts of glucocoticosteroids in the blood. The most common cause is a malfunction of the glands that produce these hormones. In some cases, however, the disease may be caused by tumors elsewhere in the body that have the ability to produce adrenocorticotropic hormone (ACTH).

In half of all Cushing’s patients, ectopic ACTH is produced by small lung cell carcinomas or lung carcinoids (a type of slow-growing lung cancer). But some tumors in the thymus and pancreas also have been found to produce ACTH.

Researchers at Damascus University Hospital in Syria presented the case of a 26-year-old man who had ectopic Cushing’s syndrome due to lung carcinoids.

The patient presented with increased appetite and rapid weight gain for more than a year. These were associated with headache, fatigue, proximal muscle weakness, and easy bruising. He had no family history of hormonal disorder.

Based on the initial physical and symptom evaluation, the clinical team suspected Cushing’s syndrome. Blood analysis revealed high levels of cortisol and ACTH hormones, which supported the diagnosis.

Administration of dexamethasone, a treatment used to inhibit the production of glucocoticosteroids by the pituitary gland, reduced cortisol levels within normal range, but not ACTH levels. This led to the diagnosis of ectopic Cushing’s syndrome.

The next step was to identify the tumor causing the syndrome. The team conducted imaging studies of the brain, chest, and abdomen, but found no tumor.

Because ectopic ACTH is commonly produced by lung cancers, the team then analyzed the patient’s lungs. Again, they failed to detect a tumor.

The patient was discharged with prescription of 200 mg of Nizoral (ketoconazole) once-daily, calcium, and vitamin D. After three months of treatment, he remained stable, with no evidence of symptom improvement.

At this point, the team decided to surgically remove both adrenal glands in an attempt to reduce the hormone levels. Treatment with prednisolone 5 mg and fludrocortisone 0.1 mg once daily was initiated, along with calcium and vitamin D.

Eighteen months later, the patient’s condition worsened and he required hospitalization.

Imaging tests targeting the neck, chest, and abdomen were conducted again. This time, physicians detected a 2 cm mass in the middle lobe of the right lung, which was removed surgically. Detailed analysis of the small tumor confirmed that it was the source of the excessive ACTH.

“ACTH secreting tumors can be very hard to detect,” the researchers stated. “Initial failed localization is common in ectopic ACTH syndrome and it is usually due to carcinoid.”

Cases where the ectopic ACTH production is caused by a carcinoid tumor can be challenging to diagnose because tumors are small and relatively slow-growing. Imaging data is often hard to analyze and the tumors can be confused with pulmonary vessels, the researchers explained.

“In such cases we should first aim to lower blood cortisol medically or through bilateral adrenalectomy to avoid Cushing’s complications,” which should then “be followed up through imaging studies (CT, MRI, scintigraphy or PET) to detect the tumor and resect it, which is the definitive treatment of these patients,” the researchers concluded.


Severe psychosis due to Cushing’s syndrome in a patient with a carcinoid tumour in the lung

Severe psychosis in patients with Cushing’s syndrome is a rare occurrence and can be extremely resistant to medical therapy. We describe a case of a 51-year-old Afro-Caribbean female patient, with refractory severe hypertension (initially resistant to polypharmacy) and gradual development of severe psychosis secondary to ectopic Cushing’s syndrome, who was subsequently diagnosed to have a carcinoid tumour in her lung.

Her psychotic episodes – secondary to hypercortisolism and initially refractory to the medical therapy – subsided only after the resection of the carcinoid tumour in her right lower pulmonary lobe. Early localization and appropriate surgical resection of the ectopic ACTH-secreting tumour can be of immense value to the successful alleviation of the psychotic episodes of the patients with ectopic Cushing’s syndrome.

Author: Mohamad BabaDebamalya Ray
Credits/Source: World Journal of Surgical Oncology 2015, 13:165


Myth: “All types of Cushing’s are the same”

Myth: “All types of Cushing’s are the same”


Fact: In the words of our dear friend and advocate, Robin Ess, “There are many genetic varieties with quite a few discovered in the past couple of years. Plus, there are several types such as adrenal, ectopic, and pituitary. And so on”….Amazingly, some doctors do not realize that there are different varieties of Cushing’s and that the symptoms can come from a different source.

For instance, a doctor might rule out a pituitary tumor and completely dismiss the patient, even with biochemical evidence of Cushing’s. That doctor, instead of dismissing the patient, should thoroughly look for other potential sources, such as an adrenal tumor, or yet another source. Did you know that tumors on one’s lungs can even cause Cushing’s? Most people don’t know that.

For more information about the different types of Cushing’s, please read:

Another great article regarding ectopic Cushing’s can be found here:

MaryONote: Folks might be interested in listening to this podcast episode with Jayne, a Cushing’s patient who had pituitary surgeries and a bilateral adrenalectomy before finding the true source of her ectopic Cushing’s – lung tumors.

Rare neuroendocrine tumours may be misdiagnosed as Cushing’s disease

By Eleanor McDermid, Senior medwireNews Reporter

Ectopic tumours secreting corticotropin-releasing hormone (CRH) and adrenocorticotropic hormone (ACTH) are very rare in children and can result in a misdiagnosis of Cushing’s disease (CD), say researchers.

Three of the patients in the reported case series had pituitary hyperplasia and underwent transsphenoidal surgery for apparent CD before the tumour that was actually causing their symptoms was located. The hyperplasia was probably caused by release of CRH from the ectopic tumour, which stimulated the pituitary gland, giving the impression of an ACTH-secreting pituitary adenoma, explain Maya Lodish (National Institutes of Health, Bethesda, Maryland, USA) and study co-authors.

These three patients were part of a series of seven, which Lodish et al describe as “a relatively large number of patients, considering the infrequency of this disease.”

The patients were aged between 1.8 and 21.3 years. Three had neuroendocrine tumours located in the pancreas ranging in size from 1.4 to 7.0 cm, two had thymic carcinoids ranging from 6.0 mm to 11.5 cm, one patient had a 12.0 cm tumour in the liver and one had a 1.3 cm bronchogenic carcinoid tumour of the right pulmonary lobe.

Four of the patients had metastatic disease and, during up to 57 months of follow-up, three died of metastatic disease or associated complications and two patients had recurrent disease.

“Our series demonstrates that these are aggressive tumors with a high mortality rate,” write the researchers in the Journal of Clinical Endocrinology & Metabolism. “It is important to follow the appropriate work up, regarding both biochemical and imaging tests, which can lead to the correct diagnosis and to the most beneficial therapeutic approach.”

The team found the CRH stimulation test to be helpful, noting, for example, that none of the patients had a rise in cortisol that was consistent with CD, with all patients showing smaller responses ranging from 2% to 15%. Likewise, just one patient had an ACTH rise higher than 35% on CRH administration, and four patients had a “flat” response, which has previously been associated with ectopic neuroendocrine tumours.

Of note, six patients had normal or high plasma CRH levels, despite all having high cortisol levels, which would be expected to result in undetectable plasma CRH due to negative feedback, implying another source of CRH production. Five patients had blunted diurnal variation of both cortisol and ACTH levels consistent with Cushing’s syndrome.

The patients also underwent a variety of imaging procedures to identify the source of ACTH/CRH production, some of which, such as octreotide scans, are specialist and not available in most hospitals, the researchers note, potentially contributing to inappropriate diagnosis and management.


%d bloggers like this: