A nipple bleb or "milk blister" presents as a white dot or bleb at the end of the nipple and is caused by inflammation or narrowing of the superficial milk ducts. Management of a nipple bleb includes warm soaks and ongoing breastfeeding while optimizing breastfeeding technique and, possibly, topical
0.1% triamcinolone cream to reduce inflammation. Oral lecithin also has been suggested for nipple blebs, but this is based on very low-quality evidence. Unroofing of the bleb should be avoided. Ductal narrowing also may occur in larger milk ducts and presents as a tender palpable lump under the areola or proximal breast, with minimal localized erythema or systemic symptoms (such as fever or malaise).