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Supernumerary nipples, also referred to as polythelia or accessory nipples, is a pigmented lesion of the skin that is present at birth. Clinically, this congenital condition is generally considered benign, but some studies have suggested there may be an association with kidney diseases and cancers of the urogenital system.

One factor that distinguishes supernumerary nipples from other skin lesions is that it has the histology of breast tissue, so it falls under the umbrella term of accessory breast tissue (ABT). Accessory breast tissue has a classification system depending on how the condition presents in the individual. Separate terms are used for different combinations of the presence of nipple, areola, or glandular tissue. The most common presentation, termed polythelia, is where only the nipple is present without the areola and glandular tissue. Conversely, the presence of all three components is known as polymastia, or supernumerary breasts.

Treatment
Since supernumerary nipples are commonly regarded as benign, treatment to remove it is usually done only for cosmetic purposes. In some cases, this skin abnormality can also cause discomfort around the breast tissue. This is particularly an issue when a component of the lesion is glandular tissue, which can cause tenderness during puberty, and occasionally lactation. Although studies are still being done to establish an association between supernumerary nipples and kidney diseases, renal ultrasounds have also been used as a precautionary measure to detect any kidney abnormalities in this population.

Cosmetically treating Becker's nevus syndrome focuses on the hyperpigmentation and hair growth. Correcting skin pigmentation can be done through a variety of methods including the use of makeup, dermabrasion, or laser treatments. Studies have also established that the tissue of Becker's nevus has an increased number of androgen receptors compared to the unaffected skin. Consequently a treatments using drugs with anti-androgenic properties have shown efficacy in reducing the pigmentation. Particularly, spironolactone and flutamide are some examples which have been studied.

Likewise, the excessive hair growth can be resolved by shaving, waxing, and electrology. Other treatments of note are Q-switched laser and intense pulsed light treatments, which are preferred for longer term effects. Proper diagnoses of the lesion can help to determine whether laser or IPL treatments are appropriate, as well as reduce the risk of recurrence and side effects, such as post-inflammatory hyperpigmentation.

Careful consideration should be taken before pursuing laser treatments because, in the case that the lesion may be associated with another disease state, you would not be able to examine it histologically after laser removal.