Follicular keratosis on the nipples can be considered as hyperkeratosis of the nipple areola, which is characterised by warty thickening and hyperpigmentation of the nipple and/or areola. In most cases it is difficult to self-identify and is characterised by an enlarged areola. Pathological examination may reveal hyperkeratosis of the epidermis with follicular keratosis and may be accompanied by inflammatory cell infiltration. Treatment is symptomatic, with topical medication such as retinoic acid ointment and 12% lactic acid cream to soften the exfoliating lesions.