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Itchy Nipples

The skin of the areola is particularly thin and can be sensitive. Read more...
 

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How can the dry air contribute to dry, itchy skin around the nipples? How do you know if your itchy nipples just need moisturizing?



Dry itchy nipples or nipple eczema are possible manifestations of atopic dermatitis. The thin skin of the areola can make the area particularly susceptible to excess dryness and irritation that can appear cracked, swollen, and even possibly crusted or oozing.



As with all types of eczema, restoring the skin barrier through moisturizers and hydrating the skin is a reasonable first step to take. However, if the skin does not improve overall, it is important to see your Dermatologist to verify the diagnosis and attempt therapy with possible topical steroids or nonsteroidals.


I routinely advise patients however that if nipple eczema does not respond to prescription topicals a biopsy may be warranted. There are forms of breast cancer such as Paget’s disease that can appear similar to nipple eczema and may not appear on mammograms.



How can an allergic reaction to your body lotion cause itchy nipples? How do you know if you should switch lotions?



The skin of the areola is particularly thin and can be sensitive to lotions and products that we use. An allergic reaction or more likely an irritant contact dermatitis could result from the use of various personal care products. If the irritation extends beyond the area of the areola onto the breast, it would be necessary to change your lotion. If the irritation is limited to the nipple and not the surrounding skin, it is reasonable to continue your current lotion and avoid the application of the product directly to this area to see how it responds.



Can atopic dermatitis or eczema cause itchy nipples? Why does this happen and how do you know if you should seek medical treatment from a doctor?



Nipple eczema is a known manifestation of atopic dermatitis. This can happen to men, women, or children. When eczema affects the nipples, medical attention should be considered to verify the diagnosis. Due to the possibility of forms of breast cancer potentially mimicking nipple eczema, it is best to be under the guidance of a Dermatologist to guide your course of therapy.



Can psoriasis cause itchy nipples? Why does this happen and how do you know if you should seek medical treatment from a doctor?



Psoriasis has been reported to affect the nipple in rare cases. Given the rarity of involvement of the nipple-areolar complex, medical attention should be sought to verify the diagnosis, especially in the absence of involvement of psoriasis elsewhere on the skin.



Can a yeast infection cause itchy nipples? How and why? When to consult a doctor?



Although traditionally mammary and nipple pain in lactating women has been attributed to yeast such as Candida, many medical reviews have demonstrated that this may not be as common as once considered. Although yeast is certainly a possible cause of painful or itchy nipples, an accurate diagnosis is essential through evaluation by a Dermatologist for prompt therapeutic intervention and relief from discomfort.



How can pregnancy cause itchy nipples? What's the treatment?



Hyperkeratosis of the nipple can occur during pregnancy which results in thickened plaques on the nipples. This can be itchy and irritating. The thickened plaques may need to be treated with retinoids or liquid nitrogen.



How or why can breastfeeding cause itchy nipples? How to treat it?



Breastfeeding can lead to excess dryness, irritation, as well as skin breakdown that can result in itching, pain, or discomfort. Protecting and repairing the skin through the use of barrier creams such as lanolin can help the skin feel less uncomfortable.



How do changes in your hormones sometimes cause itchy nipples? Menopause? Can your period? Etc.? Please elaborate on why these changes affect nipples. How to treat?



Although not necessarily more common to see with hormonal changes, nipple eczema can be exacerbated by changes noted during menses or menopause. As these changes are likely more related to stretch on the thin skin of the areola, use of lanolin can help reduce the irritation experienced.



How can hyperkeratosis--wart-like, bumpy skin in the nipple area--cause itchiness? Treatment?



See above under hyperkeratosis of the nipple.



How can thyroid issues cause itchy nipples? How to treat/when to consult doctor?



Hyperthyroidism can trigger gynecomastia or enlargement of the breast. This can potentially trigger itching of the nipple. If there is a known history of thyroid disease this is certainly a reason to check with your doctor to see if there is evidence of a poorly controlled thyroid.



How can nipple adenoma--overgrowth of nipple tissue that's a non-cancerous tumor--cause itchiness? How to treat/when to consult doctor?



Adenomatosis of the nipple has been associated with itching of the nipple. This may be from a sensitivity of the skin involving the overgrowth of tissue. Any change in the nipple is reason for a doctor to evaluate to verify the diagnosis of adenomatosis. If there is a known adenoma and triggering itching, then medical intervention may be warranted to treat the tissue that is affected.



Can uncomfortable clothing/bra rubbing against your nipple cause itchiness? How to fix?



Bras have been linked to itching of the nipple either from the texture of the textile, type of textiles, sweating that accumulated between the skin and the textile of the bra, lack of breathability or moisture wicking of the fabric, or ill-fitting nature of the bra. If itching is noted consistently with a particular type of bra, it is worth looking for softer textiles that have moisture-wicking or breathability features.



How can a bug bite in the area cause itchiness to the nipple? How to treat?



A bug bite can certainly trigger itching of the nipple that can be treated with mild hydrocortisone creams or cooling the skin to reduce the swelling of the affected area.



Do recent breast surgeries cause nipple itchiness? Why? How to treat?



As the skin is healing post-operatively, itching can be noted. Avoiding excess friction or irritation can help manage the discomfort.



Why can itchy nipples be a sign of breast cancer? What kind of breast cancer? What other symptoms to look out for and when to consult a doctor?



See above for Paget’s



For someone who is post breast-cancer and doing radiation, how does radiation cause itchy nipples? How to treat? When to consult doctor?



Radiation impacts the skin appendages including sweat ducts, oil glands, and hair follicles. With reduced natural hydration of the skin, itching can follow. Routinely hydrating the skin with moisturizers can replace the moisture lacking in the skin that can trigger itching and irritation.


Breast itchiness should first have several factors to take into consideration.

  • is it localized to one area?

  • is it only one breast and not the other or both?

  • is it associated with something you can feel underlying the area- like a bump or lump?

  • is it itching by itself or is there are rash you can see?


If itchiness is on both breasts all over, no rashes or lesions, and not localized to one area, I often see contact dermatitis as a cause. Reactions to the material of bras as well as to detergents that may not be completely rinsed out in the wash can occur.


We come across yeast folliculitis from sweating excessively as well.


Heat rash from excess sweat and heat from menopausal flushes can also lead to this common symptom.


If the breasts are itchy overall, hormones can play a role. This is possibly due to swelling of the breasts that can lead to itchiness and irritation. Common times this may be seen is during puberty and during pregnancy.


If itchiness or discomfort is localized to under both breasts, perhaps more concentrated on the side you sleep on: Yeast infections in general can also cause itching and discomfort but tend to be localized to the area under the breasts.


Eczema, dry skin and psoriasis can also impact the breasts as well and may even be localized to the areola and nipples.


I have come across some less common causes as well including a genetic condition that can occur later in life called Hailey Hailey disease.


For all of the above mentioned, initiating intervention of using topical steroids, moisturizers, trying different materials for bras, cooling the skin can often help.


Over the past 20 years I have seen my fair share of breast cancer presenting on the skin. I would strongly advise that if itchiness lasts longer than 2 weeks and the interventions listed above do not work or if there is an underlying lesion, lump/bump, rash, discoloration, tenderness, localized to one spot - see your doctor. I have a lowered threshold to biopsy the breast given the fact that I have seen inflammatory breast carcinoma present as a simple red patch, Paget disease that looks like eczema. The key with each of these is a lack of response to treatment over 2 weeks or lasting response over a month.




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