Peeling, flaking, or dryness of the nipple and areola skin is a very common experience during pregnancy, and it is usually a normal physiological response. The skin changes are often an early symptom as the body begins preparations for potential breastfeeding. This dryness or flaking is a transient condition that reflects the dramatic internal shifts occurring. Understanding the underlying causes can help alleviate concern, as this type of skin change is rarely a sign of a serious issue.
Hormonal Shifts and Skin Changes
The primary driver of nipple and areola changes is the significant surge in pregnancy hormones, particularly estrogen and progesterone. These hormones act on the mammary glands, stimulating growth and increasing blood flow to the breasts, which can lead to increased sensitivity and a feeling of tightness. This rapid expansion and increased fullness can stretch the skin around the nipple, making it more susceptible to dryness and minor peeling.
The areola often undergoes hyperpigmentation, darkening in color, while the skin texture itself becomes more pronounced. The Montgomery glands, which are small bumps on the areola, enlarge during pregnancy. These glands secrete an oily, waxy substance that naturally lubricates and protects the nipple and surrounding skin.
Sometimes, this oily secretion can dry on the skin’s surface, leading to superficial flaking or crusting that appears like peeling. Additionally, in later stages of pregnancy, the production of colostrum, the precursor to breast milk, may begin. Leaking colostrum can dry on the skin, contributing to the crusty or flaky appearance of the nipple.
At-Home Care and Comfort Measures
Managing the peeling and dryness often involves making adjustments to your daily hygiene and clothing choices. Since the skin is sensitive and prone to irritation, use gentle cleansing methods. When showering, avoid using harsh soaps or cleansers directly on the nipples, as these can strip away the natural, protective oils produced by the Montgomery glands.
Washing the area with plain, clean water is often sufficient to keep the skin clean and maintain its natural moisture barrier. After washing, gently pat the area dry, avoiding any rubbing or vigorous toweling that could worsen the irritation. Applying a safe, protective emollient can provide relief from the dryness and discomfort.
Medical-grade lanolin ointment or specialized nipple balms are highly recommended, as they create a barrier to lock in moisture and are safe for use during pregnancy. For those who prefer plant-based options, natural oils such as coconut oil can also be gently massaged into the skin to soothe and moisturize.
Wearing supportive, breathable clothing helps minimize chafing and friction, which exacerbate peeling. Soft, cotton bras or tops are generally preferable to synthetic fabrics, and ensuring the bra is the correct size is important as the breasts increase in volume. Allowing the nipples to air-dry whenever possible can also aid in the recovery process.
Identifying Signs That Need Medical Attention
While mild peeling and flaking are typically normal, certain accompanying symptoms warrant a consultation with a healthcare provider. Persistent or severe pain that does not resolve with simple home care should be evaluated. Similarly, any instance of persistent bleeding from the nipple or the surrounding areola skin requires professional medical assessment.
Signs of a possible infection, such as increased warmth, localized swelling, or the presence of pus or unusual discharge, are red flags. A rash that spreads beyond the areola, intense, unremitting itching, or a bright pink color may indicate a skin condition like dermatitis or a fungal infection, such as thrush. Thrush often presents with shooting or burning pain deep within the breast, and it requires specific antifungal treatment.
In rare instances, scaly, flaking, or crusty skin on the nipple that is resistant to treatment can be a symptom of a very rare condition known as Paget disease of the breast. Any new change in the nipple’s shape, such as it becoming retracted or pulled inward when it was not previously, should also be brought to the attention of a doctor immediately.