Nipple pain is a common and often distressing symptom. While many causes are temporary and benign, understanding the potential reasons behind the discomfort is important. This article explores common causes, from everyday factors to medical conditions, and provides guidance on when to seek professional advice and how to find relief.
Everyday Reasons for Nipple Pain
Nipple pain often stems from common factors. Hormonal fluctuations are a significant contributor, with changing levels of estrogen and progesterone throughout the menstrual cycle often leading to tenderness. Nipples may become particularly sore in the week leading up to menstruation, and increased sensitivity can also be an early sign of pregnancy due to sharp hormonal increases. During perimenopause and menopause, unpredictable shifts in these hormones can cause aching, tenderness, or a burning sensation.
Breastfeeding is another common source of nipple pain, often due to issues with how the baby latches onto the breast. An improper or shallow latch, where the baby primarily sucks on the nipple instead of a larger portion of the areola, can cause significant soreness. Engorgement, where breasts become overly full, and blocked milk ducts can also lead to discomfort. Trauma from improper use of a breast pump or prolonged suction can also irritate the nipple tissue.
Friction and irritation are frequent culprits. Ill-fitting bras, especially those that are too tight or too loose, can cause constant rubbing against the sensitive nipple skin. Activities like running, where clothing repeatedly chafes against the nipples, can lead to “runner’s nipple,” characterized by soreness, stinging, or even bleeding. Allergic reactions to laundry detergents, soaps, lotions, or certain fabrics can manifest as itchy, painful rashes on the nipple area.
Underlying Medical Conditions
While often due to everyday factors, nipple pain can also stem from medical conditions. Infections, for example, can cause significant discomfort. Mastitis, a bacterial infection of the milk ducts, often occurs in breastfeeding individuals but can affect others. Symptoms typically include a swollen, red, and painful breast, often accompanied by fever and flu-like symptoms. Yeast infections, such as thrush, can also affect the nipples, causing burning, itching, or stinging pain, sometimes with visible signs like redness or flaky skin.
Various skin conditions can present with nipple pain. Eczema, dermatitis, or psoriasis can cause the skin around the nipple to become dry, itchy, inflamed, crusted, or flaky. These conditions involve immune responses causing inflammation; contact dermatitis specifically results from exposure to irritants like chemicals in perfumes or soaps. In some cases, benign (non-cancerous) lumps or cysts within the breast tissue can cause localized pain or sensitivity, which may extend to the nipple area.
Though less common, certain serious conditions can also involve nipple pain. Inflammatory breast cancer, a rare and aggressive form, typically presents with widespread breast changes, including rapid swelling, redness, warmth, and skin resembling an orange peel, often without a distinct lump. Nipple changes like inversion or discharge can also occur. Paget’s disease of the nipple, another rare form, specifically affects the skin of the nipple and areola, appearing as a red, scaly rash that may be itchy, burning, or lead to nipple changes like flattening or discharge.
When to Seek Professional Medical Advice
It is important to seek medical advice when nipple pain is persistent, severe, or accompanied by other concerning symptoms. If the pain does not improve with self-care measures or lasts for several weeks, a healthcare professional should evaluate it. Sudden, severe, or debilitating pain also warrants prompt medical attention.
Particular associated symptoms indicate a need for professional assessment:
Redness, swelling, or warmth around the nipple that persists or worsens.
Any discharge from the nipple that is not breast milk, especially if it is bloody or pus-like.
The appearance of a new rash, skin changes such as dimpling, scaling, or crusting.
A nipple that becomes inverted or flattened.
A lump felt in the breast or under the armpit.
Systemic symptoms like fever or chills.
Unexplained nipple pain that interferes with daily life, sleep, or work.
Relief and Prevention Strategies
Implementing practical strategies can help manage and prevent nipple pain. Wearing supportive, well-fitting bras is often beneficial, as this can reduce friction and provide adequate support, especially during physical activity. Opting for bras made of breathable fabrics like cotton can also minimize irritation. For individuals experiencing pain during exercise, covering the nipples with waterproof bandages or using petroleum-based ointments can help prevent chafing.
For those experiencing pain related to breastfeeding, adjusting the baby’s latch is crucial. Seeking guidance from a lactation consultant can help ensure a proper, deep latch that covers both the nipple and a significant portion of the areola, reducing trauma. Varying feeding positions and ensuring the correct breast pump flange size can also minimize discomfort. Applying lanolin ointment or hydrogel pads to the nipples can provide soothing relief and aid in healing, particularly for cracked or sore nipples. Expressing a few drops of breast milk and air-drying it on the nipples after feeding may also offer antibacterial protection and promote healing.
Maintaining good hygiene is important for nipple health. Gentle cleansing with mild soap and water, followed by thorough drying, can prevent irritation and infection. Avoiding harsh soaps, perfumed lotions, or detergents known to cause skin sensitivities can reduce the risk of allergic reactions. If moisture is an issue, regularly changing breast pads or allowing nipples to air dry between feedings can be helpful. For general comfort, warm or cool compresses can be applied to the affected area to soothe pain.