Nipple crust is dried fluid, skin cells, or debris on or around the nipple. It can appear flaky, scaly, or hardened. While often normal, nipple crust can also signal an underlying condition. This article explores common causes, other potential conditions, and guidance on when to seek medical advice.
Common Reasons for Nipple Crust
Dried breast milk or colostrum is a frequent cause, particularly for pregnant or breastfeeding individuals. During pregnancy, colostrum, an early form of milk, can leak and dry on the nipple. Similarly, milk leakage between feeds can dry, leading to a visible crust. This is a common occurrence.
Beyond lactation, natural bodily secretions like sweat and sebum can accumulate and dry. Sebum, an oily substance from skin glands, along with sweat, can mix with dead skin cells and particles, creating a harmless crusty residue from normal skin function.
Physical irritation or friction can also lead to nipple crusting. Constant rubbing from tight clothing, ill-fitting bras, or vigorous activity can cause minor abrasions or chafing on the sensitive nipple skin. The body’s healing process for these small injuries forms a protective crust as the skin repairs itself.
Dry skin and certain dermatological conditions, such as eczema, may also present with nipple crusting. Eczema, an inflammatory skin condition, can cause the skin around the nipple to become dry, red, itchy, and flaky, often leading to crust formation. Minor trauma, like small cracks, can also heal with a crusty appearance.
Other Possible Underlying Conditions
Nipple crusting can signal an infection. Bacterial infections, such as impetigo, or fungal infections, like candidiasis, can cause the skin around the nipple to become crusted, often accompanied by redness, itching, or pain. An infection in the breast, known as mastitis, can also result in nipple discharge that may dry and crust.
Contact dermatitis is another condition where nipple crusting may occur. This inflammatory reaction happens when the skin comes into contact with an irritant or allergen, such as harsh soaps, detergents, or certain fabrics. The resulting inflammation can lead to itching, redness, and the formation of crusts on the nipple area.
Psoriasis, a chronic autoimmune disease, can also affect the nipple. This condition causes skin cells to build up rapidly, forming thick, silvery scales and red patches that can become crusty. While less common in this area, psoriasis can manifest on any part of the skin.
Paget’s disease of the nipple is a more serious, though rare, condition. This is a rare form of breast cancer that begins in the nipple and can spread to the areola. Symptoms often mimic benign skin conditions like eczema, presenting as flaky, scaly, crusty, or oozing skin on one nipple, along with itching and redness.
When to Consult a Healthcare Professional
While often benign, certain signs warrant medical evaluation. Consult a healthcare professional if nipple crusting persists or worsens despite home care. This may indicate an underlying issue needing diagnosis and treatment.
Seek medical advice if crusting is paired with unresolved pain, tenderness, redness, swelling, burning, or itching. Any unusual nipple discharge, especially if bloody, clear, or unusually colored, is a significant concern. Discharge from only one nipple is a particular red flag.
Changes in nipple appearance, such as inversion, new asymmetry, or skin thickening, necessitate a medical visit. A palpable lump or mass in the breast with nipple crusting requires immediate medical attention.
Seek medical advice if crusting does not respond to general hygiene or moisturizing practices. Any personal anxiety or concern about the symptom should prompt a consultation, as early diagnosis and intervention can be important.
Care and Prevention
Gentle hygiene is fundamental for managing and preventing benign nipple crusting. Wash the nipple area daily with mild, fragrance-free soap and warm water to remove debris and prevent build-up. Avoid harsh scrubbing, as this can exacerbate irritation.
After cleansing, apply a gentle, hypoallergenic moisturizer to prevent dryness and maintain skin hydration. Moisturizers support the skin’s natural barrier, reducing flakiness. For breastfeeding individuals, applying expressed breast milk after feeding can also provide moisture and soothing benefits.
Identify and avoid potential irritants. This includes harsh soaps, detergents, strong perfumes, or certain fabrics that may trigger contact dermatitis or skin irritation. Opt for breathable, loose-fitting cotton clothing to minimize friction and allow better air circulation, reducing chafing.
Resist picking at or forcefully removing crusts, as this can lead to irritation, skin damage, or infection. For new mothers, ensuring a proper latch during breastfeeding is crucial to prevent nipple cracks and soreness. Consulting a lactation consultant can help address latch issues and provide guidance on nipple care.