Nipple pain in men can be a source of concern, yet it is a common symptom that is often not serious. Many causes of nipple discomfort are benign and can be managed with simple adjustments. Understanding the various reasons why nipple pain might occur can help men address their symptoms effectively and determine when medical evaluation is necessary.
Common Irritations
One of the most frequent causes of nipple pain in men is friction. Physical activities like running or cycling can lead to chafing, often termed “runner’s nipple,” where clothing repeatedly rubs against the nipples, causing soreness, tingling, or skin breakdown. Poorly fitting workout clothes or repetitive movements without adequate protection contribute to this discomfort. Friction from bedding or skin-on-skin contact during intimacy can also irritate the skin.
Skin conditions like eczema, contact dermatitis, or allergic reactions to detergents and fabrics can also cause nipple pain. These irritations may present with itching, redness, scaling, or cracks around the nipple. Superficial trauma, such as minor injuries or aggressive grooming, can cause pain due to the rich nerve and blood vessel supply in the nipple tissue. This pain is typically localized and resolves once the irritation source is removed.
Hormonal Changes and Glandular Enlargement
Hormonal fluctuations play a role in nipple pain and the enlargement of breast tissue in men, known as gynecomastia. Gynecomastia involves an increase in glandular breast tissue, distinct from pseudogynecomastia, which is an increase in fat deposits. This condition often results from an imbalance between estrogen and testosterone levels, where estrogen is relatively high or testosterone is low.
Gynecomastia is common during life stages like puberty, causing temporary nipple tenderness and swelling that usually resolves within months to two years. Aging can also lead to gynecomastia as testosterone declines. Medications, health conditions like liver or kidney disease, thyroid issues, or obesity can disrupt hormonal balance and contribute to glandular enlargement and pain. Enlarged glandular tissue can become tender or sensitive, leading to discomfort, particularly with clothing friction.
Inflammatory and Infectious Causes
Nipple pain can arise from inflammatory or infectious processes affecting the nipple or surrounding breast tissue. Mastitis, an inflammation of breast tissue, though more common in women, can occur in men. It typically presents with redness, warmth, swelling, and pain in the affected area, sometimes accompanied by fever or pus discharge. Infections can develop if cracks or openings in the skin allow bacteria to enter.
Folliculitis, an inflammation of hair follicles, can affect the skin around the nipple. It appears as red bumps resembling pimples and can be itchy or sore. It often results from bacterial infection, sometimes exacerbated by shaving or irritation. Abscesses, localized pockets of pus, can also form under the areola, causing significant pain, swelling, and sometimes fever. These causes often require medical attention to prevent complications and ensure proper treatment, typically with antibiotics.
Less Common but Concerning Possibilities
While most causes of nipple pain are not serious, some less common possibilities warrant attention. Benign growths, such as cysts or lipomas, can occasionally develop in the breast tissue and cause pain. Cysts are fluid-filled sacs that are usually harmless but can become sore. Lipomas are non-cancerous fatty lumps that typically do not cause pain unless they press on nerves.
Male breast cancer is a rare but serious consideration, accounting for less than one percent of all breast cancer diagnoses. While often painless, a firm lump behind the nipple can be a primary symptom. Other concerning signs might include nipple changes such as inversion, discharge (which may contain blood), skin dimpling, or a rash around the nipple area. Swollen lymph nodes in the armpit can also be an indicator. Recognizing these signs is important, even though such occurrences are infrequent, as early detection can improve outcomes.
When to Seek Medical Guidance
It is important to seek medical guidance when nipple pain is persistent or accompanied by other concerning symptoms. If the pain continues daily for more than a few days or weeks, or if it seems to be worsening over time, a medical evaluation is advisable. Specific “red flag” symptoms that warrant prompt medical attention include the presence of a new lump or thickening in the breast tissue, particularly if it is firm or painless.
Any changes to the nipple itself, such as inversion (turning inward), discharge (especially if bloody), or the development of a rash or scales around the nipple, should be assessed by a healthcare professional. Other signs like skin changes on the breast, such as dimpling or redness, or pain accompanied by fever or chills, also necessitate medical consultation. Professional diagnosis is essential to determine the underlying cause and ensure appropriate management.