What's the Deal with Itchy Nipples?
As if the subtle ache and tenderness in your breasts that come with every period weren't torturesome enough, most women have had to put up with another uncomfortable sensation in their breasts at least once in their life: itchy nipples.
While you maybe haven't chatted with many other people about your itchy nipple issue, you should know: Itchy nipples (and areolas, the area around the nipple) are actually a fairly common condition for women, says Sherry A. Ross, M.D., ob-gyn and author of She-ology and She-ology: The She-quel.
But itchiness isn’t always the lone symptom. Depending on the cause, your (itchy) nipples may also feel tender or dry, have a burning or stinging sensation, appear pink or red, feel painful, or look cracked or crusted, among others, explains Dr. Ross. Oof.
So how can you tell if your ultra-itchy nipples are just a one-off occurrence or a sign of a more serious medical condition? Here, all the itchy nipple causes to keep on your radar, plus how to treat the itch without clawing at your chest.
Possible Causes of Itchy Nipples
Harsh or Fragrant Detergents and Soaps
The floral-scented detergent you use to keep your clothes fresh can be one of the most common culprits of itchy nipples, says Dr. Ross. When the chemicals in soaps, detergents, and fabric softeners are too harsh for your skin, they can create contact dermatitis, a condition in which the skin becomes red, sore, inflamed, or—you guessed it—itchy, according to the U.S. National Library of Medicine (NLM). Depending on the chemical's strength, you could see a reaction shortly after contact or after repeated use. (Related: The Truth About Sensitive Skin)
By the same token, you can also develop itchy nipples because of the fragrances in these products, which are common skin allergens. In that case, you may also develop a rash that feels warm and tender, has red bumps and weeping blisters (meaning, they release fluid), or becomes scaly or thick, according to the NLM.
To keep your nipples itch-free in the future, substitute your Hawaiian-breeze detergent or soap with a mild, unscented product, says Dr. Ross. And in the meantime, regularly wash the affected area with water to get rid of any traces of the irritant, according to the NLM. You should also keep your nipples hydrated and moisturized by adding extra virgin coconut oil to your warm water bathes, using lotions with vitamin E and cocoa butter (Buy It, $8, amazon.com), or applying a 1-percent hydrocortisone cream (Buy It, $10, amazon.com) to ease itchiness and other symptoms, explains Dr. Ross.
If you’re living life bra-free, your itchy nipples could be caused by whatever shirt you're wearing. Certain fabric fibers can create friction and physically irritate the skin, leading to itchy nipples and discomfort, explains Caroline A. Chang, M.D., F.A.A.D., a board-certified cosmetic and medical dermatologist. Most often, chafing will occur when you're wearing synthetic fabrics and wool, likely due to the larger size of the fiber, according to an article published in the journal Current Treatment Options in Allergy. However, the NLM suggests avoiding any coarse fabric altogether. Reason being: Superfine and ultrafine Merino wool garments, which have smaller fiber sizes, have been shown to create less irritation than large-fibered wool, according to the Current Treatment Options in Allergy article. (While you might not be able to figure out the exact fiber size of the yarn in your shirt, you can look to fabric stiffness and softness/prickliness as a good indicator: the smaller the fiber size, the softer the fabric and the easier it will drape, according to Biomechanical Engineering of Textiles and Clothing.)
When your nips are inflamed and itchy due to chafing, Dr. Ross recommends applying a topical antiseptic cream (Buy It, $4, amazon.com) to the affected area, which will help prevent infection and soothe skin. Then, to keep further chafing and itchy nipples at bay, make sure you’re wearing soft, cotton sports bras that are free of seam lines near your areola while exercising, says Dr. Ross. If you're lounging around, stick to wearing cotton and other soft-to-the-touch fabrics for undergarments and clothes, she adds. If that doesn’t do the trick, try covering your nipples with waterproof bandages or applying Vaseline to act as a topical barrier, she adds. (Prone to chafing? Read this complete guide to preventing and treating it.)
Your belly isn’t the only thing that swells while you’re expecting. During pregnancy, hormones estrogen and progesterone cause your breasts, nipples, and areolas to grow. All this extra skin hitting your clothing can create more friction and lead to irritated, itchy nipples, says Dr. Chang. Plus, your skin will stretch while your breasts expand, which can create an itching sensation, she explains. (Related: Exactly How Your Hormone Levels Change During Pregnancy)
Oftentimes, your itchy nipples during pregnancy will vanish after the baby is delivered, says Dr. Ross. But for the rest of your term(s), Dr. Chang recommends treating symptoms by wearing soft cotton clothing and moisturizing more frequently. Try using cocoa butter or Lanolin Nipple Cream (Buy It, $8, walgreens.com), says Dr. Ross.
A Yeast Infection from Breastfeeding
Surprise: Your vagina isn’t the only place you can get a yeast infection. Typically, your body has a healthy balance of bacteria that keeps Candida albicans, a type of pathogenic yeast, in check. When your bacterial balance is out of whack, Candida can overgrow and create an infection. And since it thrives on milk and warm, moist areas, you can develop an infection on your nipples or in your breast while breastfeeding, according to the NLM. Along with itchy nipples, you may also experience flaky, cracked, or sore nipples, and achy breasts, according to the U.S. Office of Women’s Health (OWH).
You can also pick up the infection from your child. Since babies don’t have fully formed immune systems, it’s more difficult for their bodies to prevent Candida from overgrowing, according to the NLM. When it builds up in the baby’s mouth and creates an infection (known as thrush), it can be passed to the mother.
To treat itchy nipples and the yeast infection, your doctor will likely prescribe you an oral medication or an anti-fungal cream, says Dr. Ross. You’ll rub it on your breasts several times a day for about a week, but it can take several weeks to completely clear up. So, it's important that you sterilize pumping equipment, wear a clean bra every day, and wash any towels or clothing that comes in contact with the yeast in very hot water to prevent its spread, according to the OWH. (Related: Is It Safe to Take Cold Medicine While Breastfeeding?)
If you’re one of the 30 million people who have eczema, your itchy nipples may be a result of the skin condition (which, BTW, is a generic term for skin dermatitis that causes inflamed red skin, dark-colored patches, and rough or leathery skin, among other symptoms). When eczema occurs on the nipple, you might develop a scaly and irritated rash on the areola, according to Breastcancer.org. “This rash can lead to itching, which can cause an itch-rash cycle,” explains Dr. Chang. Translation: Scratching that rash will only lead to more itchiness. Ugh.
To alleviate symptoms, the National Eczema Association recommends applying a nourishing moisturizer, such as one with ceramides (lipids that help skin retain moisture), to replenish the skin barrier throughout the day, applying cold compresses, and wearing soft, breathable clothing. But for a long-term management plan, make sure you see your dermatologist, says Dr. Chang. (Or, try one of these expert-approved eczema creams.)
Paget’s Disease of the Breast
While only 1 to 4 percent of all cases of breast cancer are Paget’s disease of the breast, it’s worth mentioning. With this rare form of breast cancer, malignant cells called Paget cells are found in the surface layer of the skin on the nipple and areola, according to the National Cancer Institute. Along with itchy nipples, you may also experience redness, discharge from the nipple, painful breasts, thickened skin that’s similar in texture to an orange peel, or an inverted nipple, explains Dr. Chang.
“If you're experiencing any of these symptoms, it's important to call your doctor immediately for further evaluation,” says Dr. Chang. The reason: Early symptoms of the disease can mimic those of eczema, so it’s often misdiagnosed. In fact, many people with the disease have symptoms for several months before being diagnosed, according to the National Cancer Institute.
Along with yeast infections, itchy nipples may also be caused by mastitis in breastfeeding women. This inflammatory condition occurs in the breast tissue and develops when a milk duct (the thin tube in the breast that carries milk from the production glands to the nipple) becomes blocked and infected, according to the National Cancer Institute. This can happen when the milk duct stops draining properly and the breast doesn't completely empty during feedings. What's more, mastitis can also occur when bacteria on your skin's surface or in your baby's mouth makes its way into your milk ducts through a crack in the skin of your nipple. Any breast milk that isn't emptied acts as a hotbed for the bacteria and causes an infection, according to the Mayo Clinic. (P.S. it can also be one of the causes of lumps in the breast.)
In addition to itchy nipples, you may feel breast tenderness, redness, swelling, or pain, says Dr. Chang. “Warm compresses may help in the early stages,” she says. “However, if symptoms worsen, then you should call your ob-gyn for further management.” From there, you’ll typically treat the condition with antibiotics and by draining any milk from the breast to relieve the blockage, according to the American Cancer Society. Good-ish news: You can continue breastfeeding while on the path to recovery, as it can actually help clear up the infection, and suddenly weaning your baby can worsen symptoms. (See also: Why Some Moms Experiences Major Mood Shifts When They Stop Breastfeeding)
When Should You See a Doctor About Itchy Nipples?
Even if you don’t think you’re suffering from Paget’s disease of the breast or mastitis, “you should see a doctor if the symptoms of itchy nipples worsen despite home remedies or have other concerning symptoms,” says Dr. Ross. That means if you’re noticing severe nipple tenderness, burning or stinging, dry, flaking nipples, red or white rash, nipple or breast pain, cracked, ulcerative or crusted nipples, and bloody or clear nipple discharge, it's better to play it safe by seeing your doctor.