Nipple Pain
Everyone experiences nipple pain differently. You might feel a shooting pain or an ache in one or both nipples. Or they might feel raw, sensitive to touch, or itchy.
Treatments for nipple pain can be as simple as finding a more comfortable bra or switching out your soap. But, in some situations, you may need to see a doctor.
Causes of nipple pain
Most of the time, there are simple explanations for why nipples hurt — for instance, sore nipples can be a sign of natural changes in the body. But in rare cases, nipple pain may point to a more serious condition, like breast cancer.
The first step to finding relief from nipple pain is to figure out what’s causing the pain. There are many reasons your nipples might hurt.
Hormonal changes
Nipple pain and sensitivity are common symptoms for people experiencing hormonal changes. People may experience sore nipples during puberty, in the days before a period, when changing birth control, throughout pregnancy, and in the early stages of menopause.
Irritation from clothes
Nipple skin is very sensitive. If nipples rub, or chafe, against clothing that doesn’t fit right, they can become irritated. Your nipples may be especially vulnerable to irritation if you run long distances or have recently ramped up your exercise routine. Pain caused by the friction between the nipples and clothing is called jogger’s nipple. If you have jogger’s nipple, you might experience rawness, tenderness, itchiness, or bleeding in one or both nipples.
Skin reactions
If you’re experiencing persistent itchiness, discoloration, redness, a rash, or inflammation on your nipples and areola (circle of darker skin surrounding the nipple), you may have nipple eczema. Eczema is caused by the breakdown of the outer layer of skin that keeps out bacteria and other irritants.
When you come into contact with a trigger, your immune system activates and creates inflammation, causing symptoms of eczema on your skin. Symptoms can appear on one or both nipples. An allergic reaction to soaps, laundry detergents, or lotions can also cause itchiness, stinging, or pain.
Infection
Mastitis is painful breast inflammation caused by an underlying infection. Bacteria can enter the breast duct (the thin tubes in the breast that can carry milk from the lobules to the nipple) through a crack in the skin or nipple pores.
Mastitis is most common in people who are breastfeeding, but it’s possible for people who are not breastfeeding to develop it as well. Mastitis can occur during breastfeeding when milk does not drain from the breast to the nipple properly.
Breast cancer
Paget's disease, also called Paget disease of the breast, is a rare type of breast cancer that affects the nipple and areola.
Symptoms of Paget’s disease include:
itching, tingling, or redness in the nipple or areola area
flaking, crusty, or thickened skin on or around the nipple
flat or inverted nipple
yellowish or bloody nipple discharge
Although some of these symptoms are common in eczema, eczema usually affects both nipples. Paget’s disease symptoms usually affect one breast and one nipple.
Diagnosing Paget’s disease usually involves a combination of tests, including a physical breast exam, mammogram, ultrasound or breast MRI, and biopsy. If you’re experiencing nipple discharge, your doctor will likely take a sample of the discharge.
Pregnancy and Breastfeeding
Normal breast changes from pregnancy and breastfeeding might include areola darkening; nipple sensitivity and soreness; cracked nipples; and clear, white, or pale nipple discharge. While cracked nipples are normal, the cracks make the nipple vulnerable to the environment. Bacteria can potentially enter and infect the nipple, leading to pain.
You may also experience nipple pain if your milk ducts become inflamed during breastfeeding, producing a milk bleb. A milk bleb is a small, white dot that can appear on one or both nipples.
Trauma
Like any part of the body, nipples can be injured. Piercings or sexual activity are potential sources of trauma. For people who are breastfeeding, breast pumps might cause nipple trauma if the flange or breast shield doesn’t fit properly or if you are excessively suctioning. The symptoms vary depending on the cause.
When to see a doctor about nipple pain
Some causes of nipple pain can be resolved by lifestyle changes or at-home remedies. However, certain symptoms are a sign that you should see a medical provider. Contact a doctor if:
You have bloody nipple discharge, especially if the discharge is from one nipple and occurs spontaneously (no squeezing or stimulation): this could be a sign of infection, Paget’s disease, or non-cancerous tumors
Your nipple becomes inverted: this could be a sign of Paget's disease or cancer in the area behind the nipple
Your nipple becomes inflamed, red, or scaly: these could be signs of Paget’s disease (usually affects one nipple) or nipple eczema
You have yellowish nipple discharge, painful swelling, skin blotches, or flu-like symptoms, like a high fever: these could be signs of infection
Your nipple has milk blebs: this could be a sign of inflammation
Nipple pain persists from trauma or signs of infection like swelling or pus are present
Treatments for nipple pain
How you treat nipple pain is based on what’s causing the pain:
Irritation from clothes: Applying moisturizer to your nipples can minimize rubbing against clothes. During exercise, wear a well-fitted, non-cotton sports bra. Sports bra fabrics are designed to avoid rubbing and absorb moisture.
Skin reactions: Use soap-free cleansers and fragrance- and dye-free moisturizers. Avoid scratching your skin, as that can damage the skin, allowing more contact with irritants. Doctors can also prescribe an anti-inflammatory ointment.
Hormonal changes: Nipple sensitivity can be reduced by minimizing rubbing against clothes and avoiding contact with irritants.
Infection: Infections are treated with antibiotics prescribed by a medical professional. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, and a warm water or non-flavored black tea compress can help manage pain.
Breast cancer: If you have breast cancer that’s causing nipple pain, possible treatments may include surgery, immunotherapy, chemotherapy, hormonal therapy, and/or radiation therapy.
Breastfeeding: If breastfeeding is causing nipple pain, try adjusting the child’s position at the breast. You can also gently clean the nipple with lukewarm water after breastfeeding and then air-dry it. If a food allergen is causing a skin reaction, the child’s mouth can be rinsed between eating solid foods or you can breastfeed before giving solid food.
Trauma: Nipple pain caused by trauma is usually temporary and should heal within a few days.