Breast and Nipple Eczema: What Causes It and How Is It Treated?

Eczema is a common condition caused by damage to the skin barrier — the protective outer layer of skin that locks in moisture and keeps out bacteria and other irritants. The breakdown of the skin barrier can cause dry skin, rashes, and discoloration on the chest, breast, and nipple.

Breast eczema is usually caused by irritation from clothes, soaps, laundry detergents, or lotions, but it can be uncomfortable and cause distress. If you’re unable to identify your eczema triggers or avoiding them doesn’t seem to help, your healthcare provider may prescribe a medication (usually a steroid) to apply to the irritated area.

Breast eczema isn’t usually a symptom of breast cancer. However, if you are experiencing tingling, flaking, or crusting of the nipple, you should talk to your doctor to help rule out Paget disease — a rare breast cancer.

The exact cause of eczema is not known, but scientists believe that it’s likely a combination of factors, including genetics, immune response, the environment, and stress.

Genetics: Studies suggest that people with eczema have a mutation in the gene that creates a protein called filaggrin, which supports the skin barrier. Without enough filaggrin, the skin barrier becomes leaky, allowing moisture to escape and bacteria and viruses to enter. 

Environment: Allergens such as pollen, pet dander, and sweat can irritate skin, triggering eczema flare-ups. 

Stress: Studies show that stress can increase inflammation in the body, which may make eczema worse. 

Breast eczema, like eczema elsewhere on the body, is known for its uncomfortable symptoms:

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  itching

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  dry skin

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  redness

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  discharge

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  thick or leathery skin

There isn’t an official test for diagnosing breast eczema. If you think you have eczema on your breast, doctors will perform a breast exam and ask about your medical history.

There is no cure for eczema, but there are medications and lifestyle modifications that can help manage it. 

Identify and avoid eczema triggers: Triggers could include harsh soaps, certain laundry detergents, products with fragrances, stress, changes in temperature, sweating, and rough clothing.  

Avoid scratching your skin: Scratching can lead to further breakdown of the skin barrier and introduce additional irritants.

Practice a daily skincare routine: Bathing daily with soap-free cleansers followed by the application of fragrance and dye-free moisturizer can help to keep irritants off of your skin and moisture in.

If at-home remedies alone do not offer relief,  your doctor can prescribe medicines to treat troublesome symptoms. Typically, the doctor will start you on an anti-inflammatory ointment or cream — for instance, a steroid — which can be applied to the irritated skin area. There are other treatments available for more severe symptoms as well. 

There are other conditions that may cause rashes to appear on your breasts and nipples.

Paget disease: Paget disease is a rare kind of breast cancer. It presents as redness, soreness, and flaking that affects the nipple and can easily be mistaken for eczema or infection.

Breast cancer treatment: Rashes can be a side effect of chemotherapy, radiation therapy, hormonal therapy, targeted therapy, and pain medications. 

Psoriasis: Psoriasis is a scaly rash that can appear similar to eczema. However, psoriasis tends to show up as thicker, raised, well-defined patches of skin.