Eight causes of nipple pain

Causes

In this article, we look at some of the possible causes of nipple pain:

1. Friction

Friction is the most common reason for the nipples to be sore. Friction can occur if the nipples rub against a shirt or poorly-fitting bra, during sports activities, such as running, surfing, or basketball. This is known as “jogger’s nipple.”

Friction on the nipple can often cause soreness, a stinging pain, or even bleeding. The skin may also become dry or chapped.

Furthermore, longer periods of exercise mean extended periods of friction, too.

2. Infection

Nipples that have already been injured by friction, an allergic reaction, or are cracked or bleeding have a higher risk of infection. Lactation and breastfeeding may also increase the risk of infection.

It is possible to get a yeast infection of the nipples, which is a fungal infection caused by Candida albicans. This can be the result of damage to the surrounding tissue, recent antibiotic use, or when a person has a history of fungal infections.

A yeast infection, also known as thrush, at the nipples is often felt as a burning, stinging pain that does not go away by reducing sources of friction. The nipples may be bright pink and the areola may be reddish or flaky.

Those who breastfeed describe thrush as a sharp, hot pain that is felt immediately after the feed. Signs of the infection may also appear on their baby.

Mastitis is possible during pregnancy if milk becomes trapped in one of the milk ducts. Bacteria can start to grow in the duct and spread. This type of infection can cause a swollen, red, sore breast and nipple.

Mastitis needs to be treated with antibiotics. If it is left untreated, an abscess can form. Anyone experiencing the following symptoms, as well as nipple and breast pain, should see a doctor:

• fever or chills
• breast feeling warm to the touch
• skin redness on the breast and nipple
• irregular breast swelling

3. Allergy or atopic dermatitis

Pain and irritation accompanied by flaky, crusty, or blistering skin may be a sign of an allergic reaction or atopic dermatitis (eczema).

There are a variety of household products that can irritate the nipples or trigger flare-ups of existing skin conditions, such as atopic dermatitis. These include:

• body lotion
• laundry detergent
• soap
• shaving cream
• fabric softener
• perfume
• fabrics

Other signs of an allergic reaction include red or chapped skin around the nipple and areola, and persistent itchiness. In some cases, a rash may occur.

4. Sexual contact

Sexual activity can be another cause of nipple pain. Body friction or sexual activity that involves the nipples can cause soreness. This pain is usually temporary and is often treated by simply giving the nipples time to heal.

5. Hormonal changes

The normal hormonal changes in a female’s monthly cycle can also trigger nipple and breast soreness. These symptoms are usually felt in the days just before her period starts, when increases in estrogen and progesterone levels draw more liquid to the breasts and cause them to feel swollen.

The pain associated with hormonal changes usually subsides when the period begins. If this pain continues for more than a few days, a person may want to speak to her doctor.

6. Cancer and Paget’s disease

Some nipple pain and other symptoms can be a sign of issues such as cancer, although tumors do not usually cause pain. Nipple pain caused by cancer will often only affect one breast and nipple.

Paget’s disease is a rare type of cancer involving the nipple that commonly occurs alongside tumors in the same breast. People with Paget’s disease and breast cancer may experience other symptoms, including:

• a flattened or inverted nipple
• yellowish or bloody discharge from the nipple
• itching or tingling sensations
• reddish, flaky, crusty, or scaly skin around the nipple and areola

Paget’s disease and breast cancer are diagnosed by inspecting the affected cells. While Paget’s disease is rare, anyone who is uncertain about their symptoms should see a doctor.

7. Nipple pain during pregnancy

Nipple pain or soreness may occur during pregnancy. The breasts may become larger and feel sore. The nipples and areola may darken and ache, and small bumps may pop up around the nipples.

Well-fitting support bras may help reduce friction and ease soreness. Some people find it helpful to wear a supportive sleep bra overnight or apply a cooling gel pack. These items are also helpful for reducing nipple and breast pain after the baby is born.

8. Breastfeeding

Breastfeeding is a common cause of nipple soreness. This is mostly due to the latching technique of the baby. If the baby does not have enough of the breast in its mouth, the nipple will be up against the gum and hard palate. Babies should latch deep on the breast with the nipple at the back of the throat.

If a breast pump is used, this can also cause nipple pain. The pain may be caused by too much suction or using a nipple shield that does not fit correctly. Adjusting the breast pump to a more comfortable setting and acquiring properly-fitting nipple shields may help reduce discomfort.

An infant starting to teeth is another potential cause of nipple pain, as they may change how they latch on and even bite the nipple. To avoid an infant biting down as easily, they can be encouraged to take more of the breast into their mouth.

If a baby presses the nipple too hard between their gums and the roof of their mouth, it can restrict blood flow to the nipple. This can result in what is called a vasospasm, which is painful and causes the nipple to turn white, then red, then purple in quick succession.

Treatment

Nipple pain caused by friction may be prevented by wearing a properly-fitted sports bra, smooth synthetic fabrics, or by using protective products, such as rash guards, nipple shields, or surgical tape. Some creams, ointments, or moisturizers may also help reduce friction.

Those who are breastfeeding are encouraged to seek the assessment and care of a lactation consultant to help their baby establish good feeding habits. Many health insurance plans cover this health need.

A topical anti-inflammatory cream can treat minor cases of nipple eczema, but a person should speak to a doctor if the rash or redness increases, spreads, and does not respond to an over-the-counter treatment.

Nipple soreness caused by hormonal changes in menstruation or pregnancy may respond well to warmth or pain relievers, such as ibuprofen (Advil) or acetaminophen (Tylenol).

Breast cancer is frequently treated with surgery, radiation, and chemotherapy. Treatment of minor cases of Paget’s disease usually involves removing the nipple and using radiation therapy on the affected breast. Some cases may require the entire breast tissue to be removed.

Frequently asked questions

Below are some commonly asked questions about sore nipples.

What kind of breast pain indicates pregnancy?

Pregnancy can make the breasts feel sore or even tingly. The breasts may feel fuller or heavier as well.

Why are my nipples so sore but no cycle?

A person may experience sore nipples despite not having their menstrual cycle. Common reasons for this include friction caused by clothing during exercise, an infection, eczema, or sexual contact.

How early in pregnancy are nipples sore?

Some people experience tender, swollen breasts or nipples as early as 1 to 2 weeks after conception.

Why do my nipples hurt for no reason?

A person’s nipples may hurt for no apparent reason if they are experiencing hormonal changes, such as during menstruation or with pregnancy. Friction can also cause sore nipples. If a person regularly experiences nipple pain and cannot identify the cause, it is best to contact a doctor for advice. Underlying causes can include infection, allergy, and more.

What hormone causes sore nipples?

During a person’s menstrual cycle, an increase in estrogen and a decrease in progesterone can cause sore nipples. Estrogen levels can also increase during pregnancy, which may result in sore or tender nipples.

Summary

Common causes of sore nipples include friction caused by clothing during exercise, an infection, eczema, sexual contact, hormonal changes, pregnancy, and breastfeeding. In more serious cases, nipple pain may point to cancer or Paget’s disease.

In most cases, pain in the nipples is simple and will clear up once the cause is treated.

Anyone experiencing persistent symptoms should see their doctor to discuss diagnosis and the correct treatment.

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