Itch you can’t scratch? We’ve all been there. An occasional itchy feeling is usually nothing to write home about, but when that itch is in an area with the thinnest, most sensitive skin—like your nipples or boobs—it can really be annoying. Especially if those itchy nipples just won’t quit. Itchy nipples can range from the unpleasant to the downright insufferable, and if you’re experiencing this issue combined with other symptoms as well, there’s a chance that your body is trying to tell you something. But what? It’s worth noting that most causes of itchy nipples are likely harmless. Everything from the wrong bra to the moisturizer you’re using can be causing you to scratch. If, however, the itchiness persists and/or is accompanied by additional symptoms, it’s important to seek a medical opinion. Wondering what itchy nipples indicate? Parade consulted both Melissa Kotlen, Lactation Consultant and Manager at Boram Postnatal Retreat, and Board Certified Dermatologist at Schweiger Dermatology and CEO and founder of AmberNoonErum N. Ilyas, MD, MBE, FAAD, to demystify nipple itchiness. Keep reading for 16 possible reasons for nipple itchiness.
16 Reasons Why Your Nipples Are Itchy
1. You need to moisturize.
Sometimes the simplest answer is the right one. Especially during the winter or when the air is particularly dry, you could be experiencing dry skin on your nipple area, which could very well be the cause of your itchiness. “Especially in colder weather when skin tends to be dry, our nipples can also take a hit,” Kotlen explains. “Our gut instinct is to warm up in a hot shower, but that can do more damage than good, drying our skin even more. Keep showers at a comfortable temperature and don’t linger for too long.” Treatment: Luckily, you likely won’t need to seek medical treatment if this is the issue. Simply moisturize more and like Kotlen recommends, don’t stay in the shower too long. Kotlen adds, “Using coconut oil on the nipple can help to retain moisture—plus, it has antibacterial and antifungal properties.”
2. You need to switch lotions.
Perhaps you’re already good about moisturizing but the lotion you’re using isn’t cutting it. You may just be allergic to your moisturizer, which again, is a relatively easy fix, all things considered. “Allergic reactions of the nipple are very common,” Kotlen says. “Soaps, lotions, and laundry detergents are the typical culprits.” Treatment: Switch out the product you think may be wreaking havoc on your nipples. “The safest bet is to switch to hypoallergenic, dye-free, and unscented products,” Kotlen says.
3. You have atopic dermatitis.
Maybe you haven’t heard of atopic dermatitis, but you probably have heard of eczema. According to NationalEczema.org, eczema is “an inflammatory skin condition that causes itchiness, dry skin, rashes, scaly patches, blisters, and skin infections.” Though there are seven different types of eczema, atopic dermatitis is one of them. And if you have eczema on your nipples, that very well could be the cause of your itchiness. “Eczema can cause painful or itchy nipples, " Kotlen explains. “Many people have typically suffered from dermatitis in other areas of the body, but the nipples are particularly sensitive.” Treatment: Eczema—or atopic dermatitis—surrounding the nipple or breast area will likely require medical attention. If you think eczema is the cause, consult your primary care doctor or dermatologist. Kotlen says, “Always alert your doctor or see a dermatologist to diagnose, but they will usually recommend a topical steroid to reduce the inflammation, crustiness, and itching. In addition, they may prescribe antibiotics (oral or topical) if there are open cracks and/or infection present.”
4. You have psoriasis.
Another skin disease that is known to cause a rash, itchiness, or even scale-like patches is psoriasis. According to The Mayo Clinic, psoriasis—a long-term condition that typically flares up in cycles—most often presents on the elbows, knees, scalp, and trunk (which refers to the chest, abdomen, pelvis, and back). Inverse psoriasis, though, usually attacks areas of the skin that have folds: the groin, butt, or breasts. Unpleasant factors like friction, sweating, and fungal infections can exacerbate or inflame symptoms associated with inverse psoriasis. “Psoriasis has been reported to affect the nipple in rare cases,” Ilyas explains. “Given the rarity of involvement of the nipple-areolar complex, medical attention should be sought to verify the diagnosis, especially in the absence of involvement of psoriasis elsewhere on the skin.” Though psoriasis of the nipples is rare, Kotlen recommends consulting your doctor to rule it out. Treatment: Consult your doctor if you think psoriasis might be the cause. In order to either rule out psoriasis as a cause or diagnose you with psoriasis, doctors usually do a biopsy, then examine the sample of skin. Most psoriasis treatments are topical and according to The Mayo Clinic can include everything from creams and ointments to light therapy, oral, or injection medications.
5. You have a yeast infection.
Believe it or not, yeast infections don’t just happen down below. According to Medical News Today, yeast infections can occur just about anywhere on the skin, though they are most likely to transpire wherever there are folds of skin. You may mostly hear about vaginal yeast infections, but it’s true, too, that breasts and nipple areas are also susceptible to yeast overgrowth. “Thrush is very common in breastfeeding mothers who had a vaginal yeast infection during delivery or who had antibiotics (for GBS positive or C/S prophylaxis),” Kotlen says. “It takes a while to clear up because it’s back and forth between mom and baby with a lot of harbored moisture. Other than itchy nipples, moms describe the feeling of cracked glass or pins and needles, and a burning sensation.” Kotlen adds that a yeast infection may also be coupled with symptoms like very red, pink, or white nipples, shininess, and pain. Treatment: Consult your OB/GYN if you are experiencing symptoms associated with a yeast infection—whether you are breastfeeding or not. If you are breastfeeding, consult a lactation consultation or OB. Diflucan, an antifungal medication that is taken orally, is usually the default treatment for a yeast infection in any area.
6. You’re pregnant.
Pregnancy can come with a slew of different “symptoms” or “side effects” that are tangentially related to, well, growing an actual human. The body goes through a host of changes—and not just on the outside but on the inside, too. During pregnancy, estrogen and progesterone levels can increase dramatically at different points. These spikes in hormones can affect everything from mood to fetus development. So, these changes are important! However, these drastic fluctuations in hormone levels can cause other uncomfortable side effects like itchy nipples. It’s annoying, sure, but for the most part, it’s perfectly normal. Not to mention, the average woman (who starts at an average, healthy weight) gains anywhere from 25 to 35 pounds during pregnancy. Like the rest of the body, the breasts may stretch as they grow larger. This, in combination with significant hormone changes, can also cause itchy nipples. “Hormonal changes and stretching skin of the breast can cause itchy nipples in pregnancy,” Kotlen explains. Treatment: You can most likely treat this cause at home with coconut oil or lanolin. If the symptoms persist, consult your OBGYN.
7. You’re breastfeeding.
As mentioned above, yeast infections are a common side effect of breastfeeding with one 2020 study showing that 34.55 percent of lactating women tested positive for Candida on their breasts. (And actually, 17.65 percent of non-lactating women, too.) “With all of the physical and hormonal shifts from pregnancy to postpartum, itchy nipples are a common occurrence, but the reasons can vary from sensitivity reactions to thrush,” Kotlen explains. As the Manager and Lactation Specialist at Boram Postnatal Retreat in New York City, the first of its kind postnatal care center in the country, Kotlen sees postnatal, breastfeeding women dealing with this issue somewhat frequently. “We’ve seen all these kinds of challenges crop up and are here to help guide and transition mothers, equipping them with the tools and know-how to take care of their baby and themselves with natural lactation and some of the side-effects that can result, such as itchiness,” Kotlen says. Treatment: Consult your OB/GYN or lactation consultant. If breastfeeding leads to a yeast infection, which can cause itchy nipples (see #5), your OB/GYN may prescribe Diflucan, an oral antifungal medication. According to Kotlen, treatment could also include applying Nyastatin ointment to the nipple area. Kotlen adds, “We also treat baby at the same time, so the baby would get Nystatin oral suspension.”
8. Your hormones are changing.
In most cases—whether you’re pregnant, breastfeeding, going through menopause, or experiencing your period, even—itchy nipples can often be traced back to changes in your hormone levels. For whatever reason! “Just as in pregnancy and breastfeeding, hormones cause itchy nipples in menopause,” Kotlen explains. “Skin is becoming thinner and drier as a result of the drop in estrogen [due to menopause].” If you have your period, you might also experience itchier nipples than usual. Again, that’s because your hormones are doing a lot of work during your time of the month. “It’s similar to pregnancy in that the breasts enlarge, albeit temporarily [during your period],” Kotlen explains. “That can cause itchy skin.” Not to mention, if you already struggle with eczema, changes in hormones can worsen these symptoms in both scenarios. “Nipple eczema can be exacerbated by changes noted during menses or menopause,” Ilyas says. Treatment: Kotlen warns not to linger in a hot shower and recommends moisturizing frequently with lotion specifically formulated for sensitive skin. Ilyas adds, “As these changes are likely more related to stretch on the thin skin of the areola, use of lanolin can help reduce the irritation experienced.”
9. You have hyperkeratosis.
Hyper—what? Hyperkeratosis is defined as “an uncommon, benign skin condition characterized by a warty thickening and pigmentation of the nipple, areola, or both.” This condition can cause the nipple and surrounding area to take on a wart-like appearance, developing thick, bumpy skin. This condition is extremely rare, but is most likely to develop during pregnancy. “Hyperkeratosis of the nipple can occur during pregnancy and results in thickened plaques on the nipples,” Ilyas says. “This can be itchy and irritating.” Treatment: Consult your OB/GYN, primary care doctor, or dermatologist if the skin in this area appears wart-like or feels rough or bumpy to the touch in addition to feeling itchy. According to Ilyas, the thickened plaques may need to be treated with retinoids or liquid nitrogen. In the most severe of cases, surgical removal may be the preferred treatment option.
10. You have a thyroid problem.
The thyroid, a butterfly-shaped gland located in the neck, is responsible for both the production and regulation of your thyroid hormones, which can impact everything from weight and mood to energy levels. Since hormone fluctuations play a big role in nipple itchiness, this syptom could potentially indicate an issue with the thyroid. The thyroid relases two hormones—thyroxine (T4) and triiodothyronine (T3). “Once again, those tricky hormones! When thyroid levels are low, you may have itchy nipples,” Kotlen says. According to Healthy Women, too low a dose of T4 can result in hypothyroidism. Symptoms of hypothyroidism can include depression, low body temperature, trouble remembering, muscle aches, and dry or itchy skin. If your T4 dose is too low—if you remain somewhat hypothyroid—you may experience symptoms of hypothyroidism (depression, low body temperature, dry or itchy skin, poor memory, muscle aches, slowed reflexes, among other symptoms).Sep 16, 2009 Treatment: An endocrinologist may check your thyroid hormone levels to see if a thyroid issue could be the cause. Medications, like Synthroid or a daily dose of synthetic T4, may be prescribed or, if you’re already on meds, be adjusted.
11. You have nipple adenoma.
Extremely uncommon, nipple adenoma is a benign tumor that can develop in the breast. According to the World Journal of Surgical Oncology, this condition is mostly seen in patients 40 to 50 years old and is paired with other symptoms like nipple discharge, erosion, and/or alteration. It’s also likely that there would be either a visible or palpable tumor located under the nipple. “[Nipple adenoma can occur] from a sensitivity of the skin involving the overgrowth of tissue,” Ilyas explains. “Any change in the nipple is reason for a doctor to evaluate to verify the diagnosis of adenomatosis. If there is a known adenoma and triggering itching, then medical intervention may be warranted to treat the tissue that is affected.” A nipple adenoma is an overgrowth of tissue—AKA a tumor—but it is benign, as in, non-cancerous. “Nipple adenomas are rare and often mimic malignancies,” Kotlen says. “There is usually a palpable lesion that is very itchy, swollen, and often eroded with discharge.” Sometimes, nipple adenoma comes up in breastfeeding women as it can be associated with lactiferous ducts, according to Kotlen. The lactiferous ducts—or milk ducts—transport breast milk to the surface of the nipple through a network of pores. Treatment: Kotlen recommends consulting a breast specialist or OBGYN in order to rule out any malignancies. If diagnosed with nipple adenoma, the most common treatment is surgical excision. However, other treatment options could include cryotherapy, Mohs micrographic surgery, and nipple splitting enucleation.
12. Your clothes (or bra, really) are uncomfortable.
Itchy nipples could also be the result of chafing. Is your bra really uncomfortable? Does your shirt rub up against you the wrong way? If you’re answering yes, your clothes might be the problem. “Bras have been linked to itching of the nipple either from the texture of the textile, type of textile, sweating that accumulated between the skin and the textile of the bra, lack of breathability or moisture-wicking of the fabric, or ill-fitting nature of the bra,” Ilyas explains. “If itching is noted consistently with a particular type of bra, it is worth looking for softer textiles that have moisture-wicking or breathability features.” But that’s not all. If your nipples tend to get itchy post-workout, your sports bra or exercise clothes could also be the cause of the discomfort. “Runner’s nipples is a thing!” Kotlen adds. “Any kind of friction can cause itching and burning. Make sure your bra fits well and if you are working out— especially running—use vaseline or nipple guards to protect.” Treatment: If symptoms are exacerbated by the wearing of certain clothes, stop wearing those clothes in favor of fabrics with more moisture-wicking and/or breathable qualities. Also, make sure you’re worrying the correct size bra and that it’s not irritating your nipple area. In the event that working out or running causes your symptoms to flare up, take Kotlen’s tip and use Vaseline or nipple guards to alleviate pain or discomfort.
13. You have a bug bite.
Mosquitoes don’t just bite on our arms and legs; those little buggers are willing to crawl anywhere on us to get a taste. Yep—even on your breasts! “Just like anywhere else on the body, bugs can nip your nips,” Kotlen says. Treatment: Kotlen recommends Hydrocortisone or calamine lotion to alleviate the itch. Ilyas adds, “A bug bite can certainly trigger itching of the nipple that can be treated with mild hydrocortisone creams or cooling the skin to reduce the swelling of the affected area.”
14. You’ve had surgery recently.
If you recently had breast surgery—lumpectomy, mastectomy, removal of non-cancerous lumps, breast reduction or augmentation, or reconstruction—it’s possible that itchy nipples could be a side effect of that procedure. For anyone who’s ever been in a cast after breaking an arm or leg, then you know; itching is a totally normal part of the healing process. “Just like any other wound that is healing, you usually notice the area begins to get itchy,” Kotlen says. “In that light, breast surgery can cause nipple itchiness because histamine is released to aid in the healing process.” Treatment: Ice the affected area frequently. Ilyas also adds to avoid excess friction or irritation to keep the discomfort at a minimum. Be sure to wear comfortable bras and clothing as you heal post-operatively.
15. It could be breast cancer.
Never diagnose yourself on the internet. If you are concerned about symptoms you might be experiencing, it’s best to consult your primary care doctor immediately. That being said, itchy nipples is a symptom that can sometimes be associated with a rare type of breast cancer. According to Ilyas, Paget’s Disease, a rare condition associated with breast cancer, is sometimes mistaken for nipple eczema or another kind of skin dermatitis. “I routinely advise patients, however, that if nipple eczema does not respond to prescription topicals, a biopsy may be warranted,” Ilyas explains. “There are forms of breast cancer such as Paget’s Disease that can appear similar to nipple eczema and may not appear on mammograms.” According to the National Cancer Institute, symptoms also associated with Paget’s Disease include tingling or redness in the nipple or areola, flaky, crusty, or thickened skin in the surrounding area, a flattened nipple or yellow or bloody discharge from the nipple. Of course, there’s a strong possibility that the tumor itself is benign. A tumor—either benign or cancerous—can result in itchiness. “Benign breast tumors can also present with itchy nipples,” Kotlen adds. “If you feel a lump, be in touch with your doctor and schedule a mammogram or breast ultrasound.” Treatment: Consult your OB/GYN or primary care doctor if you think you may have symptoms of breast cancer. Doctors may first start with a mammogram or ultrasound of the breast. A breast surgeon can also do a biopsy, where they will take a sample of the tissue and test it under a microscope, in order to rule out or diagnose.
16. You’ve had breast cancer and are now in the midst of radiation.
Alternatively, if you are a breast cancer survivor currently undergoing radiation treatment, it’s possible that radiation could also cause a flare-up of itchy nipples. While the most commonly known side effects of radiation include fatigue, hair loss, and nausea/vomiting, the skin of the treated area can also have a reaction. The American Cancer Society maintains that radiation of the breasts can result in symptoms like skin irritation, dryness and color changes, soreness of the breast, and swelling due to lymphedema. “Radiation impacts the skin appendages including sweat ducts, oil glands, and hair follicles,” Ilyas explains. “With reduced natural hydration of the skin, itching can follow.” “Radiation is very drying to the skin as it kills skin cells and itching occurs as the skin peels off. Doctors are aware of this and will typically give a heads-up that this will happen,” Kotlen says. “Staying hydrated is important.” And not just in the way of drinking water; Ilyas adds, “Routinely hydrating the skin with moisturizers can replace the moisture lacking in the skin that can trigger itching and irritation.” To avoid irritating the skin around the breasts, try to go without wearing a bra. If this isn’t possible, wear a soft cotton bra without underwires. Treatment: Kolten recommends staying hydrated by drinking ample amounts of water and also moisturizing the affected area. If symptoms are extremely uncomfortable, consult your doctor or oncologist, who may prescribe oral antihistamines or a topical corticosteroid. Next up, if your vagina is itchy, it could be because of one of these 20 reasons.
Sources:
Erum N. Ilyas, MD, MBE, FAAD, Board Certified Dermatologist Schweiger Dermatology, CEO and Founder AmberNoonMelissa Kotlen, Lactation Consultant and Manager at Boram Postnatal RetreatCandida albicans Mastitis in Breastfeeding Woman: An Under Recognized DiagnosisHyperkeratosis of the Nipple and AreolaAdenoma of the nipple projecting out of the nipple: curative resection without excision of the nipple, World Journal of Surgical Oncology
