What Is Breast Eczema?
Eczema (also known as atopic dermatitis) is a painful and itchy skin condition resulting from damage to your skin barrier, the outer layer of skin that keeps moisture in and bacteria out. When eczema happens on your breasts, it causes dry skin, rashes, and skin color changes in this area.
What Is Nipple Eczema?
Nipple eczema causes an itchy rash on your nipples and the darker area surrounding them (called the areola). It's not contagious, but when eczema affects the sensitive skin around your nipples, it may put you at risk for other, more serious skin conditions.
What Causes Breast Eczema and Nipple Eczema?
Many things can cause or worsen eczema on your breasts or nipples, including:
Immune system issues. Your immune system may react easily to minor irritants or allergens, inflaming your skin.
Genetics. If your family has a history of eczema, you're more likely to get it. Your chances are higher if there's hay fever (allergy caused by pollen or dust), asthma, or allergens in your family history. Changes in your genes that affect skin health proteins may also be a reason for the condition.
Environment. Things in the world around you can irritate your skin. Tobacco smoke, air pollution, harsh soaps, wool fabrics, and certain skin care products can all cause issues. Dry air can make your skin dry and itchy, while heat and humidity can lead to sweating, which makes you more itchy.
Stress. Mental, physical, and emotional stress can trigger or worsen breast eczema.
Breastfeeding (chestfeeding). It can lead to a rash around your nipples, which can turn into eczema.
Symptoms of Eczema on Breasts and Nipples
Breast eczema symptoms
Symptoms of breast eczema include:
- Itchy skin
- Dry skin
- Rash
- Skin bumps
- Patches on your skin that feel leathery
- Crusty skin
- Swelling
Nipple eczema symptoms
Signs of nipple eczema may include:
- Dry, itching skin
- Patches that appear red, brown, or gray
- Tiny raised bumps that leak fluid when scratched or irritated
- Skin that grows thick and scaly, even forming scabs
- Raw, sensitive, swollen skin from scratching
- Nipple discharge
Nipple eczema vs. Paget's disease
Paget's disease is a rare breast cancer that causes the nipple skin to grow darker. Your nipple may itch, tingle, leak, and appear flaky or crusty.
Other conditions that may look like breast and nipple eczemas
You may have a more serious health condition that needs to be addressed. Eczema may look similar to other skin conditions, including:
- Inflammatory breast cancer: This aggressive form of breast cancer develops if cancer cells begin producing inside the lymph nodes of your breast. Symptoms include thickening of the skin, rash, infection, pitted skin, redness, and swelling.
- Mastitis: This condition is most common in breastfeeding mothers when milk ducts are clogged from an overproduction of milk. Your breast may swell and feel painful, be red and warm to the touch, and produce nipple discharge.
- Breast abscess: If you have a bacterial infection, it may cause pus buildup under your skin. Symptoms include redness, swelling, inflammation, fever, and warmth.
- Mammary duct ectasia: This noncancerous health condition happens when a milk duct stretches out, and the cell walls thicken. It may lead to a thick discharge, a noticeable lump, redness, and tenderness around the nipple.
Other conditions that may affect the breasts and nipples
Several skin conditions, apart from eczema, may affect your breasts and nipples. They include:
Breast Eczema and Eczema on Nipples Diagnosis
Your doctor can usually spot eczema by just looking at your skin. They may ask about your symptoms and check the skin around your nipples. They'll also look at other parts of your body for signs of eczema. Your doctor may suggest:
- Allergy testing to see if you’re allergic to specific substances or foods
- A complete blood count (CBC), which tests for infections and other health issues
- A skin biopsy to test for infection and look for the type of dermatitis you have
If you’re breastfeeding, make sure to tell your doctor. You are more likely to get mastitis, which is an infection of your milk ducts causing breast pain, redness, and swelling.
How to Treat Breast Eczema and Eczema on Nipples
Over-the-counter treatments
Taking care of your skin condition is the best way to improve your symptoms. Moisturize your skin at least twice a day using fragrance-free products such as:
- Creams
- Ointments
- Lotions
- Petroleum jelly
You can also take an over-the-counter antihistamine to ease itching.
Prescription treatments
Your doctor may suggest prescription medications to treat your eczema, including:
Steroids. These medications come as creams, pills, or shots. If you use them long-term, steroids can cause high blood pressure, weight gain, and skin thinning.
Topical immunomodulators. If other medications fail to treat your eczema, topical immunomodulators (TIMs) are another option. These drugs change the way your body responds to allergens. They also have fewer side effects than steroids.
Phototherapy. Doctors have found that ultraviolet light waves can treat eczema and other skin conditions. Phototherapy uses this type of light through a special lamp to ease eczema symptoms.
Biologics. These targeted drugs block a certain type of protein chemical messenger that leads to inflammation in people with eczema.
Topical calcineurin inhibitors. These medicines, which you apply to your skin, block calcineurin, a protein that promotes inflammation in eczema.
Diet changes
In some people, food allergens can cause eczema flare-ups. You may need to cut some things out of your diet such as:
- Soy
- Eggs
- Wheat
- Milk
Home remedies
To avoid stressing sensitive skin, you can also try:
- Shortening your time in the bath or shower
- Using warm instead of hot water
- Using gentle soaps with mild ingredients
- Avoiding antibacterial soaps and deodorants
- Applying moisturizer while your skin is still damp from the shower
- Discussing with your doctor how to take bleach baths
- Using skin products with ceramide, which can help replace your missing skin barrier
- Wearing cotton clothing and avoiding other fabrics, which can dry your skin
While you can't completely cure eczema, there are many treatment options to improve symptoms. If one treatment plan doesn’t work, you can try another until you find the right products and strategies for the severity and symptoms of your eczema.
Prevention of Nipple Eczema
Avoiding irritants. Finding a product that works best for you may take some trial and error, as certain products may contain irritating ingredients. Since the skin around your nipples is thin and sensitive, try a mild product. If you’re worried about a product irritating your skin, talk to your doctor about ingredients to avoid. Check all product labels for those ingredients before choosing one.
Remember that the products your loved ones use can also affect you. If you hug them, lotions, perfumes, and detergents may rub off on your skin and clothing. You should remove irritants from your home wherever possible.
Things that may worsen your eczema include:
- Dust and pollen
- Laundry detergents
- Sweat
- Stress
- Strong soaps
- Obesity
- Dehydration
- Sudden changes in temperature and humidity
- Wearing nonbreathable fabrics
While nipple eczema may be uncomfortable, it can be managed by considering several factors. By tracking when your skin improves or worsens, you may be able to track down your source of irritation. This process differs for everyone and may be sped up with a doctor's help.
Breastfeeding With Eczema
Here are some tips to avoid problems while breastfeeding with eczema:
- Apply expressed breast milk or edible oils such as sunflower, coconut, or olive oil to your nipples.
- Make sure your baby is latched well to your breast.
- Drink plenty of water.
- Apply heat to your breast before nursing or pumping.
If your nipples become sore or you get dermatitis, talk to your doctor. They may suggest pain relievers or NSAIDs or prescribe topical steroids. Be sure to apply a topical steroid right after you finish breastfeeding so your baby doesn't come into contact with it, and wipe your breast before breastfeeding again.
Takeaways
If you have redness, itching, and dryness on your breasts and nipples, talk to your doctor since these are common signs of eczema. Over-the-counter treatments and home remedies, such as avoiding irritants and wearing breathable fabrics, can ease painful symptoms. But if they don't help, prescription medicines such as topical corticosteroids are another option. If you're breastfeeding, apply treatments after nursing and clean the area before the next feeding to avoid affecting your baby.
