Why Do My Nipples Hurt?

Nipples are sensitive, and they can hurt for lots of reasons. Tight clothes, rashes, and infections can all irritate the tender skin. For women, sore nipples are common during periods, pregnancy, and breastfeeding.

Any pain in your nipples can make you wonder if you have breast cancer. It's rare for it to be the main symptom of the disease, but you should still see your doctor to have nipple pain checked out if it doesn't go away.

Here are some of the most common causes of nipple soreness and how to treat them.

Poorly Fitting Clothes

A loose shirt or bra can rub against your nipples and irritate your skin, especially with repeated motion like long-distance running. Too much friction could make your nipples bleed.

Avoid this problem by wearing tops and bras that fit you well. Before you run, cover your nipples with waterproof bandages or nipple guards to protect them.

When chafing causes soreness, apply an antibiotic ointment. Then cover the nipple with sterile gauze.

Skin Conditions

Soreness plus an itchy rash and swelling around your nipple could be signs of skin irritation called dermatitis. Allergies and irritants in your environment cause this common condition.

  • Eczema, also called atopic dermatitis, happens because of dry skin, genetics, and problems with the immune system.
  • Contact dermatitis starts when something touches your skin and irritates it, like a chemical in perfume, soap, or jewelry.

Treating eczema will ease any soreness it causes. Your doctor might give you:

If your dermatitis is caused by an allergy or irritant, your doctor may suggest antihistamine pills, moisturizer, and a corticosteroid cream for your skin. An oatmeal bath can ease soreness, too.

Call your doctor if your symptoms don't get better in a couple of weeks or if they get worse. Also call if you have these signs of an infection in your nipple:

  • Fever
  • Pus
  • Severe pain
  • Redness that doesn’t get better

Menstrual Periods

Sore nipples and breasts can be signs that your period is coming. Rising estrogen levels cause breast tissue to swell. The pain should stop once you get your period or shortly afterward.

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Pregnancy

Hormone changes also cause nipple tenderness during pregnancy. But the main signs that you're pregnant include:

Your breasts and nipples will also swell. They may leak fluid as you get closer to delivery.

Choose a maternity bra that fits well. If your breasts really hurt, ask your doctor which pain relievers are safe for you to take during pregnancy.

Breastfeeding

As your baby latches onto your breast, you may feel a short burst of pain in your nipple. The pain should stop after a few seconds.

If your baby doesn't latch on correctly, the pain could last through the whole feeding. It might feel like a sharp pinch. Your nipples can also crack and bleed.

Your symptoms should get better as your baby gets the hang of feeding. But there are a few ways you can ease soreness:

  • Gently squeeze out a few drops of milk and rub them over your nipples to soften them before you nurse.
  • Put a balm or ointment, such as lanolin, on your nipples.
  • Let your nipples air dry after each feeding. Change your breast pads often to keep them dry.
  • Wear a comfortable cotton nursing bra. Make sure it fits well so it doesn't rub against your nipples.
  • Try different feeding positions until you find one that's comfortable.

If you’re having trouble getting a good, non-painful latch, your doctor or a lactation consultant can help you and your baby make some adjustments to make you more comfortable.

Infections

Intense pain in your nipple could be a sign of an infection.

Mastitis is an infection of the milk ducts. It happens when bacteria grow inside blocked ducts. It's most common during breastfeeding, but women can get it during other times of life. Men can sometimes have mastitis, too.

Other symptoms are:

  • A fever of 101 F or higher
  • Chills
  • Redness or red streaks on the breast
  • Warmth or burning in the breast
  • Swollen breasts

You'll need antibiotics to treat the infection. Make sure to take the whole dose your doctor prescribes, even if you start to feel better.

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Thrush is a yeast infection of the breast and nipple that can happen when you’re breastfeeding, especially if you have cracks in your nipple. You can also get it after you've taken antibiotics.

Pain from thrush feels like a stabbing, shooting, or burning in your nipples. You might also see:

  • Redness on your nipples or breast
  • Dry or flaky skin around the nipple

Your baby can catch thrush while breastfeeding, or he can pass it to you. It can look like a white coating on his tongue and cheeks.

Antifungal medicine treats thrush. Your baby will also need treatment if he's infected.

Breast Cancer

Any pain in your breast could make you worry about breast cancer. Although nipple pain can be a sign of the condition, it's rarely the main symptom. You're much more likely to have a painless lump in your breast.

Other symptoms of breast cancer include:

  • A nipple that turns inward
  • Redness or scaling of the skin over the breast or nipple
  • Discharge from the nipple that isn't breast milk
  • Swollen lymph nodes under your arm

Call your doctor if you notice any changes like these in your breasts. Men should stay alert too, because they can also get breast cancer.

Breast cancer treatments include:

Paget's Disease

The odds of nipple pain being Paget's disease are very low. This rare cancer affects only 1% to 4% of people with breast cancer.

Paget's usually affects only one breast. It looks a lot like dermatitis, with red, flaky, and itchy skin around the nipple. It may also cause symptoms like:

  • A flat or turned-in nipple
  • Yellow or bloody discharge from the nipple
  • A lump in the breast
  • Thickened skin over the breast

See your doctor for symptoms like these. Men can get Paget's too, and they should also ask the doctor about nipple changes.

Doctors treat this cancer with surgery to remove the nipple and the colored area around it, called the areola, along with part or all of the breast. Radiation or chemotherapy afterward kills any cancer cells that are left behind.

WebMD Medical Reference Reviewed by Nivin Todd, MD on October 23, 2018

Sources

SOURCES:

American Academy of Dermatology: "What is eczema?" “Contact dermatitis.”

American Cancer Society: "Breast Cancer Signs and Symptoms."

Australian Breastfeeding Association: "Sore/cracked nipples."

Breast Cancer Care: "Breast changes during and after pregnancy."

Cancer.Net: "Breast Cancer: Treatment Options."

CDC: "How Is Breast Cancer Treated?"

Cleveland Clinic: "Thrush."

KidsHealth: "Breastfeeding FAQs: Pain and Discomfort."

Mayo Clinic: "Contact dermatitis: Symptoms & causes," "Dermatitis: Diagnosis & treatment," "Dermatitis: Symptoms & Causes," "Mastitis: Diagnosis & treatment," "Mastitis: Symptoms and Causes," "Paget's disease of the breast: Diagnosis & treatment," "Paget's disease of the breast: Symptoms & causes," "Symptoms of pregnancy: What happens first."

National Cancer Institute: "Paget Disease of the Breast."

NHS: "Breastfeeding and thrush," "Sore or cracked nipples when breastfeeding."

Ochsner Clinic Foundation: "How to Avoid Nipple Chafing While Running."

Susan G. Komen: "Warning Signs of Breast Cancer."

The Royal Women's Hospital: "Breast & nipple thrush." "Breast soreness."

UpToDate: “Common breastfeeding problems.”

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