What is nipple pain?
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Nipple pain can describe any discomfort in the nipple area and can result from mild physical surface abrasion from such activities as breastfeeding, engaging in physical activity (for example, exercise or jogging) without a bra, wearing a poorly fitted bra, or participating in any activity that produces friction on the skin of the breast.
Nipple pain can also be caused by specific disorders, particularly inflammatory disorders. Both mastitis (an infection and inflammation of the ducts of the breast) and breast abscess (a collection of pus located in a specific area) can result in nipple pain. These conditions are common in women who are breastfeeding.
A rare type of cancer, known as Paget’s disease of the breast (also known as Paget's disease of the nipple, or simply Paget's disease), can result in inflammation and pain that is particularly localized to the nipple area.
Ordinary soreness from surface abrasions should clear up within a few days. Inflammatory conditions will need more attention. if you experience any of the following symptoms: excessive cracking or open wounds on the surface of the nipple or areola; heat or redness in the nipple, breast tissues, or on the breast surface; nipple or breast pain on one side only; fever or chills; new, unusual, or changing lumps in the breast; nipple abscess or nipple discharge not related to breastfeeding, especially a brown or bloody discharge; or bleeding from the nipple.
If your nipple pain is persistent or causes you concern,
Symptoms
What other symptoms might occur with nipple pain?
Nipple pain may accompany other symptoms, which will vary depending on the underlying disease, disorder or condition. A few symptoms that affect the nipple may also involve other body systems.
Breast or nipple symptoms that may occur along with nipple pain
Nipple pain may accompany other symptoms affecting the nipple including:
- Bleeding from the nipple
- Breast lump
- Breast tenderness
- Change in the look and feel of the skin of the breast, such as dimpling or puckering
- Change in the size, shape or appearance of the breast
- Hardened area within the breast
- Nipple discharge
- Rash or sore on the breast or nipple; cracking or itching
- Redness, warmth or swelling
- Retracted (“caved in”) nipple
- Skin discoloration such as bruising
Other symptoms that may occur along with nipple pain
Nipple pain may accompany symptoms related to other body systems including:
- Fever
- Nausea with or without vomiting
Symptoms that might indicate a serious condition
In some cases, nipple pain may occur with other symptoms that might indicate a serious condition. For example, breast abscess can be a complication of mastitis and, left untreated, can spread into the bloodstream causing sepsis (a life-threatening bacterial blood infection) and potentially leading to organ failure. immediate medical care if you, or someone you are with, have a painful, possibly inflamed nipple or breast that has progressed to any of the more serious symptoms of sepsis including:
- Confusion or loss of consciousness for even a brief moment
- Fainting or change in level of consciousness or lethargy
- Shortness of breath
- Significant decrease in urine output
Causes
What causes nipple pain?
Nipple pain can occur as a normal symptom of the menstrual cycle as breasts, and sometimes nipples in particular, become more sensitive with changes in levels of the hormones estrogen and progesterone. Another frequent cause is nipple irritation or surface abrasion from friction with fabric if you don’t wear a bra or if you wear an ill-fitting bra.
A frequent cause of nipple pain is breastfeeding. The nipples can easily become dry and cracked. Furthermore, if the nipple surface becomes cracked, bacteria can enter and lead to an inflammatory disorder, which causes additional nipple and breast pain.
Friction causes of nipple pain
Nipple pain may be caused by abrasions due to friction including:
- Not wearing a bra, particularly during exercise or physical activity
- Rough handling
- Wearing an ill-fitting bra
Physical causes of nipple pain
Nipple pain can also be caused by physical changes including:
- Breast-alteration surgery
- Breastfeeding
- Drying or cracking of the nipple or areola
- Hormonal changes during the menstrual cycle
- Inverted or prominent nipple (normal conditions that can cause positional friction in some cases)
- Onset of puberty
Disorder-related causes of nipple pain
In some cases, nipple pain may be a symptom of a specific disorder. These include:
- Breast abscess or Zuska’s disease (rare condition of abscesses around the nipple)
- Breast and nipple inflammation (mastitis)
- Candidiasis
- Contact dermatitis
- Eczema
- Galactocele (a benign cystic tumor in the breast)
- Galactorrhea (spontaneous discharge of milk in a nonbreastfeeding woman)
Serious or life-threatening causes of nipple pain
In some cases, nipple pain may be a symptom of a serious or life-threatening condition including:
- Breast cancer
- Paget’s disease
Questions for diagnosing the cause of nipple pain
To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your nipple pain including:
- How long have you felt pain in your nipple? When did you first notice it?
- Does the pain occur in association with pain in another part of the breast?
- Does the pain occur cyclically? Does it come and go at predictable intervals, or is it constant?
- Is the pain bilateral or unilateral (occurring in just one nipple or in both)?
- Do you experience fever or chills with the pain?
- Do you have any other symptoms? Any redness? Heat at the site? Swelling? Hardening?
- Do you have any new or unusual lumps in your breast? Under your arms? In your neck?
- Do you have any nipple discharge?
- Have you experienced a recent injury to your nipple or breast?
- Have you ever had breast surgery?
What are the potential complications of nipple pain?
Complications of nipple pain are rarely life threatening. You can avoid complications related to any inflammation by treating the inflammation promptly. If you are breastfeeding, practice good hand and breast hygiene, especially around the nipple area, and continue nursing unless your physician orders otherwise. Often, nipple tenderness is greatly reduced by more frequent breastfeeding to relieve the milk ducts.
Because nipple pain can be due, in a few cases, to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including spreading of a malignancy (if present) or complications of untreated infectious diseases, which include:
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