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Nipple Pain

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Last updated April 22, 2022

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Both men and women can have nipple pain. It may be caused by eczema, nipple piercing, or friction during exercise. Women may notice it before their period, and those who are pregnant or nursing may also have nipple pain.

What is nipple pain?

Both men and women can have nipple pain, though some causes are unique to women. Nipples are made up of sensitive tissue that can be easily irritated—by friction from clothing like when jogging, or by a skin condition, like dermatitis.

In women, hormone changes, pregnancy, and breastfeeding can all trigger nipple pain.

Nipple piercings in men and women can also cause pain, especially if you have an allergic reaction or infection.

Some causes of nipple pain can be treated at home with over-the-counter (OTC) products such as hydrocortisone ointment. But if you have a nipple infection, you should see your doctor. You may need to be treated with antibiotics.

People often worry that nipple pain may be a sign of breast cancer. But this is not as likely, since nipple pain by itself is usually not caused by breast cancer. See your doctor if the nipple pain doesn’t get better or you have other breast symptoms like a lump or bloody nipple discharge.

Pro Tip

Clothes keep the nipples hidden, so sometimes people will put off a visit to the doctor when a nipple problem isn’t getting better. If you have nipple pain or a wound that isn’t healing with treatments at home, make that appointment to get checked out by a doctor. This helps identify serious issues and you’ll get additional treatment recommendations. —Dr. Anne Jacobsen

What nipple pain feels like

Piercing & shooting pain

The pain feels sharp or stinging and usually doesn’t last long, but it might take your breath away for a moment. It can be triggered by breastfeeding, cracked skin, or an infection of the nipple.

Sore & tender nipples

This pain feels like an ache or irritation, and it usually gets worse when something comes in contact with the nipple. It may be caused by friction (from jogging or stimulation during sex) or from hormonal changes, pregnancy, or engorged breasts in breastfeeding women.

Severe pain or pressure behind the nipple or breast

This may not actually be pain in your nipple, but may be caused by serious or life-threatening causes, like heart attack, problems with the aorta, or blood clot in your lung. Go to the ER if the pain is severe or it feels like an elephant is sitting on your chest, or if you also have shortness of breath, nausea, or sweating.

Common causes

1. Jogger’s nipple

Both male and female runners sometimes experience painful chafing of the nipples when clothing rubs against the chest. The nipples usually feel sore or tender, but the pain can be sharp or shooting if the skin is cracked. Jogger’s nipple is common in long-distance runners like marathoners, people who exercise frequently, and those exercising in wet or sweaty clothing.

Common: Jogger’s nipple occurs in 2–16% of marathon runners [Source: British Journal of Sports Medicine].

Other symptoms you may have:

Treatment and urgency: You can treat jogger’s nipple at home by applying antibiotic ointment or petroleum jelly on the nipples and covering them with bandages to prevent further chafing.

If symptoms don’t improve within a week, see a doctor or gynecologist. A well-fitting sports bra may prevent jogger’s nipple in women. Men may want to try exercising in a top that isn’t too loose or rough and covering their nipples with bandages.

2. Nipple piercing

Getting your nipples pierced can lead to pain if the nipples become irritated or infected. While any pierced area can become infected, it’s even more likely when the nipples are pierced.

Trauma and skin tearing can also occur if the piercing gets caught on clothing or other jewelry. Nipple pain can also develop if you’re allergic to the metal or plastic components of the jewelry used during the piercing.

Common: An estimated 10–20% of nipple piercings may become infected [Source: Dermatology Online Journal].

Other symptoms you may have:

Treatment and urgency: An allergic reaction to nipple piercing can be treated at home. Remove the piercing to allow the skin to heal and apply hydrocortisone ointment to the inflamed area (once you recover, you may be able to replace the piercing with jewelry made with a different metal).

If this doesn’t help, or if you have signs of an infection, see your primary care doctor or ob-gyn. Severe symptoms like fever and aches may require a visit to an urgent care center or the ER. Infections are treated with prescription oral antibiotics. Traumatic injuries and tears may need stitches and wound care.

Dr. Rx

If you have severe nipple or breast pain related to menstrual cycles, and over-the-counter medications don’t seem to be helping, ask your doctor about other treatments. Some women take prescription birth control pills for their added benefit of regulating the hormones that cause these painful symptoms. —Dr. Jacobsen

3. Pregnancy and menstrual cycle

Increased levels of the hormones estrogen and progesterone can cause nipple and breast pain in women. These surges can happen right before your menstrual period begins or in the first trimester of pregnancy. High hormone levels cause fluid retention, leading to breast swelling and heaviness. In most cases both nipples are affected.

Very common: About 68% of women have breast pain around the time of their period, while 76% of pregnant women report breast pain or tenderness in the first trimester [Sources: Journal of Psychosomatic Obstetrics and Gynecology; Journal of Clinical Nursing].

Other symptoms you may have:

Treatment and urgency: If nipple pain is triggered by menstruation, take ibuprofen (advil) or acetaminophen (Tylenol). Don’t use ibuprofen if you think you might be pregnant. If these don’t help, your doctor may recommend prescription birth control pills to help regulate your hormone levels and relieve symptoms.

Nipple pain during pregnancy is usually most noticeable during the first trimester and lessens a bit during the second trimester. Cold packs, warm showers, and taking acetaminophen can help, as does wearing a more supportive bra (or a sports bra) and loose-fitting clothing.

4. Breastfeeding

Nipple pain is common in the first few weeks of breastfeeding as your body adjusts to the process. Your breasts may also feel swollen and sometimes firm as your milk comes in. One or both nipples may be sore.

Some women may feel a shooting pain when the baby first latches onto the nipple to nurse, but this usually goes away after a few seconds. Severe shooting pain that lasts for more than a few days can be a sign of a more complicated problem, like a yeast infection of the nipple (thrush) or a problem with the baby’s latch onto the breast.

Common: About 79% of new mothers reported nipple pain before they were discharged from the hospital [Source: Breastfeeding Medicine].

Other symptoms you may have:

  • Sensitive nipples
  • Cracked nipples
  • Bleeding
  • Flaking skin on the nipple or breast

Treatment and urgency: Some nipple pain will get better on its own as breast swelling lessens and you learn how to help your baby latch properly. If the pain interferes with your ability to breastfeed, talk to your ob-gyn or see a certified lactation consultant, who can help improve positioning so your baby can latch onto your breast properly. At home, soothe your nipples with cold compresses, lanolin ointment, ibuprofen, and by wearing a supportive bra.

If the pain is caused by thrush, your doctor will prescribe an antifungal ointment for you and an oral antifungal treatment for your baby.

Go to the ER if you have nipple pain and develop a fever, body aches, or red areas on your breast.

Pro Tip

It’s actually safe and recommended to continue nursing your baby as often as possible if you have mastitis. It’s not dangerous to your baby, and frequent nursing helps empty your breasts and clear the infection. But ask your doctor if you’re having trouble managing the pain. Usually antibiotics and frequent feedings will help you feel better within a couple days. —Dr. Jacobsen

5. Clogged milk duct or mastitis

Breastfeeding women may develop a clogged milk duct. The clog prevents milk from being expressed and creates a buildup of milk behind the blockage, causing pain. A clogged duct sometimes leads to mastitis, a bacterial infection of the breast tissue. Rarely, mastitis can occur in men and in women who aren’t breastfeeding.

Common: About two-thirds of breastfeeding women experience clogged milk ducts at least once. Around 25% of women who were still breastfeeding at 26 weeks postpartum had mastitis, according to one study. [Source: Journal of Human Lactation].

Other symptoms you may have:

  • Tiny white or yellow lump on the nipple (if a duct is clogged)
  • Breast pain
  • Redness
  • Firmness in one area of the breast that may feel wedge-shaped
  • Fever
  • Body aches

Treatment and urgency: A clogged milk duct can be treated at home by continuing to breastfeed or pumping the affected breast to unblock the clog. To ease pain, apply warm compresses, gently massage the breast while pushing toward the nipple, and soak the breast in warm water. Taking ibuprofen will also help relieve inflammation and pain.

See your doctor if these treatments don’t work or if you have symptoms of mastitis, like warmth on your breast or fever. Some women with mastitis may feel very sick and need to go to the ER.

Mastitis is treated with oral antibiotics. It’s important to continue breastfeeding while you have the infection (it has no effect on your baby).

6. Skin conditions

Some common skin problems, such as allergic reactions (contact dermatitis) and eczema, can cause nipple pain in men and women if the nipples are affected. Both conditions usually cause flaky and irritated skin around the breast and nipple. In most cases, other areas of the body are affected as well.

Uncommon: Atopic dermatitis affects 1 in 10 to 14 adults, but nipple dermatitis is much less common, occurring in 12–23% of those with atopic dermatitis. [Sources: JAMA Dermatology; Journal of the German Society of Dermatology].

Other symptoms you may have:

  • Nipple tenderness
  • Pain that may be sharp or shooting if the skin is cracked
  • Cracking and bleeding (in severe cases)

Treatment and urgency: Contact dermatitis often gets better with minimal home treatment such as avoiding the allergic trigger, using unscented soaps and detergents, and applying hydrocortisone ointment or a thick lotion like petroleum jelly to the nipples.

Eczema can be difficult to treat and may require prescription medications. Try using an over-the-counter hydrocortisone ointment or an oral antihistamine like diphenhydramine (Benadryl). See a primary care doctor or a dermatologist if your eczema doesn’t get better after treating it for a week.

7. Pain during sex

Nipple touching and rubbing during sexual activity can irritate your nipples. You may be more likely to have this reaction when your nipples are more sensitive, such as right before your period. The pain usually feels like burning and the nipples are tender to the touch. This can occur in both men and women.

Other symptoms you may have:

  • Redness
  • Bruising
  • Cracking or bleeding

Treatment and urgency: Most of the time, minor nipple trauma will get better on its own with some basic care at home. See your doctor if the nipple doesn’t heal within a few days or if there are signs of infection like fever, spreading redness or warmth on the skin, or body aches.

Avoid further nipple stimulation until the nipple heals. Wear loose-fitting clothing, use petroleum jelly as a moisturizer, and apply antibiotic ointment if cracking occurs. Cover the nipple with a bandage if your clothes rub against it. Take ibuprofen (Advil, Motrin) if the pain is severe.

8. Breast cancer

Breast cancer usually doesn’t cause nipple pain if no other breast symptoms are present. But there is a rare form of breast cancer called Paget disease that mainly affects the skin of the nipple and the darker area around it (the areola). Paget disease can sometimes be confused with skin conditions like eczema because it causes flaky, crusty skin on and around the nipple.

Common: While breast cancer is fairly common, it’s uncommon for nipple pain to lead to a diagnosis of breast cancer. Only 7% of patients diagnosed with breast cancer reported nipple abnormalities, including pain. Breast cancer is more common in women but it can also occur in men. [Source: Cancer Epidemiology].

Other symptoms you may have:

  • Tingling or burning nipple pain
  • Itching
  • Redness
  • Flaking or scaly skin on the nipple
  • New nipple discharge, including bloody nipple discharge
  • Nipple that becomes flat or inverted
  • Breast lump

Treatment and urgency: See a doctor right away if you have a new flat or inverted nipple, bloody nipple discharge, or a breast lump. Sometimes a skin problem on the breast or nipple can be an early sign of breast cancer.

Breast cancer treatments include surgery, chemotherapy, and radiation. The exact treatment plan depends on the type of breast cancer and how advanced it is.

How to relieve sore nipples

  • Wear bras that are supportive, comfortable, and don’t irritate the nipples. Get a professional fitting at a department store if you have trouble finding a well-fitting bra.
  • For jogger’s nipple, apply a lubricant like petroleum jelly or anti-chafing products on the nipples to reduce friction caused by your shirt. Or cover your nipples with bandages before you exercise.
  • For contact dermatitis or eczema, applying hydrocortisone ointment or petroleum jelly to the nipples may be recommended. Antibiotic ointment may be used for mild infections. Topical antifungals are used to treat thrush.
  • Avoid detergents or bath soaps that may be irritating your nipples.
  • Take over-the-counter acetaminophen or ibuprofen for the pain.
  • Antibiotics may be prescribed for infections such as mastitis and those related to nipple piercing.
  • Apply hot or cold compresses on the breast and nipple to reduce swelling or pain.
  • Use proper breastfeeding techniques. If your pain is caused by breastfeeding, try pumping your breast milk to prevent engorgement or see a certified lactation consultant.
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Dr. Jacobsen is a board-certified Emergency Medicine physician and writer for Buoy Health. She received her undergraduate degrees in Chemistry and Biology from Macalester College (2006) and graduated from the University of Kansas School of Medicine (2010). She completed an Emergency Medicine residency program at the University of Missouri-Kansas City (2013). She practices community Emergency Medic...
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