Causes of nipple pain and how to treat them

Have you ever experienced a piercing and shooting nipple pain that takes your breath away for a moment in your nipple? Or sore and tender nipples that worsen with touch? And you might have wondered or still wondering why your nipples hurt.

Your nipples consist of sensitive tissues that even mild friction from clothing can irritate, making them sore and painful. Nipple pain is common in women though it can also affect men. In most cases, nipple pain is not a concern as they heal on their own and do not require treatment though you should see your doctor.

Sometimes, hard nipples or any symptoms associated with nipple pain because can be due to severe conditions like breast cancer. Some STDs like herpes and syphilis can also cause breast pain.

This guide will discuss the causes and treatment of nipple pain. Stay tuned.

What is nipple pain?

Nipple pain is the throbbing, tingling, aching, burning, and tender feeling of the nipple and the areola- the ring around the nipple due to factors like hormonal changes, piercing of the nipples, breastfeeding, etc.

Nipple pain is common in pregnant, menstruating, or breastfeeding women due to hormonal changes that come with these conditions. Nipple pain can also be due to other mild causes like allergy or friction due to clothing.

Symptoms of nipple pain differ from person to person, as some may experience hard nipples others may experience soft and tender nipples. Below are how some may describe their nipples:

• Aching
• Burning
• Tender
• Sore
• Red or swollen
• Itchy
• Throbbing
• Sensitive to touch

But, in general, nipple pain feels like:

• Piercing and shooting

Nipple pain can be sharp and stinging, and though they don’t last long, it can disturb you for a moment. Breastfeeding, infection, or cracked skin can trigger this kind of nipple pain. 

• Severe pain behind the nipple or breast

Pain behind your nipple or breast may not necessarily be due to nipple pain, and it can be due to life-threatening conditions like heart attack, blood clots in the lung, or problems with the aorta. 

If you experience pressure behind your nipples or breast, nausea, shortness of breath, or sweating, go to the emergency room immediately.

• Sore and tender nipples

This type of nipple pain aches or irritates and worsens when the nipple comes into contact with something. The leading causes are hormonal changes, friction from jogging or stimulation, pregnancy, and engorged breast in breastfeeding mothers, though other factors can also cause it.

Common causes of nipple pain and how to treat them

It can come with unbearable pain, whether a hard nipple or a soft and tender nipple. There are many common causes of nipple pain though they don’t pose a significant risk. However, you should not ignore nipple pain, especially if healing takes longer. You should see your doctor for further diagnosis and treatment.

Common causes of nipple pain include:

Jogger’s nipple

Jogger’s nipple is the pain due to rubbing of clothing against the chest, and it’s common in marathoners, those who frequently exercise, and those exercising in sweaty or wet clothing. It affects both male and female runners, especially the new ones. It causes tender nipples with sharp or shooting pain when having cracked skin, and it can also cause bleeding or red nipples.

Women runners should put on the right sports bra to avoid irritation of their nipples, while men can exercise with tops that aren’t too loose or rough. They should also cover their nipples with bandages.

Home remedies to manage and treat joggers’ nipples are applying petroleum jelly or antibiotic ointment on the affected nipples and then bandaging them to prevent chafing. See your gynecologist if your hard nipples don’t improve in a week.

Nipple piercing

Piercing your nipples can also cause nipple pain if there is an infection on the nipples or if they are irritated. If the piercing catches clothing or jewelry, it can cause trauma and skin tearing to the nipples, causing pain. Also, if you are allergic to the material used for piercing, you can develop hard nipples or tender ones which are painful to touch.

According to Dermatology Online Journal, 10-20 percent of nipple piercing leads to infections. 

Symptoms of nipple pain due to piercing include;

• Itching
• Redness
• Warm skin
• Shooting nipple pain
• Burning nipple pain
• Scaly skin
• Oozing drainage
• Fever
• Bleeding or cracking
• Body aches

Suppose the pain is due to an allergy. You can treat it at home by removing the object causing the allergy and applying hydrocortisone ointment to reduce inflammation and speed up healing. After healing, you can replace the piercing jewelry with another one you are not allergic to.

And if there is an infection causing hard nipples, see your doctor, who may prescribe oral antibiotics and nurse your injuries and tears with stitches. You should visit an emergency room if your symptoms are severe and cause fever and aches.

Infections

Suppose you have bleeding or cracked nipples due to allergic reactions or friction, or you are lactating or breastfeeding. In that case, you have a high chance of getting an infection due to the open skin, which allows bacteria or fungi to get in easily. The two common types of nipple infections causing hard nipples or tender and painful nipples include:

Mastitis

Mastitis or clogged milk duct occurs when the milk is blocked in one of the milk ducts preventing the milk from being expressed, thus creating a build-up of milk. Trapping the milk for a while leads to bacterial infection, causing mastitis, which is common in breastfeeding women but can occur in women who are not breastfeeding and men.

According to Sage Journals, more than half of breastfeeding women develop mastitis at least once. Besides hard nipples, other symptoms of mastitis include:

• Redness
• Fever
• Tiny yellow or white bump on the nipple
• Body aches
• Breast pain
• Warm breast
• Breast swelling
• Pain while nursing

You can treat a clogged milk duct at home by pumping your breast or breastfeeding until you unblock the affected area. You can also manage the pain by applying warm compresses, soaking your breast in warm water, and massaging the breast gently while pushing it towards the nipple. To ease pain and inflammation, you can also take ibuprofen.

See your doctor if you have severe symptoms like warm breasts or fever or don’t respond well to treatment. Sometimes, you might need to go to an emergency room if you feel very sick. If you leave mastitis untreated, pus can collect in your breast, causing an abscess.

Generally, treat mastitis with antibiotics, and you can continue breastfeeding even if you have an infection, as you cannot pass it to your baby.

Thrush

Thrush is a fungal infection caused by candida Albicans which can happen if you have a history of fungal infections, recently used antibiotics, or if there is damage to the tissues around your nipples, like cracks due to breastfeeding. The warm moisture in the breast provides a conducive environment for yeast growth.

A mother can pass thrush to her baby through breastfeeding, causing white spots on the baby’s inside cheeks. Likewise, babies can also pass this infection to their mothers through breastfeeding.

Thrush can cause hard nipples or soft and tender nipples, which are burning, stabbing, or shooting. It can also cause other symptoms like:

• Red nipples or breasts
• Dry skin around the nipples

You can treat thrush with antifungal medicine.

Folliculitis

Folliculitis is a common skin condition due to inflammation of the hair follicles. Shaving hair around the nipples can lead to ingrown hairs causing folliculitis, which can further get infected and cause nipple soreness.

You can treat nipple pain due to folliculitis by applying a warm, moist washcloth to the nipples. You can use antibiotics if there is an infection.

Breastfeeding

Breastfeeding is one of the most causes of nipple pain in the early stages of breastfeeding, usually a month. It can be due to an incorrect latch- the positioning of a baby on the breast. A baby who latches correctly accepts the entire nipple and areola in their mouth, while an incorrect latching is where a baby only sucks the nipple causing nipple sores and making breastfeeding extremely painful.

Using an incorrect breast pump flange or breast shield- a plastic piece fitting over the areola and nipple to pump breast milk can also cause hard nipples, which can be painful. Sucking your breast vigorously can worsen the situation by using a poorly fitted breast shield.

You should therefore ensure you acquire a breast shield that fits properly on your breast and adjust it to a more comfortable position to prevent the pain.

Another cause of nipple pain in breastfeeding women is babies starting to teeth because of the possible change in how they latch, and some even bite the nipple. Encourage your baby to take the nipple and areola at the back of their mouth to avoid biting you.

If your baby doesn’t take more of your breast into their mouth, they can press your nipples with force, restricting blood flow to the nipples, leading to vasospasm, causing the nipple to change color from white to red, then purple quickly.

The shooting pain due to latching disappears after a few seconds. Besides shooting, other symptoms include:

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

As the breast swelling reduces and you teach your baby how to latch properly, your nipple pain should improve. However, if the pain continues and makes breastfeeding challenging, consult a certified lactation consultant to help improve your positioning so the baby can latch properly.

You can also try at-home remedies like cold compresses, wearing a supportive bra, or lanolin ointment to soothe your nipples.

Pregnancy

Pregnancy causes many hormonal changes in the body, which can make the skin of the breast stretch and ankles swell to support the growing baby. This causes the breast to stretch, making it enlarged and sore- these are the first signs of pregnancy. It can also cause nipple tenderness. 

The other symptoms that you are pregnant include;

• Abnormally more urination
• Vomiting
• Morning sickness
• Missed periods
• Fatigue

The nipple tenderness may go away, but your breasts will continue to grow with the pregnancy, and they may leak fluid near delivery. To reduce pain, wear a bra that fits you well, warm showers and cold compresses, and apply moisturizing treatments like coconut oil or cocoa butter.

Hormonal changes

The hormonal changes, especially before menstruation, can cause nipple sores and tenderness. This is due to the increased estrogen and progesterone that draws more liquid to the breast, causing them to swell.

Other stages of life, like the beginning of puberty or menopause, can also lead to hormonal changes causing nipple pain as a side effect. Using hormonal birth control can also cause hard nipples and soreness.

The nipple pain due to hormonal changes like menstruation usually subsides after getting the period or shortly afterward. If it doesn’t, see your doctor.

Sexual contact

Touching and rubbing nipples during sexual activities can irritate them, especially if it is rough and vigorous. This mostly happens in women with sensitive nipples to touch or right before the period. You may experience a burning pain with nipples that are tender to the touch. Nipple pain during sexual activities can occur in both men and women.

Besides the burning pain, you may experience other symptoms like:

• Bruising
• Redness
• Cracking or bleeding

Sexual nipple trauma is usually temporary and heals on its own. However, you can speed up the healing process with at-home basic care, like using moisturizers or breast nipple guards to prevent friction. See your doctor if your nipples don’t heal after a few days or if you suspect an infection due to signs like warm skin, body aches, or fever.

While the nipples are healing, avoid stimulating them when having sex. You can explore other activities, sex moves, and positions and become gentle with the breast. You should note that you can contract some STDs through cracked nipples or those having open sores.

If you have to crack in the nipples, put on loose-fitting clothing, apply antibiotic ointments, and use a moisturizer like petroleum jelly. Bandage your nipples if the clothes rub against them, and take painkillers like ibuprofen to ease the pain.

Skin conditions

Skin conditions can also cause hard nipples, which can be painful. Common skin conditions causing nipple pain are contact dermatitis, allergic reactions, atopic dermatitis, or eczema. If they affect the nipple or breast, they can cause skin irritation causing flaky skin. 

Besides skin irritation, they can present other symptoms like:

• Cracking and bleeding
• Sharp or shooting pain with a cracked skin
• Tender nipples

Let’s look at the individual skin condition to learn more.

Allergic reactions

The pain is due to an allergy if you experience nipple irritation or sensitivity after recently using certain products like soaps, laundry detergents, lotions, or shampoos. If you are allergic to some of these products and use them on or around your nipples, they can irritate your nipples and cause red and itchy patches.

This type of skin condition is called contact dermatitis, and it mainly occurs when you use an irritant that triggers an allergic reaction in the skin, making the skin red. 

If your hard nipple and irritation are due to contact dermatitis, use fragrance-free and hypoallergenic products, which can be gentler on your skin. You can also try other at-home remedies, like applying petroleum jelly or hydrocortisone ointment on the nipples.

Atopic dermatitis

Atopic dermatitis or eczema is another common skin condition causing flaky, itchy skin. It occurs when there is an overreaction of your skin’s immune cells, causing inflammation. Atopic dermatitis can affect the nipples, areola, and breast.

Though atopic dermatitis is common, it is uncommon to cause nipple dermatitis. According to research, of those with atopic dermatitis, only 12-23% have nipple dermatitis.

See your dermatologist if your eczema doesn’t improve after taking medication for about a week.

Treating atopic dermatitis can be difficult as you may need prescription medications. You can use OTC medications like antihistamines or hydrocortisone ointment. See your dermatologist if your eczema doesn’t improve after taking medications for about a week.

Rare causes of nipple pain

There are uncommon but serious causes of nipple pain because they could indicate severe underlying conditions. Nipple pain due to these causes requires a proper diagnosis by a doctor.

See a doctor if your nipple pain causes abnormal discharge other than breastfeeding or any change in the shape of the nipples or breasts. Some rare causes of nipple pain include:

Paget’s disease

Paget’s disease is cancer affecting the milk duct and spreading to the nipples and surroundings. When this condition affects the nipples, it is called mammary Paget’s disease. Paget’s disease is rare cancer affecting only one side of the breast.

Its symptoms resemble atopic dermatitis or eczema with flaky, itchy, and red skin on and around the nipples. Eczema affecting the areola only cannot be a Paget’s disease because for one to have Paget’s disease, it must involve the nipple. Other symptoms of Paget’s disease include:

• A bump in the breast
• Bloody or yellow nipple discharge
• A flat nipple
• Breast with thick skin

If you have such symptoms, immediately see your doctor. Men can also develop Paget’s disease and if you see any nipple changes, see your doctor.

After diagnosis, your doctor can treat your condition through surgical removal of the nipple, areola, and some parts or all of the breast. After that perform, chemotherapy is to kill any cancer that may remain.

Breast cancer

It is uncommon for breast cancer to cause nipple pain, but it can, and knowing the warning signs is important. Some types of breast cancer, like inflammatory breast cancer, can cause nipple changes like redness and tenderness. Other breast cancer symptoms include:

• Unusual nipple discharge
• Swollen lymph nodes under your arm
• A nipple that turns inwards
• Burning nipple pain
• Itching
• Breast lump
• Flaking nipple skin

If you notice any of these symptoms, see your doctor. This is the same for men, who can also get breast cancer.

You can treat breast cancer through:

• Chemotherapy drugs
• Surgery
• Radiation
• Immunotherapy
• Hormone therapy
• Targeted therapy

Diagnosis

Sometimes, you can trace back to what causes your painful nipples to your period or any other obvious causes. If you can’t, you must see your doctor, who will ask about your symptoms and what triggers the pain. They will also examine your nipples and breasts; if you think you might be pregnant, they will do a pregnancy test to confirm.

If your doctor suspects cancer, they’ll perform the following tests:

• Mammogram. Your doctor will use an X-ray to check if you have cancer. 
• Ultrasound. Your doctor will use sound waves to check for changes in your breast. This device can tell if you have a hard nipple due to a solid lump which could be cancer.
• Biopsy. Your doctor will take a tissue sample from your breast and rake it to the lab for examination. 

When to seek medical attention

Some symptoms can imply a more severe problem, and ensure you see a doctor if you notice any of the following:

• Unusual nipple discharge
• A nipple that sunk into the breast
• Changes in the shape of the breasts, one or both
• Orange peel-like skin breast
• A hard breast lump that doesn’t move
• Nipple rush

Conclusion

Nipple pain is a condition that affects both men and women, but it is most common in women. Though nipple pain is normal and should not cause worry, some can be due to severe underlying conditions. There are common and uncommon causes of nipple pain.

 The common causes include hormonal changes, pregnancy, friction, nipple piercing, breastfeeding, etc. The rare causes of nipple pain are Paget’s disease and breast cancer.