Nipples are one of the most sensitive parts of the body, so it is not uncommon for them to sometimes feel sore or painful. Whether it is a sharp nipple pain or more subtle pain, the following is a rundown of some of the most common causes. It is important to note that all of the below (with the obvious exceptions of the menstrual cycle, pregnancy, and breastfeeding causes) apply equally to men and women.
Friction
Maybe your bra is too loose or too tight or maybe you’re wearing a shirt that is too tight and made of itchy material. Any of these issues could cause already sensitive nipples to become irritated and sore. The issue is also common in athletes, such as runners and swimmers, who often have to apply lubricant or other material to their nipples to prevent chafing.
Menstrual Cycle
For some women, sore nipples and breast tenderness is a sign of an impending period. When the hormones estrogen and progesterone rise shortly before your period begins, it can cause your breasts to feel larger and heavier, making your nipples feel sore and painful. You’ll typically feel pain relief shortly after your period begins.
Pregnancy
The hormonal changes that come with pregnancy affect multiple parts of a woman’s body, including the breasts and nipples. It is important to know that breast enlargement and breast and nipple soreness are among the earliest signs of pregnancy.
Breastfeeding
If you are breastfeeding, nipple pain is unfortunately a common occurrence, especially in the beginning. Some women will feel a sharp pain in the nipple when the baby first latches on. If the baby latches correctly, then this pain will disappear after a few seconds. If your baby is not latching on properly, you may feel pain throughout an entire feed and beyond. The pain may be accompanied by cracked and bleeding nipples. It is important to differentiate this regular nipple pain from less benign causes, such as mastitis.
Infections
There are certain infections that can cause nipple pain, particularly in breastfeeding women. The two most common are:
- Mastitis: Mastitis is an inflammation and infection of the breast tissue, and it occurs most often in women who are breastfeeding. In addition to nipple pain and swelling, other symptoms of mastitis include a fever, chills, red streaks on the breast, warmth or burning feeling in the breast, and increased tenderness to the breast tissue.
- Thrush: Breast and nipple thrush is a yeast infection that tends to occur in breastfeeding women, particularly when the nipple is cracked or injured. Thrush can also occur after taking antibiotics. A sharp, stabbing, or burning pain in your nipple, itching, and a light colored or white nipple can indicate a yeast infection. Other symptoms include redness on the breast or nipple and/or dry flaky skin around the nipple.
Other common causes of nipple infection include bacterial infections after trauma, such as after a nipple piercing. If you think that your nipples are infected, it is important to see a doctor.
Skin Conditions
If your nipple pain is accompanied by flaking, crusting, or blistering skin in the area around your nipple, called the areola, you may have dermatitis. Dermatitis is a skin condition in which your immune cells create a localized inflammatory reaction. There are several different types of dermatitis. Contact dermatitis is caused by a reaction to an irritant that your nipples come in contact with, such as a detergent or soap. Atopic dermatitis (known as eczema) is a chronic, genetic condition, often associated with allergies and asthma. Eczema causes patchy areas of dry, flaky, and itchy skin, and is rarely confined to just the nipples alone.
Breast Cancer
Nipple pain on its own is very unlikely to be a sign of cancer. But, if you have nipple pain along with a new lump in your breast, bloody discharge from your nipple, if your nipple becomes inverted, or if there is a change in shape or size of one breast, you should check in with your doctor right away.
Paget’s Disease
Paget’s disease is a very rare type of cancer, affecting only 1-4% of people with breast cancer. Although the chances of your nipple pain being Paget’s disease are extremely low, it is worth mentioning to your doctor, particularly if you’re experiencing pain only in the left nipple or only in the right nipple. Like with other types of breast cancer, symptoms may include a flat or turned-in nipple, yellow or bloody discharge from the nipple, and/or a lump in the breast.