Eczema On Nipples

Eczema On Nipples
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Eczema or dermatitis,

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Atopic dermatitis of the nipple,

Allergic contact dermatitis of the nipple,

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Chronic dermatitis of the nipple

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Nipple eczema

Authors: Nicole S Kim, Medical Student, University of Toronto, Canada; Dr Yuliya Velykoredko, Dermatology Resident, University of Toronto, Toronto, Canada. DermNet NZ Editor in Chief: Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Gus Mitchell/Maria McGivern. September 2018.
Nipple eczema is a localised dermatitis involving the nipple and areola and is characterised by erythema and scaling . It may be itchy and painful. Nipple eczema can be a local manifestation of atopic dermatitis/eczema when it arises with classic age-related patterns of eczema on other body sites, or it can occur in isolation.
Nipple eczema can occur in anyone as a solitary condition; however, it often occurs in patients with current or past eczema elsewhere. Nipple eczema is mostly diagnosed in teenage girls, regardless of any prior history of atopic dermatitis , but it can also affect infants, children, and older men and women. Nipple eczema may occasionally affect non-atopic breastfeeding women [1,2]. [see Lactation and nipple problems ]
A genetic predisposition and environmental triggers cause nipple eczema. It occurs in the context of different types of dermatitis , mainly, atopic dermatitis , irritant contact dermatitis , and allergic contact dermatitis .
Nipple eczema most commonly affects the skin of one or both areolae , but the part of the areola at the base of the nipple and the nipple itself are usually spared. Nipple eczema rarely extends into the periareolar skin (around the areola) or to the rest of the breasts.
Acute nipple eczema can present with erythematous papules and plaques , with vesicles , oozing, crusting , or erosions . Chronic nipple eczema has a dry, scaly appearance, with lichenification on an erythematous or hyperpigmented base. Nipple eczema is often itchy and painful, especially in breastfeeding women [3,4].
Secondary bacterial infection may occur, due to fissures and the compromised skin integrity in nipple eczema. Colonisation with Staphylococcus aureus can be further complicated with mastitis or breast abscess if not treated promptly.
Other complications include the rare side effects associated with the therapeutic agents used for nipple eczema, such as atrophy from the excessive use of potent corticosteroids or folliculitis from an occlusive emollient [3,4].
The diagnosis of nipple eczema is made clinically. Occasionally, other tests may be required.
Other conditions that should be considered in a patient with nipple eczema include:
A diagnosis of allergic contact dermatitis should be considered if there is a minimal response to conventional treatment methods for nipple eczema, especially in patients with bilateral lesions extending beyond the areola. Mammary Paget disease , a slow-growing cutaneous form of intraductal carcinoma , should be ruled out in an adult with a unilateral and chronic eczematous lesion of the nipple persisting for more than three months that has not improved after using a topical steroid .
Other rarer conditions that may be mistaken for nipple eczema include erosive adenomatosis , psoriasis , Hailey–Hailey disease , and pemphigus . Skin cancers (eg, intraepidermal squamous cell carcinoma , basal cell carcinoma , and malignant melanoma ) should be ruled out when there is a reasonable degree of suspicion [4].
The multifactorial causes of nipple eczema should be addressed. The prevention of recurrence is key, and patients should be encouraged to avoid precipitating irritants and allergens where these are known. Routine skin care should include moisturisers , as these will help restore the skin’s normal barrier function and reduce pain and itch [3,4].
Topical corticosteroids (especially in ointment formulation ) are the mainstay of treatment for most cases of nipple eczema. They work well and are easily absorbed by the thin areolar skin.
In breastfeeding women with nipple eczema, topical steroids should be applied after breastfeeding the infant. Before nursing, these should be then wiped off to avoid potential steroid-related adverse effects by expressing breast milk from the breast and using it to wipe off the steroid ointment; the fat contained in the milk may help retain moisture in the nipple and minimise dryness.
Systemic steroids are rarely necessary for eczema confined to the nipple or the skin of the breast.
Topical calcineurin inhibitors (eg, tacrolimus and pimecrolimus ) are also useful, but there is little information in the literature about the potential side effects on the breastfed infant.
Secondary bacterial skin infection ( S. aureus ) should be treated with antibiotics . Systemic antibiotics have shown better eradication of infection compared to topical antibiotics; they are also less likely to induce methicillin-resistant bacteria and are less likely to result in antibiotic allergy [3].
Pain or burning discomfort of the nipples can be relieved by taking paracetamol; this is generally safe in a breastfeeding mother [1,4].
Nipple eczema tends to run a chronic course with varying degrees of relapse and remission . The aim is to prevent exacerbations by identifying and avoiding precipitating factors.
Patients should be educated on basic skin care. Mild nipple eczema can generally be well-controlled with the avoidance of soap , the application of liberal emollients , and the intermittent application of a topical steroid when the eczema is active [3,4].
DermNet NZ does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice.
© 2022 DermNet New Zealand Trust.
DermNet NZ does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice.

Medically Reviewed by Dan Brennan, MD on April 14, 2021
Eczema is a noncontagious skin condition that is painful and itchy. It is often harmless, although it can be uncomfortable physically and emotionally for the individual who has it. When it affects the sensitive skin around your nipples, it may leave you at risk for other, more serious, skin conditions. Learn how you can treat eczema on your nipples and protect yourself from future skin damage.
When it comes to eczema, children younger than five are the most diagnosed demographic. Eczema is a lifelong condition that has no cure. Over time, your eczema breakouts may calm or even disappear, but they may flare up again when an irritant is introduced to your skin.
There are several skin conditions that may affect your nipples , and eczema is just one. Other common skin conditions affecting your breast may include:
Both children and adults are susceptible to eczema. Certain kinds of dermatitis may only affect certain areas, and it is common for a person with preexisting eczema to develop other patches. Places with thin or sensitive skin, like eyelids or nipples, are especially prone to eczema.‌
Some external irritants may make your eczema worse:
Signs of nipple eczema may include:
Before self-treating, talk to your doctor. You may have a more serious health condition that needs to be addressed. Eczema may look similar to other skin conditions like:
You should see a doctor if your eczema is:
These are all signs of infection. If your condition worsens, it could lead to other health conditions.
Higher risk for other conditions. Eczema leaves your skin raw, leaving you more susceptible to bacteria entering your bloodstream. Talk to your doctor about treatment options, especially if you're breastfeeding, as treatment may be different for you.
Treatment options. While eczema cannot be completely cured, there are many treatment options to improve symptoms. If one treatment plan doesn’t work, you can try another until you find the right products and strategies for the severity and symptoms of your eczema.
Treating eczema on your nipples. Taking care of your skin condition is the best way to improve your symptoms. Moisturize your skin at least twice a day using fragrance-free products such as:
In some people, food allergens can cause eczema flare-ups. You may need to cut something out of your diet like:
‌To avoid stressing sensitive skin, you can also try:
Avoiding irritants. It may take some trial and error to find a product that works best for you, since certain products can contain irritating ingredients. Since the skin around your nipples is thin and sensitive, try a product that is mild. If you’re worried about a product causing irritation to your skin, talk to your doctor about ingredients to avoid. Check all product labels for those ingredients before choosing one to try.
Keep in mind that the products your loved ones use can also affect you. If you hug them, lotions, perfumes, and detergents may rub off on your skin and clothing. You should eliminate irritants from your home where possible.
Things that may worsen your eczema include:
While this condition may be uncomfortable, there are a variety of factors to approach with dealing with nipple eczema. By keeping track of when your skin improves or worsens, you may be able to track down your source of irritation. This process is different for everyone, and may be sped up with a doctor's help.‌
American Academy of Dermatology Association: “ADULTS WITH ECZEMA SHOULD WATCH FOR EYE PROBLEMS.”
American Family Physician: “Differential Diagnosis of the Swollen Red Eyelid.”
Mayo Clinic: “Atopic dermatitis (eczema).”
National Eczema Society: “About eczema around the eyes.”
A good one helps halt eczema flares
And be educated when shopping for cosmetics.
© 2005 - 2022 WebMD LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment.

Eczema is a common skin condition that can appear anywhere on the body – including the nipples. Characterized by redness, itchiness, and inflammation, it can be physically uncomfortable, as well as emotionally painful.
In this post, we discuss causes and symptoms of nipple eczema, plus natural ways to treat eczema on the nipple
Please keep in mind that although what we discuss in this post can relieve eczema, we are in no way medical professionals. If you’re experiencing severe eczema symptoms like an infection, it is best to seek medical advice immediately.
Eczema on the nipple can affect one or both nipples . It may appear as an itchy, scaly, and irritated rash on the nipple itself or the areola , which is the dark skin surrounding the nipple.
The condition can appear in isolation, or it may develop along with eczema on other parts of the body. It rarely extends to the rest of the breast.
If you suffer from nipple eczema, you may notice that the nipple or areola is red, oozing, cracked, crusted, and tender. In some cases, there may be nipple discharge.
Anyone can experience nipple eczema but it is often diagnosed in teenage girls, even if they do not have a prior history of atopic dermatitis.
It can also affect breast-feeding women , especially if they have easily irritated skin or a history of eczema. Non-breastfeeding women and men who have a history of eczema or sensitive skin may also develop this condition.
Like all types of eczema, nipple eczema is caused by a genetic predisposition and environmental factors. Those who have a history of atopic dermatitis are more likely to develop nipple eczema.
External irritants that can make nipple eczema worse include contact with certain articles of clothing , laundry detergents, soap , and skincare products that contain harsh chemicals.
While there is unfortunately no cure for eczema, there are ways to manage symptoms and make life more comfortable. Here are some of our top recommendations:
Moisturizing your skin with a natural cream or balm can keep dryness, itchiness, and irritation at bay. We suggest this Organic Manuka Skin Soothing Cream because it’s safe and effective anywhere on the body , including sensitive areas like the nipples. Made with just 6 ingredients , including the ultra-hydrating Manuka honey, it helps to calm redness and reduce itchiness from head to toe.
Certain foods are known for triggering eczema flare ups. Common culprits include nuts, eggs, gluten, red meat, soy, tomatoes, shellfish, and citrus fruits. It’s important to understand your body and avoid food triggers that can make your eczema worse.
To determine which foods are triggering your eczema, try an eczema elimination diet . This involves removing certain foods from your diet for a specific period of time (usually around a month) and then slowly incorporating them back into your diet to determine which cause a reaction.
Many laundry detergents can aggravate eczema symptoms because of the chemicals they are made with. The best laundry detergents for eczema-prone skin are free from harsh chemicals and irritants.
We recommend this SmartKlean Laundry Ball because it’s natural, non-toxic, and eco-friendly. It also won't leave behind any residue on your clothing like other detergents do.
Many bras can further irritate the skin, including the nipple. To avoid this from happening, try this 100% Organic Cotton Front Closure Bra . It provides a loose fit that allows for comfortable support without skin irritation.
You can also try this 100% Organic Cotton Bra Liner that’s free from latex, spandex, and chemicals. The hypoallergenic material is a great choice for those with tender skin on the breasts.
Last but not least, this Remedywear ™ Bra that’s made from TENCEL and zinc-embedded fibers, helps to both protect and soothe sensitive skin.

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