Why Do My Nipples Itch

Why Do My Nipples Itch

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By Heather Rupe, DO Board-certified OB/GYN September 15, 2020
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April 13, 2021

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Itchy nipples are sheer misery. Not only are they awkward to scratch during the daytime, but at nighttime, they make sleeping nearly impossible. If you’re clawing at your chest at 3 a.m. and wondering what in the world is going on with your nipples, the good news is that, in most cases, it’s nothing serious. In rare cases, itchy nipples is a sign of something more serious – and we’ll get to that – but like I said, it’s rare. So first let’s talk about what’s more likely to be going on.
Atopic dermatitis, also known as eczema, is the most common cause of itchy nipples. With this condition, itching is almost always present and can be severe. The itching may start even before you’re able to see a rash. The rash can include small blisters with oozing or crusting. If you keep scratching, you could open the skin to infections or create thickened areas from constant inflammation and irritation.
Atopic dermatitis can appear in women and men of all ages. Since it's thought to be due to a hypersensitivity reaction, you may be more prone to develop it if you have a personal or family history of allergies, asthma, or hay fever.
Environmental triggers that can prompt atopic dermatitis to flare up can include:
Doctors usually diagnose atopic dermatitis by doing a physical exam and asking about your health history. If needed, they can also do a skin biopsy to rule out other causes.
The majority of atopic dermatitis remedies are treatments that you apply directly to the skin, like steroid creams or ointments. It is important to use an ointment and not lotion in this area, as lotions can sometimes contain drying agents that might make the symptoms worse.
Topical ointments that might help include:
When your itching is severe or there is a known allergic trigger, antihistamine pills can help. Hydrocortisone cream is also an option.
There are also self-care and preventative strategies that can ease your symptoms. Your best strategy for getting rid of atopic dermatitis is to avoid triggers, but you should also do what you can to keep moisture in your skin. For instance, don't use drying soaps, and don't take long, hot baths. Once out of the bath or shower, apply an ointment to the area.
As I mentioned, there is a more serious cause of itchy nipples, and it’s important to know the signs:
Paget’s disease is a rare form of breast cancer that can involve both the nipple and the areola (the colored area that encircles the raised nipple). One of the first symptoms of Paget’s disease can be an itching or burning sensation of the nipple or areola.
In Paget's disease, the itching is often accompanied by a crusty rash. The scaly rash does not get better with topical creams. More advanced cancers will form open sores and might have nipple discharge. Paget's is most often found in just one breast and is typically found in women between the ages of 50 and 60.
Doctors diagnose Paget's disease with a breast exam and a mammogram. They might also do a biopsy of the nipple. Any breast lumps would be biopsied as well. The treatment for Paget’s disease is breast surgery, either removing the whole breast (known as mastectomy) or removing just the diseased part of the breast.
If you have any of the symptoms of Paget’s, contact your doctor for an evaluation.
In general, though, itchy nipples are also not something you need to run to the ER for at the first twinge of discomfort. Try the topical ointments and antihistamines mentioned above, and if the symptoms don’t get better or a rash develops, then follow up with your doctor to get things thoroughly checked out.
Heather Rupe, DO, is a board-certified OB/GYN in private practice in Franklin, TN, and serves as the vice chief of staff at Williamson Medical Center. She is the co-author of The Pregnancy Companion: A Faith-Filled Guide for Your Journey to Motherhood and The Baby Companion: A Faith-Filled Guide for Your Journey through Baby’s First Year.
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Um, it could be a yeast infection—seriously.
Of all the inconvenient places to have itchy skin, your breasts and nipples rank pretty high. I mean, you can’t just rub calamine lotion all over your boobs at any given moment. And reaching down your shirt to scratch those itchy nipples would probably be pretty awkward in any setting.
But don’t worry—you’re not doomed to feeling yourself up in public for eternity. There are a bunch of reasons why you may be experiencing itchy breasts—and most of them are pretty harmless. “Itching is the result of inflammation or stimulation of nerves in the skin. This may be the result of dryness, allergic reactions, direct irritation, or even a result of internal health issues,” says Joshua Zeichner, MD, of Zeichner Dermatology .
Rarely are itchy nipples the result of something more serious, but it can happen. “There is a condition called Paget’s disease which looks like a non-healing, red rash on the nipples. It is actually a low-grade skin cancer that needs to be surgically removed,” explains Dr. Zeichner.
But most treatments for other causes of itchy nipples have easy fixes, like topical remedies (think: a hydrocortisone ointment) or eliminating irritants, like a poorly fitted bra.
Still, if itching is actually driving you crazy, it's best to book an appointment with your ob-gyn or derm. In the meantime, here are 15 potential reasons why you just can't stop scratching your boobs, and what you can do about each one.
The skin around your nipples is a lot more sensitive than the skin on other parts of your body, says Dr. Zeichner. This may make it more prone to irritation, dryness, and inflammation, especially in dryer weather. "Cold, dry weather strips the skin of essential oils, disrupting the outer skin layer, resulting in loss of hydration, and inflammation," explains Dr. Zeichner.
If you're experiencing dry or flaky skin, he suggests applying a moisturizer to help repair the skin barrier. "Look for ingredients like petrolatum, ceramides, or colloidal oatmeal," says Dr. Zeichner, who often recommends Vaseline Intensive Care Advanced Repair Lotion, given that it helps build a protective seal over the skin without leaving you feeling sticky.
The thyroid is involved in the regulation of several organs, including your skin. "We know that when thyroid hormone levels are low, the skin can become dry which leads to itching," says Dr. Zeichner. But itchy nipples aren't the only possible symptom of thyroid issues. Other symptoms include changes in your appetite, muscle aches and fatigue, among others.
If you suspect you're having thyroid issues based on your symptoms, consult your doctor, who can refer you to an endocrinologist if necessary.
Hormonal changes occur during menopause, like a drop in estrogen production. Now that your body's producing less estrogen, the end of menstruation can also have an effect on your skin too, says ob-gyn Felice Gersh, MD. "Menopause is a state of estrogen deficiency, and estrogen is key to maintaining healthy skin. Without it, the skin atrophies and becomes drier."
One way to avoid itchy nipples caused by menopause is to use a topical estrogen treatment, says Dr. Gersh. Consult your doctor about menopause hormone prescriptions.
Eczema is a genetic skin disorder often made worse by environmental exposures, says Kari Martin, MD, associate professor of dermatology at the University of Missouri School of Medicine .
An eczema rash has a pretty specific look; it's often categorized as small raised bumps or reddish patches on the skin, and it can definitely show up on your nipples. But Dr. Martin says the rash will likely appear on both your nipples and breasts.
Dr. Martin recommends avoiding harsh soaps and moisturizing the skin regularly with an emollient such as petroleum jelly. You can also try an OTC hydrocortisone ointment twice a day for up to two weeks, but check with your dermatologist if your eczema flare-up doesn’t clear up after that.
Like eczema, psoriasis is another skin condition—but this one is caused by an autoimmune disorder.
Psoriasis also has a tell-tale look: red, scaly plaques on the skin, most commonly on the outsides of your elbows and knees, says Dr. Martin. But the rash can appear anywhere–including your breasts and nipples.
You'll want to see a dermatologist for this one too, but in the meantime, Dr. Martin recommends trying hydrocortisone ointment for any psoriasis-related itching.
There are a lot of reasons why your doctor might prescribe an opioid pain reliever—severe migraines, broken bones, surgery. But while the narcotic is working to ease your pain, it might also be causing you to itch.
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