What causes itchy nipples? Related conditions and treatments

Dealing with an itchy nipple can be extremely irritating and uncomfortable. Not only that, but you probably have lots of questions and concerns about why this is happening. In most cases, it’s nothing to worry about. By far, the most common causes include irritation from soap and clothing, skin conditions like eczema, dry skin, and hormonal fluctuations. In rare cases, itchy nipples are caused by breast cancer. The good news is that the causes of itchy nipples are treatable.  

 Key takeaways:

• Itchy nipples are common and may be caused by skin irritants, dry skin, eczema, and hormonal fluctuations.
• Treatments for itchy nipples vary by cause and may include topical lotions or steroids.
• Use coupons for itchy nipple treatments, like hydrocortisone, and triamcinolone acetonide, to save up to 80%.

What causes itchy nipples?

The tricky thing about itchy nipples is that there isn’t just one possible cause of itching on or around the nipples. Some causes are environmental or hormonal. Others stem from different diseases and conditions. Here, we’ll take an in-depth look at itchy nipple causes with advice from healthcare experts.

Contact dermatitis

According to Kelly Culwell, MD, OB-GYN, also known as Dr. Lady Doctor, itchy nipples are usually caused by an irritant making contact with your nipple, a condition known as contact dermatitis.

“The most common cause of itchy nipples is likely dermatitis or skin irritation around the nipples,” Dr. Culwell says. This could be due to irritation from clothing or sensitivity to anything touching the nipple, including body creams, laundry detergents, and itchy fabrics such as wool or lace.

As the American College of Allergy, Asthma, and Immunology explains, when you have contact dermatitis, you may notice that your skin is itchy and also may look reddish, feel warm to the touch, and may even have bumps or blisters.

In the case of itchy nipples, the bra you are wearing might be what’s irritating your skin. When the culprit of dermatitis is the fabric that’s touching the skin, it’s called textile contact dermatitis, which may be caused by the fibers in the fabric or an allergic reaction to chemicals used in manufacturing the fabric. Fabric additives like formaldehyde resins, para-phenylenediamine (PPD), and flame retardants are some of the most common culprits when it comes to textile contact dermatitis.

Eczema

Another common cause of itchy nipples is eczema, also known as atopic dermatitis. “In my practice, I’ve seen that a common cause of itchy nipples is eczema, which is an inflammatory skin condition leading to redness and itchiness,” says Hannah Kopelman, DO, dermatologist and chief medical officer for DermOnDemand. “It occurs due to a combination of genetic and environmental factors that disrupt the skin’s barrier function.”

The condition is characterized by red, dry, flaky, itchy patches of skin, according to the American Academy of Dermatology Association (AAD). It’s usually a lifelong condition that goes through periods of flare-ups and remission. Eczema can affect any part of the body, but the most commonly affected areas are the wrists, elbows, and behind the knees.  

Hormonal fluctuations

In some cases of itchy nipples, hormonal changes may be to blame. “Hormonal fluctuations that occur during different phases of your menstrual cycle or during pregnancy, breastfeeding, or menopause are all times when you might experience sensitive or itchy nipples,” says Ila Dayananda, MD, MPH, OB-GYN and chief medical officer of Oula Health.

A study published in the European Journal of Dermatology found that itchy skin often correlates with hormonal fluctuations. The researchers surveyed 278 women between the ages of 20–65. Of the women who were still menstruating, 42% said that they experienced skin sensitivity right before and during their periods. Besides skin sensitivity, most of these women experienced itchiness, dryness, pimples, bumps, and redness.  

Dry skin

Dr. Dayananda says that dry skin is another typical cause of itchy nipples. Dry skin is most common when the weather turns colder, according to the AAD. Dry skin can lead to many uncomfortable symptoms, such as itchiness, redness, flaking skin, and cracked skin. Sometimes, the skin can even bleed a little if it cracks from dryness.  

Radiation dermatitis

Some medical treatments can lead to dry skin, which can cause itchiness. One common cause of itchy skin that can affect the nipple is radiation therapy for cancer. When you have dry, itchy skin following radiation therapy, it’s called radiation dermatitis. According to the American Cancer Society, during radiation therapy, you may notice that your skin looks reddish and irritated, like a sunburn. After a few weeks’ time, the skin becomes itchy, flaky, and dry and may start to peel.

Breast cancer

Though extremely rare, sometimes itchy nipples are a sign of breast cancer. One type of breast cancer that can cause itchy nipples is Paget disease. The condition often starts by looking like other forms of dermatitis, with itchy nipples and red, flaky skin. “It eventually involves ulcers or sores on or around the nipple and a clear or bloody discharge or skin cancer,” Dr. Culwell describes. Inflammatory breast cancer can also cause itchy nipples as well as other symptoms that include swelling, inflammation, nipple dimpling, and skin that looks like an orange peel. If a healthcare provider suspects inflammatory breast cancer, they’ll ask you to schedule a mammogram and a biopsy. 

Should I be worried about itchy nipples?

It’s common to experience itchy nipples at one point in your life, and the most common causes—reaction to irritants, eczema, dry skin, and hormonal changes—are not dangerous or life-threatening. “Itchy nipples are often not a cause for alarm and can be treated effectively,” Dr. Kopelman assures.

Although most causes of itchy nipples are not worrisome, you should see a healthcare provider if you have a history of dermatitis, eczema, or breast cancer. You should also see your doctor if you experience other symptoms with the itching. “If you’re experiencing persistent or severely itchy nipples, or if this symptom is associated with pain, discharge, or exterior changes of the nipples or breasts, it’s important to consult your doctor for possible causes,” Dr. Dayananda explains.

Complications

Most of the time, if you address the cause of itchy nipples and receive proper treatment, no further complications arise. Still, “complications such as infections can arise if the skin is broken from excessive scratching,” Dr. Kopelman says.  

How is the cause of itchy nipples diagnosed?

To diagnose the cause of itchy nipples, your healthcare provider may want to figure out what is causing them. To do this, they may ask:

• About your general medical history
• How long your nipple has felt itchy and if it’s itchy at certain times of the day, certain days during the menstrual cycle, or after certain activities
• What other symptoms you are experiencing, such as changes in weight, fatigue, nausea, or other relevant symptoms
• Whether you’re taking any medications  
• If you are older than 40, when the last mammogram was performed and whether it was normal

Your physician will need to examine your breast and nipple for signs of discharge, redness, blistering, scaling, dryness, or infection. Sometimes, medical tests are necessary to diagnose the cause of itchy nipples. This may include getting a biopsy. Biopsies aren’t just for cancer—they also help identify different infections and other causes of itchy skin.

How long do itchy nipples last?

How long itchy nipples last depends largely on the cause and whether treatment is necessary. For example, untreated contact dermatitis, eczema, and dry skin rarely heal on their own and usually require treatment or lifestyle changes.

Usually, with proper treatment, the most common causes of itchy nipples will resolve in a week or two. “If symptoms persist despite short-term treatment (six to eight weeks) additional evaluation by your healthcare provider is needed to rule out more concerning conditions,” Dr. Culwell says.

How to stop itchy nipples

If dry skin is causing itchy nipples, a simple moisturizer you have at home can help. The AAD recommends applying a moisturizer after washing the area and letting it dry. It also recommends using creams, rather than lotions, on dry skin. Recommended creams and ointment ingredients include jojoba oil, lanolin, mineral soil, shea butter, and glycerin.

If you suspect that your itchy skin is caused by an irritant that your nipples are being exposed to, change your bathing and laundering routine to help decrease allergen exposure. Try switching soaps, lotions, perfumes, and laundry detergent to see if that helps. You can also try wearing a different bra made of a less irritating fabric to solve the problem.

Sometimes, itchy nipple treatment involves medication, either over-the-counter or prescribed. Your physician will tell you which medication is best for your condition. Here’s what to know, according to Dr. Kopelman:

• If you have eczema or dermatitis, topical steroids or emollients can be an effective treatment.
• In cases of infection from scratching an itch, antibiotic treatment may be necessary.
• If the itchy nipples are due to a fungus, an antifungal cream may be needed. 

Living with itchy nipples

Most of the common causes of itchy nipples are not lifelong. For example, dry skin and contact dermatitis can be treated and will likely resolve. If your itchy skin is due to hormonal changes, these are usually temporary as well. Eczema is a skin condition that tends to be lifelong, though it has times when it is in remission. If you have breast cancer, the course of your illness will depend on what stage your cancer is in and how the treatments are working. Again, breast cancer is not a common cause of itchy nipples, and itchy nipples are not the only symptom of breast cancer.

Most importantly, itchy nipples are treatable

Itchy nipple causes may include dry skin, contact dermatitis, eczema, and hormonal fluctuations. Some causes of itchy nipples may resolve on their own without treatment. However, if itchy nipples continue, worsen, or are accompanied by burning, severe pain, scaling, or blistering, it could be a sign of eczema or a nipple infection, both of which require treatment. Only your healthcare provider can rule out infection or other serious health conditions. Visit your doctor to determine the best treatment for itchy nipples.