What causes nipple pain? Related conditions and treatments

Overview: What does nipple pain look/feel like?

Nipple pain can feel different for everyone. Some may experience soreness, tenderness, or sensitivity, while others can feel stabbing, throbbing, or burning pain. Sometimes, nipple pain can accompany other symptoms, such as crustiness or flaking. The pain might also extend into the areola or breast. Usually, nipple pain goes away on its own or is easily treated. Here is what you need to know about the causes of nipple pain. 

What causes nipple pain?

There are many possible causes of nipple pain. It can be due to something as simple as an allergy to laundry detergent, or it can be due to something more serious like an infection. Nipple pain is common during hormonal changes, such as periods, pregnancy, or breastfeeding. In rare cases, nipple pain can be a sign of breast cancer. 

Common causes of nipple pain

1. Friction

Friction from clothing or bras can cause nipple chafing. This is especially common in joggers and athletes, and it can cause your nipples to get dry, red, or chapped. 

2. Injury 

Injuries to the nipples from sexual activity or nipple piercings can cause nipple soreness. Keep an eye out for any signs of infection, such as swelling or nipple discharge. Otherwise, the pain should resolve over time. 

3. Menstruation 

Some women feel nipple pain or soreness just before their period. This is caused by hormonal changes, specifically a rise in estrogen and progesterone, during the menstrual cycle. This pain is normal and will typically go away after your period starts. In the meantime, people can take over-the-counter pain medications, such as Tylenol (acetaminophen) or Advil (ibuprofen), for relief.

4. Pregnancy

Pregnancy raises your hormone levels, which causes changes to your breasts. Your hormones prepare your breasts for lactation, so you can expect your breasts and nipples to be more sensitive.  

5. Breastfeeding and pumping

Nipple pain is common among breastfeeding mothers. Whether a mother is nursing or pumping breast milk, the repetitive suction of the baby’s mouth or pump can lead to sore nipples. Ensuring your baby has a good latch and that you are using the right-sized pumping parts will lower your chances of experiencing nipple pain. Most breastfeeding pain resolves within the first month of breastfeeding, but if you still have nipple pain beyond the first few weeks, contact your healthcare provider or a lactation consultant. 

6. Skin irritation or allergic reaction

Household products, such as laundry detergents, lotions, soaps, or perfume, may contain allergens irritating nipples. This can lead to itchiness, scaliness, or a rash, especially if you have a skin condition called eczema (or atopic dermatitis). 

7. Infections

Nipple pain causes also include infections, such as mastitis or yeast infections. Irritated or cracked nipples have a higher risk of infection because the open skin makes it easier for bacteria to get in. Common nipple infections include: 

• Mastitis: Breastfeeding raises your risk of developing mastitis, a breast infection, when a milk duct gets blocked. This causes pain, fever, fatigue, and hard, red spots on the breast.

• Thrush (yeast infection): Thrush is a yeast infection where a fungus overgrows in the mouth and throat. If thrush develops while breastfeeding, babies can develop white plaques in their mouths. Breastfeeding mothers often experience a sharp, shooting pain in the breast and nipple. 

• Folliculitis: Swollen hair follicles around the nipples can get infected and cause nipple discomfort.

Rare causes of nipple pain

Breast cancer

Rarely, nipple pain can be a sign of breast cancer. Although, in these cases, nipple pain is usually accompanied by other symptoms, such as nipple redness, dryness, flaking, discharge, or retraction (when the nipple turns inward). 

Paget’s disease of the breast

Paget’s disease is a rare breast cancer affecting the nipple and areola (dark circles around the nipple). It usually only affects one breast and occurs alongside a tumor in the breast. It can cause redness, scaliness, and crustiness on the skin of the nipple and areola. 

Should I be worried about nipple pain?

Nipple pain is usually caused by friction from clothing, allergic reactions, or hormonal changes. It is not typically caused by a serious condition like breast cancer. However, if you experience pain alongside nipple discharge, lumps in your breast, or a change in your nipple shape, contact your healthcare provider. If your nipple pain is related to breast cancer or Paget’s disease, leaving it untreated can lead to cancer progression.

How is the cause of nipple pain diagnosed?

In most cases, people can determine the cause of their nipple pain. If not, contact a healthcare provider or if the pain is persistent. They will ask you questions that will help them pinpoint the cause of the pain, such as when the pain started, if you suspect you might be pregnant, or when your last period was. If they can’t determine the cause, they might order a breast ultrasound, mammogram, or biopsy. 

How long does nipple pain last?

If the cause of your nipple pain is benign, it will usually resolve with time or by removing the cause of your pain. For example, if a new soap is causing your nipple tenderness, try switching to a different soap, preferably one that is hypoallergenic.

How to stop nipple pain

How to treat nipple pain depends on the cause of the pain. If an injury causes the pain, you might just need time to heal. If your nipple pain is caused by your period, pain relievers may help.                                                                                                                                              

Nipple pain caused by friction can be treated using a bandage, creams,  or petroleum-based ointment over your nipples to prevent chafing. If an infection causes the pain, ask your healthcare provider how to eliminate nipple pain. They may prescribe antibiotics.

If you are experiencing nipple pain while breastfeeding or pumping, consider contacting a lactation consultant. They can evaluate your baby’s latch and ensure you use appropriately sized breast pump parts. They can also give you nipple pain treatment options, such as lanolin ointment or cold compresses.

Nipple irritation caused by household allergens is best treated by removing the offending agent. In the rare case that your nipple pain is caused by breast cancer, treatment will depend on the severity of your condition.

FAQs about the causes of nipple pain

Which hormone causes nipple pain?

Rising estrogen and progesterone levels can cause nipple pain. Both hormones cause your breasts to swell with fluid, resulting in breast tenderness and sore nipples.

Does low estrogen cause nipple pain?

While changes in hormone levels are a common reason for nipple pain, a rise in estrogen levels typically leads to nipple and breast soreness. 

When should I be concerned about nipple pain?

If you experience persistent nipple pain or nipple pain that occurs alongside nipple retraction, nipple discharge, or breast lumps, reach out to your provider. These symptoms can be signs of a more serious condition. 

What’s next? Additional resources for people with nipple pain

Test and diagnostics

• Sore nipples, Cleveland Clinic

Treatments

• Nipple pain remedies, American Pregnancy Association

Scientific studies and clinical trials

• Nipple pain in breastfeeding mothers: incidence, causes and treatments, International Journal of Environmental Research and Public Health

More information on related health conditions

• Breast cancer treatments and medications, SingleCare