Illnesses or irritants in your environment can cause nipple problems. These problems, including those involving the milk ducts, can occur in men and women. This article addresses nipple problems in both sexes but not in women who are breast-feeding or who have just had a baby.
Many nipple problems have nothing to do with breast cancer, but they could indicate a serious underlying condition. Always see a doctor if you have nipple discharge and you aren’t pregnant or breast-feeding. The Mayo Clinic defines nipple discharge as any fluid that comes out of the nipple. It can appear:
Other types of nipple problems include:
- changing shape
You might see discharge, such as pus or a white, watery fluid. You may also feel pain, itchiness, or swelling in your nipples. See your doctor right away if you have any discharge at all or discomfort that lasts for more than a few days.
You may also notice changes in the shape of your nipple or areola, which is the skin around your nipple. These changes may include puckering or dimpling of the skin. Always discuss changes like this with your doctor.
In women, hormone fluctuations during the menstrual cycle can cause monthly discomfort that lasts for a few days. You should talk to your doctor if it bothers you.
There are a variety of circumstances that could lead to nipple problems, including:
- small, benign, or noncancerous, tumors
- hypothyroidism, or an underactive thyroid
- ectasia, which is a widening of the milk ducts
- a pituitary gland tumor
- Paget’s disease of the breast
- an injury to the breast tissue
Your nipples can become irritated, sore, or even cracked due to friction. Running and sexual activity are sometimes causes of temporary nipple problems due to vigorous rubbing.
A severe blow to your breast or unusual pressure on the chest can also cause nipple discharge.
Newborn babies sometimes have discharge from their nipples. This is because they absorb their mother’s hormones as she prepares for breast-feeding. Another name for nipple discharge in babies is “witch’s milk.” Doctors don’t consider this a dangerous condition. It should go away promptly.
Your doctor will examine your nipple and areola. They’ll ask you:
- about medicines you’re taking
- about any changes in your diet
- whether you might be pregnant
- about any recent exercise or activity that could have irritated your nipples
If you have nipple discharge, your doctor may perform a test to find out how many of the ducts that bring fluid to your nipples are involved. This is called a ductography. During a ductography, your doctor injects dye into the ducts in your breasts and then takes an X-ray to monitor the ducts’ function.
Your doctor may want you to have a mammogram. A mammogram is an imaging test that records an image of the tissues inside your breast. This exam can reveal if there’s a growth inside of your breast causing the problem.
If your doctor thinks you may have Paget’s disease, which is a rare breast cancer, they may order a skin biopsy. This will involve removing a tiny piece of skin from your breast for examination.
Other tests your doctor might order include:
- a prolactin level blood test
- a thyroid hormone test
- a CT scan
- an MRI scan
The treatment for your nipple problem will depend on its cause.
Your doctor will treat an infection of the nipple with the appropriate medicine. For example, a bacterial infection will require antibiotics. If you have a fungal infection, such as candidiasis, your doctor will prescribe an antifungal medicine. You can take these medicines by mouth or apply them to your skin.
Small, benign tumor
A noncancerous tumor doesn’t need removal, but your doctor may schedule you for regular checkups to monitor its growth.
Hypothyroidism occurs when your body doesn’t produce enough thyroid hormones. This can upset the normal balance of chemical reactions in the body. Replacing the missing hormones with a prescription medicine can treat hypothyroidism.
Ectasia, or swollen milk ducts, usually goes away on its own. If you continue to experience it, you should ask your doctor about surgery to remove the swollen milk ducts. If ectasia causes a bacterial infection in your nipples, your doctor can prescribe an antibiotic.
The pituitary tumor known as a prolactinoma is usually benign, and it might not require treatment. Because of its location in your head, these tumors can press on the nerves that lead to your eyes, causing vision problems if they grow too large. In that case, surgery is necessary to remove them.
Two medicines, bromocriptine and cabergoline, can treat pituitary tumors by reducing the amount of prolactin in your system. If the tumor doesn’t respond to medication or continues to grow, radiation treatments may be necessary.
Paget’s disease of the breast
The treatment for this cancer depends on whether tumors reside elsewhere in the breast besides the nipple. If there are no other tumors present, treatment includes surgery to remove the nipple and areola, followed by a series of radiation treatments on the whole breast. If your doctor finds other tumors, you may need a mastectomy to remove the entire breast.
You can prevent some nipple problems. Speak to your doctor about the medications you’re taking and if nipple problems may be a side effect. Your doctor may be able to suggest an alternative medication.
You can prevent nipple problems when you exercise by wearing properly fitting clothes. Women should wear a well-fitting sports bra during exercise such as running and horseback riding. Men who do the same should consider wearing a snug undershirt. There are also products available to help prevent chafing. You can apply them to your nipples before exercise.