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Understanding Nipple Pain: Causes, Treatment, and More

Overview

There are many possible causes of sore nipples. Some are as benign as a poorly fitting bra. Others, like breast cancer, are more serious. That’s why you should see your doctor about any nipple soreness that doesn’t improve.

Read on to learn about causes of nipple pain and what you can do to manage this symptom.

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Causes

Causes of sore nipples

One of the easiest explanations for sore nipples is friction. A loose bra or tight shirt can rub against your sensitive nipples and irritate them. If friction isn’t the cause, here are a few other conditions to consider.

Menstrual periods

Some women notice that their breasts get sore just before their period. This soreness is caused by a rise in the hormones estrogen and progesterone, which causes your breasts to fill with fluid and enlarge. The pain should go away once your period arrives or shortly thereafter.

Pregnancy

Pregnancy is a time of change in your body. You’ll notice several changes, from sore breasts to swollen ankles, as your body’s hormone composition changes to support your growing baby. Breast enlargement and soreness are among the earliest signs of pregnancy. You might also see some small bumps pop up around your nipples.

Other signs that you might be pregnant include:

  • missed periods
  • nausea or vomiting, including morning sickness
  • urinating more often than usual
  • fatigue

Learn more: 17 Early signs of pregnancy »

The soreness should pass, but your breasts will likely keep growing as your pregnancy progresses.

Eczema or dermatitis

Crusting, flaking, or blistering around your nipple in addition to pain may indicate that you have a skin condition called dermatitis. Eczema is one type of dermatitis.

Dermatitis happens when immune cells in your skin overreact and cause inflammation. Sometimes you can get dermatitis from coming into contact with irritating substances like detergents or soaps.

Breast cancer

Nipple pain is one sign of breast cancer. Along with the pain, you might also have symptoms like these:

  • a lump in your breast
  • nipple changes like redness, scaling, or turning inward
  • discharge from the nipple other than breast milk
  • change in the size or shape of one breast

Learn more: What does a breast cancer lump feel like? »

Nipple pain is most likely not cancer. If you have other symptoms or breast cancer, it’s worth getting checked out.

In breastfeeding

Nipple pain and breastfeeding

Moms who breastfeed can sometimes develop sore nipples from the suction, especially when your baby first starts to latch on. Expressing milk with a breast pump can also cause nipple pain if the shield is ill-fitting, or if the suction is too high.

Pain in the nipples could also be a sign of one of these infections:

Mastitis

Mastitis is an infection that makes the breast swell up, turn red, and become sore. Other symptoms include a fever and chills.

You can develop mastitis when milk gets trapped in one of your milk ducts and bacteria start to grow inside. Your doctor can prescribe antibiotics to treat the infection.

Untreated mastitis can lead to a collection of pus in your breast called an abscess. See your doctor right away if you’re breastfeeding and have pain in your nipple along with any of these symptoms:

  • fever
  • breast swelling or warmth
  • skin redness on your breast
  • pain while nursing

Thrush

Another cause for sore nipples while breastfeeding is thrush. Thrush is a yeast infection you can get if your nipples dry out and become cracked from breastfeeding. When you have thrush, you’ll feel a sharp pain in your nipples or breasts after your baby feeds.

Your baby can also get thrush in their mouth. It shows up as white patches on their tongue, gums, and other surfaces inside the mouth.

Thrush is treated with an antifungal cream that you rub on your nipples after you breastfeed.

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Diagnosis

Diagnosis

If you can’t trace nipple soreness back to an obvious cause, like your period or an ill-fitting bra, and the pain doesn’t go away, see your doctor. You can see your primary care doctor or an OB-GYN for tests.

Your doctor will ask about your symptoms, and what seems to trigger the soreness. For example, they may ask if your nipples hurt right before your period or when you breastfeed. Then the doctor will examine your breasts and nipples. If you suspect you might be pregnant, your doctor will do a blood test to confirm it.

If the doctor thinks you might have cancer, you’ll have one or more of these tests:

  • Mammogram is a test that uses X-rays to look for cancer in your breast. You can have this test as part of a regular screening or to diagnose breast cancer.
  • Ultrasound uses sound waves to look for changes in your breast. An ultrasound can tell whether a lump is solid, which could be cancer, or fluid-filled, which could be a cyst.
  • Biopsy removes a sample of tissue from your breast. That tissue is examined in a lab to see if it’s cancerous.

Treatment

Treatment

Your treatment will depend on what’s causing the nipple soreness. If the cause is friction, switching to a better-fitting bra or shirt may help. Dermatitis is treated with steroid creams and lotions that bring down inflammation.

Try these tips to relieve nipple tenderness caused by breastfeeding:

  • take pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)
  • hold a warm, moist compress to your breasts
  • use a lanolin ointment to prevent nipple cracking

Breast cancer is treated with:

  • surgery to remove the lump or the entire breast
  • radiation therapy, which uses high-energy rays that destroy cancer cells
  • chemotherapy, or drugs that travel through the body to kill cancer cells
  • hormone therapy, which are treatments that block the hormones certain types of breast cancer need to grow
  • targeted therapies, which are drugs that block specific changes in cancer cells that help them grow

Read more: Breast cancer treatment options by stage »

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Outlook

Outlook

Your outlook depends on which condition is causing your nipple pain. Soreness related to your period should go away on its own. Breastfeeding pain caused by an infection should improve with treatment. Breast cancer outlook depends on the stage of your cancer and what treatment you get.

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Prevention

Tips for preventing sore nipples

Avoiding tight clothes and wearing a more supportive bra can help control nipple pain. Every time you buy a new bra, try it on. It can help to visit a store where the salesperson measures you to make sure you get the right fit. Breast size can change over time, so it’s worth having your size rechecked from time to time.

If the pain happens before your periods, here are a few ways to prevent it:

  • Avoid caffeine, which may contribute to growths called cysts in your breasts.
  • Limit salt during your period. Salt can cause your body to hold onto more fluid.
  • Exercise more often to help your body remove excess fluid.
  • Ask your doctor about going on birth control pills, which can sometimes help prevent soreness.

To prevent soreness while breastfeeding, try these tips:

  • Feed your baby regularly or pump to prevent your breasts from getting too engorged with milk.
  • Nurse your baby on the sore side first to relieve the pressure.
  • Make sure your baby latches on properly.
  • Change your baby’s position regularly.

If you’re having trouble helping your baby to establish a good latch, or if you can’t find a comfortable position to hold your baby, considering talking to a lactation consultant, your doctor, or your child’s pediatrician. They can watch you breastfeed and provide tips and guidance to help make it easier.

Read more: Nipple problems »

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