Why Are My Nipples Sore

Your baby can catch thrush while breastfeeding, or they can pass it to you. It can look like a white coating on their tongue and cheeks.

Why are my nipples sore? 7 possible causes

Medically reviewed by Carmen Fookes, BPharm. Last updated on Sep 1, 2022.

Official answer

by Drugs.com

Nipple pain is a common complaint, especially in pregnant, menstruating, or breast-feeding women. But there are other reasons for nipple pain.

Some people have pain they describe as sharp or accompanied by itching. Others say their nipples just feel sore, sensitive, and tender. Any nipple pain accompanied by a nipple discharge, lumps, or changes in the color or texture of the skin on your breast needs to be investigated by a doctor straight away.

The following are the most common reasons for nipple pain:

Menstruation
Pregnancy
Breast-feeding
Infection
Cancer
Friction during exercise
Allergy (to washing powder or fabric softener)

1. Menstruation

The hormonal changes that occur as part of a woman’s normal monthly cycle can trigger nipple pain and breast soreness. Both estrogen and progesterone levels increase just before a woman’s period starts. Both these hormones draw fluid into the breasts making them feel swollen and tender. Estrogen causes breast ducts to enlarge and progesterone causes milk glands to swell. Nipple pain during this time is also common.

Symptoms often peak just before menstruation and then fade and resolve during menstruation. The severity of symptoms can vary from woman to woman but in most cases it is more of an annoyance rather than a serious medical concern. However, if you notice any discharge from the nipple, especially if discharge is brown or bloody, see your doctor.

2. Pregnancy

Pregnancy causes several breast and nipple related changes, for example:

Nipple tenderness and hypersensitivity
Darkening of the nipples and areolas (the skin around your nipples)
Enlargement of the areolas and nipples, and nipples tend to stick out more
Small glands on the surface of the areolas (Montgomery’s tubercles) may become raised bumps
Breast growth and enlargement
Darkened veins along with the breasts due to the increased blood supply to your breasts
A yellowish, thick discharge from the breasts (this is known as colostrum).

3. Breast-feeding

It is not uncommon for nipples to feel sore and tender after breastfeeding; especially in the first few minutes when the baby first latches onto the breast. However, nipples should not remain sore or bleed for long periods of time.

If your nipple pain is severe or continuous or recurs then this may be caused by a technique problem, which should be corrected. Technique problems include:

The baby is not taking in the areola as well as the nipple
Problems with latching on
Improper positioning
A poor let-down reflex in the mother
Inverted nipples
Babies sucking for comfort and falling asleep at the breast
Pulling the baby’s mouth away from the breast without first breaking the suction
Babies with short frenulum (the frenulum is the piece of tissue that connects the tongue to the bottom of the mouth), also known as being “tongue-tied”.

Modified lanolin, cold compresses, hydrogel pads, and breast shields may help to reduce pain. But you should always seek further advice from a lactation consultant or doctor who can help you with your breastfeeding technique.

4. Infection

A yeast infection (also called thrush) is the most common type of infection that can occur on your nipples. Around your nipples there are large pores and hair follicles that can become clogged and infected. Yeast infections are more likely to occur in areas that are moist and dark where sweat collects, such as under the breasts; however, women who wear bras made of non breathable material may also develop yeast infections on their nipples too.

Women who are breastfeeding are particularly prone to yeast infections on their nipples, and also breast infections, such as mastitis. If you are breastfeeding and develop sore nipples or breasts then talk to your doctor.

Infections can also occur in men or women with nipple piercings, especially if piercings are not done with good technique or cared for properly afterwards.

5. Cancer

Paget’s disease is a type of cancer that may cause nipple pain. It usually only affects one nipple and the same breast and is rare. The following other symptoms may also be present, including:

An inverted or flattened nipple
A yellowish or bloody discharge from the nipple
Nipple itching or tingling
Skin changes, such as reddish, flaky, crusty, or scaly skin around the nipple and areola.

If you have any symptoms such as those described above with your nipple pain, see your doctor.

6. Friction

Nipple chafing as a result of friction is common during running or other active forms of exercise, particularly in men who wear rough cotton shirts or in women wearing ill-fitting bras or bras made of lace or cotton.

Sweating also softens the skin, and the salt in your sweat can crystallize and provide another source of irritation. Over the course of a long run or workout, your nipples can be rubbed to the point of bleeding.

Chafing usually causes a stinging nipple pain, and the skin may also become dry or chapped. Wearing synthetic fabrics close to your skin that wick away sweat can help reduce nipple chafing as can applying a lubricant or antichaffing cream to the nipples before exercise. Covering the nipples with surgical tape or a nipple cover may also help.

7. Allergy

If the skin around your nipples is flaking and crusty or blistering, you may be experiencing an allergic reaction or atopic dermatitis (eczema). Nipple allergies can develop to:

Body lotion
Fabric softener
Fabrics
Laundry detergent
Perfume
Shaving cream or rough facial hair rubbing against your nipples.

If the nipple pain has come on suddenly, try to work out if anything has changed for you recently, for example, a new laundry detergent, body lotion, or perfume. Try not using it for a week to see if that makes any difference to the nipple soreness.

A topical anti-inflammatory may help for a few days but speak to your doctor if the soreness persists or worsens.

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Why Do My Nipples Hurt?

Nipples are sensitive, and they can hurt for lots of reasons. Tight clothes, rashes, and infections can all irritate the tender skin. For women, sore nipples are common during periods, pregnancy, and breastfeeding.

Any pain in your nipples can make you wonder if you have breast cancer. It’s rare for it to be the main symptom of the disease, but you should still see your doctor to have nipple pain checked out if it doesn’t go away.

Here are some of the most common causes of nipple soreness and how to treat them.

Poorly Fitting Clothes

A loose shirt or bra can rub against your nipples and irritate your skin, especially with repeated motion like long-distance running. Too much friction could make your nipples bleed.

Avoid this problem by wearing tops and bras that fit you well. Before you run, cover your nipples with waterproof bandages or nipple guards to protect them.

When chafing causes soreness, apply an antibiotic ointment. Then cover the nipple with sterile gauze.

Skin Conditions

Soreness plus an itchy rash and swelling around your nipple could be signs of skin irritation called dermatitis. Allergies and irritants in your environment cause this common condition.

Eczema, also called atopic dermatitis, happens because of dry skin, genetics, and problems with the immune system.
Contact dermatitis starts when something touches your skin and irritates it, like a chemical in perfume, soap, or jewelry.

Treating eczema will ease any soreness it causes. Your doctor might give you:

Steroid creams
Creams or lotions that calm your immune system
Light therapy (phototherapy)

If your dermatitis is caused by an allergy or irritant, your doctor may suggest antihistamine pills, moisturizer, and a corticosteroid cream for your skin. An oatmeal bath can ease soreness, too.

Call your doctor if your symptoms don’t get better in a couple of weeks or if they get worse. Also call if you have these signs of an infection in your nipple:

Fever
Pus
Severe pain
Redness that doesn’t get better

Menstrual Periods

Sore nipples and breasts can be signs that your period is coming. Rising estrogen levels cause breast tissue to swell. The pain should stop once you get your period or shortly afterward.

Pregnancy

Hormone changes also cause nipple tenderness during pregnancy. But the main signs that you’re pregnant include:

Missed periods
Nausea and vomiting
Feeling tired
Peeing more often than usual

Your breasts and nipples will also swell. They may leak fluid as you get closer to delivery.

Choose a maternity bra that fits well. If your breasts really hurt, ask your doctor which pain relievers are safe for you to take during pregnancy.

Breastfeeding

As your baby latches onto your breast, you may feel a short burst of pain in your nipple. The pain should stop after a few seconds.

If your baby doesn’t latch on correctly, the pain could last through the whole feeding. It might feel like a sharp pinch. Your nipples can also crack and bleed.

Your symptoms should get better as your baby gets the hang of feeding. But there are a few ways you can ease soreness:

Gently squeeze out a few drops of milk and rub them over your nipples to soften them before you nurse.
Put a balm or ointment, such as lanolin, on your nipples.
Let your nipples air dry after each feeding. Change your breast pads often to keep them dry.
Wear a comfortable cotton nursing bra. Make sure it fits well so it doesn’t rub against your nipples.
Try different feeding positions until you find one that’s comfortable.

If you’re having trouble getting a good, non-painful latch, your doctor or a lactation consultant can help you and your baby make some adjustments to make you more comfortable.

Infections

Intense pain in your nipple could be a sign of an infection.

Mastitis is an infection of the milk ducts. It happens when bacteria grow inside blocked ducts. It’s most common during breastfeeding, but women can get it during other times of life. Men can sometimes have mastitis, too.

Other symptoms are:

A fever of 101 F or higher
Chills
Redness or red streaks on the breast
Warmth or burning in the breast
Swollen breasts

You’ll need antibiotics to treat the infection. Make sure to take the whole dose your doctor prescribes, even if you start to feel better.

Thrush is a yeast infection of the breast and nipple that can happen when you’re breastfeeding, especially if you have cracks in your nipple. You can also get it after you’ve taken antibiotics.

Pain from thrush feels like a stabbing, shooting, or burning in your nipples. You might also see:

Redness on your nipples or breast
Dry or flaky skin around the nipple

Your baby can catch thrush while breastfeeding, or they can pass it to you. It can look like a white coating on their tongue and cheeks.

Antifungal medicine treats thrush. Your baby will also need treatment if they’re infected.

Breast Cancer

Any pain in your breast could make you worry about breast cancer. Although nipple pain can be a sign of the condition, it’s rarely the main symptom. You’re much more likely to have a painless lump in your breast.

A nipple that turns inward
Redness or scaling of the skin over the breast or nipple
Discharge from the nipple that isn’t breast milk
Swollen lymph nodes under your arm

Call your doctor if you notice any changes like these in your breasts. Men should stay alert too, because they can also get breast cancer.

Surgery
Chemotherapy drugs
Radiation
Hormone therapy
Targeted therapy
Immunotherapy

Paget’s Disease

The odds of nipple pain being Paget’s disease are very low. This rare cancer affects only 1% to 4% of people with breast cancer.

Paget’s usually affects only one breast. It looks a lot like dermatitis, with red, flaky, and itchy skin around the nipple. It may also cause symptoms like:

A flat or turned-in nipple
Yellow or bloody discharge from the nipple
A lump in the breast
Thickened skin over the breast

See your doctor for symptoms like these. Men can get Paget’s too, and they should also ask the doctor about nipple changes.

Doctors treat this cancer with surgery to remove the nipple and the colored area around it, called the areola, along with part or all of the breast. Radiation or chemotherapy afterward kills any cancer cells that are left behind.

Show Sources

American Academy of Dermatology: “What is eczema?” “Contact dermatitis.”

American Cancer Society: “Breast Cancer Signs and Symptoms.”

Australian Breastfeeding Association: “Sore/cracked nipples.”

Breast Cancer Care: “Breast changes during and after pregnancy.”

Cancer.Net: “Breast Cancer: Treatment Options.”

CDC: “How Is Breast Cancer Treated?”

Cleveland Clinic: “Thrush.”

KidsHealth: “Breastfeeding FAQs: Pain and Discomfort.”

Mayo Clinic: “Contact dermatitis: Symptoms & causes,” “Dermatitis: Diagnosis & treatment,” “Dermatitis: Symptoms & Causes,” “Mastitis: Diagnosis & treatment,” “Mastitis: Symptoms and Causes,” “Paget’s disease of the breast: Diagnosis & treatment,” “Paget’s disease of the breast: Symptoms & causes,” “Symptoms of pregnancy: What happens first.”

National Cancer Institute: “Paget Disease of the Breast.”

NHS: “Breastfeeding and thrush,” “Sore or cracked nipples when breastfeeding.”

Ochsner Clinic Foundation: “How to Avoid Nipple Chafing While Running.”

Susan G. Komen: “Warning Signs of Breast Cancer.”

The Royal Women’s Hospital: “Breast & nipple thrush.” “Breast soreness.”

UpToDate: “Common breastfeeding problems.”

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Why Are My Nipples Sore

Why are my nipples sore? 7 possible causes