Itchy nipples are sheer misery. Not only are they awkward to scratch during the daytime, but at nighttime, they make sleeping nearly impossible. If you’re clawing at your chest at 3 a.m. and wondering what in the world is going on with your nipples, the good news is that, in most cases, it’s nothing serious. In rare cases, itchy nipples is a sign of something more serious – and we’ll get to that – but like I said, it’s rare. So first let’s talk about what’s more likely to be going on.
Atopic dermatitis, also known as eczema, is the most common cause of itchy nipples. With this condition, itching is almost always present and can be severe. The itching may start even before you’re able to see a rash. The rash can include small blisters with oozing or crusting. If you keep scratching, you could open the skin to infections or create thickened areas from constant inflammation and irritation.
Atopic dermatitis can appear in women and men of all ages. Since it's thought to be due to a hypersensitivity reaction, you may be more prone to develop it if you have a personal or family history of allergies, asthma, or hay fever.
Environmental triggers that can prompt atopic dermatitis to flare up can include:
- Dry skin
- Prolonged contact with water
- Dyes or scents added to skin products
- Cleaning products
Doctors usually diagnose atopic dermatitis by doing a physical exam and asking about your health history. If needed, they can also do a skin biopsy to rule out other causes.
The majority of atopic dermatitis remedies are treatments that you apply directly to the skin, like steroid creams or ointments. It is important to use an ointment and not lotion in this area, as lotions can sometimes contain drying agents that might make the symptoms worse.
Topical ointments that might help include:
A & D ointment
When your itching is severe or there is a known allergic trigger, antihistamine pills can help. Hydrocortisone cream is also an option.
There are also self-care and preventative strategies that can ease your symptoms. Your best strategy for getting rid of atopic dermatitis is to avoid triggers, but you should also do what you can to keep moisture in your skin. For instance, don't use drying soaps, and don't take long, hot baths. Once out of the bath or shower, apply an ointment to the area.
As I mentioned, there is a more serious cause of itchy nipples, and it’s important to know the signs:
Paget’s disease is a rare form of breast cancer that can involve both the nipple and the areola (the colored area that encircles the raised nipple). One of the first symptoms of Paget’s disease can be an itching or burning sensation of the nipple or areola.
In Paget's disease, the itching is often accompanied by a crusty rash. The scaly rash does not get better with topical creams. More advanced cancers will form open sores and might have nipple discharge. Paget's is most often found in just one breast and is typically found in women between the ages of 50 and 60.
Doctors diagnose Paget's disease with a breast exam and a mammogram. They might also do a biopsy of the nipple. Any breast lumps would be biopsied as well. The treatment for Paget’s disease is breast surgery, either removing the whole breast (known as mastectomy) or removing just the diseased part of the breast.
If you have any of the symptoms of Paget’s, contact your doctor for an evaluation.
In general, though, itchy nipples are also not something you need to run to the ER for at the first twinge of discomfort. Try the topical ointments and antihistamines mentioned above, and if the symptoms don’t get better or a rash develops, then follow up with your doctor to get things thoroughly checked out.