Dry nipples: Causes, other symptoms, treatments, and remedies

What causes dry nipples?

Harsh soaps that wash away your skin’s natural oils can cause dryness, according to the National Institutes of Health. Plus, irritation from synthetic fabrics like nylon, chafing from exercise, and chlorine from a pool or spa can all result in dryness around that area, says Dr. Dweck.

Not surprisingly, nursing a baby can also cause those mammary glands to crack, according to the Mayo Clinic. And breastfeeding a bb ups your chances of contracting a yeast infection on your nipple (aka thrush), per the U.S. National Library of Medicine, which can result in a crust (sorry).

If these aren’t a thing for you, it’s possible an underlying skin problem like eczema or psoriasis could be drying out your nips, says Dr. Dweck.

Signs and symptoms of benign breast conditions

There are many different types of benign breast conditions but they all cause unusual changes in breast tissue. Sometimes they affect the glandular tissue (the system of lobules and ducts that produce milk and carry it to the nipple). Or they can involve the supportive tissue of the breast, also called stromal tissue.

A benign breast condition can lead to a distinct growth or lump that sometimes can be felt through the skin. Or it can be something unusual picked up on a screening mammogram.

If you have symptoms, they’re often similar to those associated with breast cancer, such as:

pain, swelling, and/or tenderness in the breast

a lump that can be felt through the skin or nipple

skin irritation

redness or scaling on the nipple and/or skin of the breast

nipple pain or retraction (meaning part of the nipple looks like it is puckered or pulling inward)

discharge from the breast that is not milk (the color can range from clear to bloody to yellow, green, dark brown, or even black. Note: If you have discharge alone, even with no other symptoms, tell your doctor. Generally, yellow or greenish discharge is benign while discharge that is clear or tea-colored is more concerning. Any discharge should be checked out, though.)

All of these symptoms require further testing to rule out breast cancer as a possible cause.

Diagnosis of benign breast conditions

The tests and procedures used to diagnose a benign breast condition are often the same as those used to diagnose breast cancer. The goals of diagnosis are to:

make sure that the growth or other change detected is really benign

determine whether the condition is associated with any increase in cancer risk

Procedures could include:

A breast physical exam and medical history: Your doctor examines the breasts, paying close attention to the area or areas where there is a lump or other unusual change. He or she also takes a complete medical history, including your current and previous symptoms, general breast health, and any risk factors for breast cancer.

Imaging tests: The most commonly used tests are mammography, an X-ray examination of the breast; and ultrasound, which uses high-frequency sound waves to create s of the breast tissue. Ultrasound is a good tool for telling the difference between lumps that are fluid-filled (called cysts) and those that are solid (which can indicate cancer or another benign breast condition, such as fibroadenoma). A breast MRI, or magnetic resonance imaging scan, may also be done if other imaging tests don’t provide enough information.

Nipple discharge analysis: If you have nipple discharge, a sample can be taken and examined under a microscope for the presence of blood or other abnormal cells. In some cases, additional tests may be needed to figure out the cause.

Biopsy: Biopsy involves removing a tissue sample and examining it under a microscope. Typically you would have a core needle biopsy, which removes slivers of tissue, or an excisional biopsy, which removes abnormal tissue from the area.

Your testing plan will depend on your symptoms and what type of benign breast condition is suspected. Your doctor might not be able to tell you much until the test results come back. Waiting is hard, but remember that benign conditions are more common than breast cancer.

In most cases, today’s imaging techniques are advanced enough to tell the difference between a benign breast condition and cancer, notes Alan Stolier, M.D., a surgical breast oncologist with St. Charles Surgical Hospital and the Center for Restorative Breast Surgery in New Orleans. “If anything about the imaging is suspicious, we will go a step further with biopsy,” he says. “If we don’t recommend anything else be done, we have a high level of confidence it is benign.”

In some cases, he adds, your doctor might have you come back for another ultrasound or other imaging study within 6 months. This doesn’t mean he or she is concerned that the breast change could be cancer. Rather, it’s an extra precaution to make sure the area stays the same, and this often eases patients’ minds. However, most women don’t need to be followed with imaging studies in this way. Whatever your situation, don’t hesitate to ask your doctor for more information or seek a second opinion.

Learn more in Breast Cancer Tests.

Symptoms of Paget’s disease of the nipple

Pagets disease of the nipple always starts in the nipple and may extend to the areola. It appears as a red, scaly rash on the skin of the nipple and areola.

The affected skin is often sore and inflamed, and it can be itchy or cause a burning sensation. The nipple can sometimes be ulcerated.

The rash is often similar in appearance to other skin conditions, such as eczema or psoriasis. If you scratch it, or if its left untreated, it can bleed, become ulcerated or scab over.

If youre experiencing itchiness, burning or bleeding but the nipple looks normal and is not red or scaly, its unlikely to be Pagets disease of the nipple. However, you should still have it checked by a doctor.

Around half of all women diagnosed with Pagets disease of the nipple have a lump behind the nipple. In 9 out of 10 cases this is an invasive breast cancer.

Invasive cancer is where cancerous cells invade the surrounding breast tissue. Some women with Pagets disease have invasive breast cancer but do not have a lump.

However, most women with Pagets disease who do not have a lump have non-invasive cancer.

This is where the cancerous cells are contained in 1 or more areas of the breast and have not spread.