Breast Eczema

Overview

What is breast eczema?

Breast eczema (atopic dermatitis) is a condition that causes your skin to become dry, discolored, itchy and bumpy. It may appear in the dark areas around your nipples (areolas), between your breasts, under your breasts, on the sides of your breasts or elsewhere on your chest.

Eczema damages the skin barrier function (the “glue” of your skin). As a result, your skin becomes more sensitive and more prone to infection and dryness.

How can you tell the difference between Paget's disease and eczema?

Paget’s disease of the breast is a rare form of breast cancer that involves the skin of the nipple and can extend onto the areola. It has many of the same symptoms as breast eczema, which can sometimes lead to a misdiagnosis. These symptoms include:

  • Itching, tingling or discoloration in the nipple area.
  • Flaky, crusty or thickened skin.
  • A flattened or turned in (inverted) nipple.
  • Yellow or bloody leakage from the skin of the nipple.

However, there are differences between Paget’s disease and eczema. Paget’s disease may affect your nipple, while eczema rarely affects your nipple. Paget’s disease also typically only affects one breast, while eczema affects both breasts and other parts of your chest.

Paget’s disease won’t respond to the same treatments as eczema. The tests used to diagnose Paget’s disease include:

Who does breast eczema affect?

Breast eczema can affect anyone with breasts. However, it’s more common in people with:

How common is breast eczema?

Eczema is very common, and any part of your skin can develop it, including your breasts. Approximately 15% to 30% of children have eczema, and 2% to 10% of adults have it.

How does breast eczema affect my body?

Breast eczema affects the skin on and around your breasts. Your skin may itch, change color, develop bumps, dry out or thicken.

In severe cases of breast eczema, your skin may crack or leak a thick, yellow or white fluid (pus).

Symptoms and Causes

What does eczema on the breast look like?

Symptoms of breast eczema include:

  • Itchy skin.
  • Dry skin.
  • Discolored rashes.
  • Bumps on your skin.
  • Leathery patches of skin.
  • Crusty skin.
  • Swelling.

Breast eczema doesn’t hurt. However, if you scratch your breast eczema, you may break your skin, leading to an infection that can cause pain.

How did I get eczema on my breast?

Eczema can develop anywhere on your skin, including your breasts. A combination of immune system activation, genetics, environmental triggers and stress can cause it.

  • Immune system: If you have breast eczema, your immune system overreacts to minor irritants or allergens. This overreaction can inflame your skin.
  • Genetics: You’re more likely to have breast eczema if you have a history of eczema in your family. You’re also at a higher risk if you have a family history of hay fever, asthma and allergens. Allergens are substances like pollen, pet hair or foods that trigger an allergic reaction. There might also be a change in your genes that control a protein that helps your body maintain healthy skin. Without normal levels of that protein, your skin won’t be completely healthy.
  • Environment: A lot of irritants in your environment can irritate your skin. Some examples include tobacco smoke, air pollutants, harsh soaps, fabrics such as wool and some skin care products. Low humidity (dry air) can cause your skin to become dry and itchy. Heat and humidity can cause sweating, and sweating can make itchiness worse. If you have a breast eczema flare-up after coming into contact with an allergen or irritant, you may have contact dermatitis.
  • Stress: Your stress levels can cause or worsen your breast eczema. There are mental and emotional signs of stress and physical signs of stress.

Breastfeeding (chestfeeding) can also cause breast eczema. It may cause a rash to develop around your nipples, which may lead to breast eczema.

What are the mental/emotional signs of stress and physical signs of stress that can cause breast eczema?

Some mental/emotional signs of stress that can cause breast eczema include:

  • Depression.
  • Difficulty relaxing.
  • Use of alcohol, tobacco or drugs to relax.
  • A negative opinion of yourself (low self-esteem).
  • Anxiety (constant worry).
  • Feeling overwhelmed.
  • Difficulty concentrating.
  • Irritability, mood swings or a short temper.

Some physical signs of stress that can cause breast eczema include:

Is breast eczema contagious?

Breast eczema isn’t contagious. You can’t spread breast eczema to another person through skin-to-skin contact.

Diagnosis and Tests

How is breast eczema diagnosed?

Your healthcare provider will examine your breasts. They’ll look for common signs of eczema, including discoloration and dryness. They’ll also ask about your symptoms.

What tests will be done to diagnose breast eczema?

Your healthcare provider can typically diagnose eczema after a physical exam. However, if there’s any doubt, they may perform the following tests:

  • An allergy skin test.
  • Blood tests to check for causes of a rash that might be unrelated to breast eczema.
  • A skin biopsy to distinguish one type of dermatitis from another.

Management and Treatment

How do I get rid of eczema on my breasts?

Getting rid of breast eczema can be difficult if its cause is something you can’t control, like genetics. However, you may have some control over your environment and stress levels. Try to determine what triggers or worsens your breast eczema, and then avoid it. The goal is to reduce itching and discomfort and prevent infection and additional flare-ups.

Consider these home remedies and tips:

  • Use a humidifier if dry air makes your skin dry.
  • Avoid rubbing or scratching your skin.
  • See a psychiatrist for medication and a therapist for counseling if you experience poor mental/emotional health symptoms.
  • Apply hydrocortisone cream or ointment. Hydrocortisone is a corticosteroid combined with an anesthetic pain reliever. It relieves itching and discoloration.
  • Moisturize your skin using a cream or ointment. Lotions usually don’t work as well. Apply several times a day, including after your bath or shower. Moisturizers help trap moisture in the skin.
  • Bathe or shower in lukewarm — not hot — water. Limit the amount of time you spend in the water to under 15 minutes.
  • Use mild soaps or other products that are free of perfumes, dyes and alcohol. Look for products labeled “fragrance-free,” “hypoallergenic” or “for sensitive skin.”
  • Use mild laundry soap, and thoroughly rinse your clothes.
  • Use skin products that contain ceramide. These products replace some of the “glue” (the barrier) missing from your skin.
  • Wear cotton clothes. Wool, silk and other fabrics can dry your skin.
  • Take over-the-counter (OTC) antihistamines for severe itching.
  • Take prescription medications. Your healthcare provider may prescribe steroid creams, pills or shots. Long-term risks include side effects like high blood pressure, weight gain and thinning of the skin. There are newer medications, called topical immunomodulators (TIMs), that show progress in treating patients who don’t respond to other treatments. They change the body’s immune response to allergens and have fewer side effects.
  • Try phototherapy. Phototherapy uses ultraviolet light, usually ultraviolet B (UVB), from special lamps. The ultraviolet light waves found in sunlight can help certain skin disorders, including eczema.

What can’t I eat or drink with breast eczema?

The connection between breast eczema and food/drink allergies is unclear. If you have food allergies, then one of the reasons why you must avoid those foods is that they may cause or worsen your breast eczema. Examples of common allergies include peanuts, dairy, eggs, sugar, alcohol and gluten. Pay attention to what you eat. If your breast eczema flares up after you eat a particular food, then you might be allergic to it.

How soon after treatment will I feel better?

With proper treatment, your breast eczema should go away after one to three weeks. However, no treatment can claim to eliminate the symptoms of breast eczema 100% of the time. You may encounter flare-ups on your breasts for the rest of your life. Once you determine the cause of your flare-ups, you may prevent flare-ups from happening as often.

Prevention

How can I reduce my risk of breast eczema?

There are steps you can take that may prevent breast eczema outbreaks:

  • Establish a skin care routine, and follow your healthcare professional’s recommendations for keeping your skin healthy.
  • Wear a bra and shirt made from a breathable fabric that wicks away moisture. Wash new clothing before wearing it. Avoid wool and silk.
  • Use a mild soap for your bath or shower, and pat your skin dry instead of rubbing it. Apply a moisturizing cream or ointment immediately after drying your skin to help seal in the moisture. Reapply cream or ointment two to three times a day.
  • Take baths or showers with lukewarm water, not hot water.
  • Drink at least eight glasses of water each day. Water helps keep your skin moist.
  • Try to avoid getting too hot and sweaty.
  • Avoid sudden changes in temperature and humidity.
  • Learn to recognize stress in your life and how to manage it. Regular aerobic exercise, hobbies and stress-management techniques, such as meditation or yoga, may help.
  • Limit your exposure to known irritants and allergens.
  • Avoid scratching or rubbing your irritated skin.

Outlook / Prognosis

What can I expect if I have breast eczema?

If you have breast eczema, it can generally be well-managed with good skin care and treatment. However, flare-ups of symptoms can occur throughout your life.

Can breast eczema be cured?

Breast eczema is a chronic condition, which means there isn’t a cure. However, treatments are very effective in reducing the symptoms of dry, itchy skin.

Living With

How do I take care of myself?

Many people live with breast eczema. It can be challenging, though.

There may be times when your breast eczema disappears. These times are “remission” periods. The goal of a good skin care routine and treatment is to prevent flare-ups. Be sure to avoid anything that triggers your breast eczema, moisturize, take your medicine and follow your healthcare provider’s recommendations.

Reducing your stress is also very important in reducing breast eczema flare-ups. Try these tips:

  • Count to 10 as you take a deep breath.
  • Exercise daily.
  • Drink caffeine and alcohol in moderation.
  • Sleep eight hours a night.
  • Eat healthy foods.
  • Try to have a positive attitude.
  • Journal every day.
  • Talk about your life with friends, family and a therapist.

When should I see my healthcare provider?

See your healthcare provider as soon as you notice symptoms. Get treatment right away.

What questions should I ask my healthcare provider?

  • How can you tell that I have breast eczema?
  • If I don’t have breast eczema, what other skin condition might I have?
  • Is there a specific brand of moisturizer that you recommend?
  • Is there a prescription cream or ointment that you can prescribe?
  • Should I see a dermatologist or another specialist?
  • What soaps, lotions, makeup and other skin care products should I avoid?
  • What medications do you recommend?
  • What at-home treatments do you recommend?

A note from Cleveland Clinic

Breast eczema is annoying and can be embarrassing, but it’s common and very normal. It can affect your quality of life, particularly if it’s very itchy or makes you feel self-conscious. However, with a proper skin care routine and treatment, you can reduce its impact. See your healthcare provider as soon as you notice signs of breast eczema.

Last reviewed by a Cleveland Clinic medical professional on 10/27/2021.

References

  • Geria AN, Alexis AF. Atopic Dermatitis and Other Eczemas. In: Kelly A, Taylor SC, Lim HW, et al, eds. Taylor and Kelly's Dermatology for Skin of Color, 2nd ed. McGraw Hill; 2016. Accessed 9/14/2021.
  • Hardin J. Atopic Dermatitis. In: Knoop KJ, Stack LB, Storrow AB, et al, eds. The Atlas of Emergency Medicine, 5th ed. McGraw Hill; 2021. Accessed 9/14/2021.
  • Lawley LP, McCall CO, Lawley TJ. Psoriasis, Cutaneous Infections, Acne, and Other Common Skin Disorders. In: Jameson J, Fauci AS, Kasper DL, et al, eds. Harrison's Principles of Internal Medicine, 20th ed. McGraw Hill; 2018. Accessed 9/14/2021.
  • Liu J, Zhao Z, Zhou J, et al. An unusual presentation of Paget's disease of the nipple in a young woman: a case report. Int J Clin Exp Med. 2015; 8(3): 4694-4696. Accessed 9/14/2021.
  • National Eczema Association. Atopic Dermatitis. (https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/) Accessed 9/14/2021.
  • Nemeth V, Evans J. Eczema. StatPearls Publishing; 2021. Accessed 9/14/2021.
  • Shinkai K, Fox LP. Atopic Dermatitis. In: Papadakis MA, McPhee SJ, Rabow MW, et al, eds. Current Medical Diagnosis & Treatment 2022. McGraw Hill; 2022. Accessed 9/14/2021.

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