Eczema on Nipples

What is eczema on nipples?

Eczema (atopic dermatitis) is a condition that causes an itchy rash to develop on your skin. The rash can appear anywhere on your body. Eczema can develop on your nipples as well as your areola (the dark circle of skin surrounding the nipples). This condition affects babies, children and adults of all genders.

Eczema on your nipples isn’t dangerous. But it can lead to an infection, especially if you scratch the rash. Scratching can break your skin and allow bacteria to enter. It can also cause your skin to thicken and harden over time.

Nipple eczema can get worse when your nipples come into contact with irritants such as harsh laundry detergents, soaps and lotions. There is no cure for eczema, but you can relieve symptoms by avoiding the irritants that make eczema worse and using emollients such as petroleum jelly (Vaseline®) or other products that help increase the barrier function of your skin. Providers can also treat eczema with steroid creams, medications and even light treatments.

Who might get eczema on nipples?

Most of the time, eczema develops before age 5. It’s one of the most common skin problems in children. Many children outgrow the condition.

People of all genders can get eczema on their nipples. Some people develop the rash all over their body, including their nipples and areola. Other people only have eczema on their nipples and areola, but not on the rest of their body. You’re more likely to get eczema (atopic dermatitis) if you have:

• Allergic rhinitis (hay fever).
• Asthma.
• Family history of allergies, asthma or eczema.
• Food allergies.
• Obesity, or if you carry extra weight.

How common is eczema on nipples?

Eczema is very common. It affects around 15 million people in the United States, usually in cities. Every year, providers diagnose eczema in around 10% of adults and up to 20% of kids. It’s more common among women and Black people. Only a small number of people with eczema will get it on their nipples.

What causes eczema on nipples?

Eczema is a type of dermatitis. It isn’t contagious. You can’t get it from someone else, and you can’t spread it. Eczema results from:

• Genetics: Eczema is often inherited (passed down through families).
• Environmental factors: Laundry detergents, certain fabrics, soaps, lotions and perfumes can irritate the skin around your nipple and lead to a flare-up of eczema. Sweat can get trapped under your breasts inside your bra or shirt, which can cause irritation.
• Overactive immune system: The red, scaly rash can develop when your immune system reacts to a substance that isn’t actually harmful. You may have an allergic reaction to food or another substance, and that can trigger an eczema outbreak.
• Stress levels: High-stress levels, anxiety and depression can trigger the rash and make it worse.

What are the symptoms of eczema on nipples?

People with nipple eczema develop a red, itchy, scaly rash on their nipples and areola. Your areola is part of your breast anatomy. It’s the dark circle of skin around your nipple. Nipple eczema can flare up or get worse every now and then. It may get better or even go away for a few weeks, months or years and then come back. Signs of nipple eczema include:

• Dry, inflamed skin around your nipple.
• Itchy, painful, burning or sensitive skin.
• Nipple discharge.
• Rash that has brown, red or gray patches or spots.
• Scaly, dry skin that may peel, crust or scab over.
• Small bumps that ooze fluid.

How is eczema on nipples diagnosed?

Usually, providers can diagnose eczema by looking at your skin. Your provider will ask about your symptoms and examine the skin around your nipples. They will also look for signs of eczema on other parts of your body.

If you’re breastfeeding, tell your provider. People with eczema are more likely to get mastitis, an infection in your milk ducts that causes breast pain (mastalgia), redness and swelling.

Your provider may order:

• Allergy testing, to see if you have an allergy to certain substances or foods.
• Complete blood count (CBC), to check your blood for infections or other conditions.
• Skin biopsy, to test your skin for infection and see what kind of dermatitis you have.

Two rare types of breast cancer called Paget’s disease of the breast and inflammatory breast cancer (IBC) can have some of the same symptoms as nipple eczema. If your provider suspects these conditions, they may recommend a mammogram or additional tests.

How do providers treat eczema on nipples?

There isn’t a cure for eczema, but treatments can help. Your provider may recommend you:

• Avoid the substance (such as lotion or soap) that may cause your symptoms. They may also recommend avoiding certain foods if you have a food allergy.
• Moisturize the skin around your nipple using an unscented cream or lotion. You can also use petroleum jelly to keep the skin moist.
• Taking medications such as corticosteroids, which reduces inflammation and itchiness. They come in the form of creams that you to apply to your skin. You can also take corticosteroids orally (by mouth) or antihistamine medications for severe itching. Your provider may also recommend immunosuppressant drugs to regulate your immune system or antibiotics to treat infection.
• Trying phototherapy, which uses ultraviolet light waves from special lamps to relieve symptoms of eczema.

How can I prevent an outbreak of eczema on nipples?

To prevent an outbreak, you should:

• Avoid strong soaps and lotions, especially those with artificial smells or colors. Use hypoallergenic lotions. You may also want to try creams and lotions that contain ceramide, which can restore your skin’s natural barrier.
• Cut foods out of your diet that you are allergic to or that trigger an eczema outbreak.
• Maintain a healthy weight, and talk to your provider about losing weight if you have obesity.
• Manage stress levels with relaxation exercises or therapy.
• Run a humidifier in your room to keep the air from getting too dry.
• Take shorter showers or baths, and don’t bathe in water that’s too hot since it can dry out your skin.
• Try not to scratch the rash. Scratching might give you relief at first, but it can make the itching and pain worse. It can also cause your skin to break, which increases the chance that you’ll get an infection.
• Use unscented laundry detergent made for sensitive skin.
• Wear cotton shirts and bras. Manmade or scratchy fabrics (like polyester and wool) can irritate your nipples.

What is the outlook for people with eczema on nipples?

Eczema symptoms usually get better or go away with age. But flare-ups can happen throughout life. You’re more likely to have repeated flare-ups if you:

• Also have allergies or asthma.
• Got eczema at a young age.
• Have severe eczema.

People who scratch their skin repeatedly are at an increased risk of infection. Long-term scratching can also cause your skin to harden and thicken over time. To avoid these complications, don’t scratch the rash. Talk to your provider about ways to relieve the itching.

When should I see my healthcare provider about nipple eczema?

If you have a breast rash that doesn’t go away after a few days, see your provider. It’s important to get an examination. Call your provider right away if you have:

• Itchiness that’s severe or discomfort that makes it difficult for you to sleep.
• Breast lumps or nipple discharge.
• Pain or swelling in the breast or nipples.

A note from Cleveland Clinic

Eczema on your nipples can cause extreme discomfort. In severe cases, the itchy rash and dry skin can make it difficult to move, wear clothing or sleep. If you or your child has a rash on or around the nipples, see your provider for an evaluation. It’s important to get a checkup, rule out other conditions and get treatment. Although there isn’t a cure for nipple eczema, treatments can relieve symptoms.