Sore Nipples

Why are my nipples sore?

Many things can cause nipple soreness or painful nipples. Along with discomfort or sensitivity, you can also experience itching, redness or changes in the texture of your skin around your nipple.

In most cases, sore nipples are caused by hormonal changes from pregnancy or menstruation, allergies or friction from clothing. In rare cases, it can be a sign of a serious disease like breast cancer. Your healthcare provider should evaluate any pain that's accompanied by discharge or lumps as soon as possible.

Everyone experiences nipple soreness or tenderness differently. Some may describe their nipples as being:

• Very sensitive to touch.
• Throbbing or stabbing.
• Aching.
• Burning.
• Tender or sore.
• Red or swollen.
• Itchy.

What are the most common causes of sore nipples?

Symptoms of nipple pain or tenderness vary from person to person depending on the cause.

Menstruation or other hormonal changes

The hormonal changes that occur as part of menstruation can cause breast tenderness and sore nipples. Most cases of breast or nipple tenderness occur just before menstruation begins (in the days just before your period). This is because estrogen and progesterone cause your breast tissue to swell.

Similarly, other life events like menopause or beginning puberty can also cause your hormones to shift, triggering side effects like nipple pain.

Hormonal birth control can also cause changes that lead to nipple soreness.

Pregnancy

Pregnancy is a common reason for many bodily changes, including changes to your breasts. Nipple and breast soreness may be an early sign of pregnancy due to the sharp increase in hormones. Your nipples may become larger, darker and more sensitive during pregnancy.

Breastfeeding (chestfeeding) or pumping breast milk

A bad latch causes most cases of nipple pain or soreness related to breastfeeding (nursing). A latch is how your baby is positioned on your breast. A good latch involves your baby accepting your entire nipple and areola in their mouth. If your baby is sucking on just your nipple, it can make breastfeeding extremely painful. If your pain continues beyond the first few weeks, talk to your healthcare provider. Most breastfeeding pain resolves within the first month of breastfeeding.

If you’re pumping breast milk, you can experience nipple pain from using a breast shield (also called a breast pump flange) that’s the incorrect size. A breast shield is a plastic piece that fits over your areola and nipple. Strong suction makes a poor-fitting breast shield even worse.

Check with your healthcare provider or a lactation consultant if you believe nursing or your breast pump is causing your nipple pain.

Friction from clothing

Bras or shirts can rub against your nipples and cause soreness and pain. It’s especially common in runners (joggers nipple) and athletes. The friction from clothing or poor-fitting bras can cause your nipples to get dry, red or chapped. Wearing a bandage over your nipple during exercise or applying a petroleum-based ointment can help prevent nipple chafing.

Trauma

Trauma to your nipple during sex or from nipple piercings can cause pain and irritation. If you have a piercing, check for signs of infection like swelling or pus-like discharge. If nipple soreness is caused by rough foreplay, it should improve over time.

Infection

Cracked and sore nipples are prone to infection because the open skin allows for bacteria to get in. Your nipples can become cracked for several reasons, such as during breastfeeding or from trauma. Common reasons are:

• Mastitis: Lactation and breastfeeding can increase your chances of developing mastitis, a painful breast infection. Other symptoms include fever and hard, red spots on your breast.
• Thrush: A yeast infection called thrush can also cause nipple pain, stinging or soreness. Your baby may also develop thrush on their tongue, cheeks or throat.
• Folliculitis: Clogged hair follicles around your nipples can also become infected and cause soreness.

Allergic reactions or skin rashes

Reactions to skin irritants like detergents, soaps, perfume or lotions are a common cause of nipple soreness or itching skin. If the pain is accompanied by blisters, scaly patches or redness on your nipple area, it could be a skin condition called dermatitis. Contact dermatitis is caused by products or irritants touching your skin. Atopic dermatitis (or eczema) is usually related to allergies or your immune system. Both can affect your nipples.

Disease or cancer

Paget’s disease of the breast or breast cancer can cause nipple pain. In addition to sharp pain or itching, you might also have nipple discharge, lumps on your breast or your nipple may change shape (turn inward or become inverted). Although nipple pain caused by cancer is rare, you should contact your healthcare provider if you experience any of these symptoms.

Does ovulation cause sore nipples?

Ovulation can cause sore nipples due to hormonal changes that occur during your menstrual cycle. However, it’s more common to experience nipple tenderness in the days just before your period.

Why are my nipples sore to touch when I’m not pregnant?

There can be several reasons your nipples are sensitive to touch other than pregnancy. If you're not pregnant, other causes could be hormonal shifts due to menstruation or birth control, trauma or infection. If you experience prolonged soreness that’s accompanied by a lump or nipple discharge, contact your healthcare provider right away.

How do doctors diagnose nipple pain?

In most cases, you can pinpoint the cause of your nipple soreness. If you can't, or the pain and soreness persist for several days, you may need to see your healthcare provider. Your provider may ask you questions about when the pain started or if the pain is related to your period, clothing or previous nipple trauma.

If the cause can’t be determined, your provider may order a mammogram or ultrasound to look at your breasts.

How are sore nipples treated?

It depends on the cause. Sometimes all your nipples need is some time to heal. Your healthcare provider may recommend medications or ointments to speed up the healing process.

Pain caused by hormonal changes associated with menstruation can be treated with over-the-counter pain relievers like acetaminophen or ibuprofen. Most people feel relief after 24 or 48 hours.

Nipple pain caused by poor-fitting bras or shirts can be treated by changing fabrics or purchasing new clothes. Placing a bandage or petroleum-based ointment over your nipples can reduce chafing or rubbing.

If you’re nursing or pumping breast milk, visiting a lactation consultant may be beneficial. They can help with your baby's latch or feeding positions and ensure your breast pump fits correctly. Other solutions for nipple pain during breastfeeding include lanolin ointment and cold compresses. Antibiotics are used if the pain is being caused by an infection like thrush or mastitis.

A topical anti-inflammatory cream may help with inflammation and pain caused by an allergic reaction. Similarly, an oral antihistamine can help reduce symptoms caused by allergies.

In the case of cancer or other breast diseases, treatment could involve radiation, chemotherapy, surgery or a mastectomy (surgically removing your breasts). Sore nipples alone don’t mean you have cancer. Along with nipple pain, you might also have nipple discharge, lumps on your breast or your nipple may turn inward.

When should sore nipples be treated by a healthcare provider?

Sore nipples are usually not a cause for worry or a sign of cancer. However, you should contact your provider if:

• The pain is persistent or doesn’t go away.
• You notice a discharge from your nipple (that’s not breast milk).
• You feel lumps in your breast.
• The pain is accompanied by fever or a general unwell feeling.

A note from Cleveland Clinic

Nipple soreness or pain is common and can be caused by many factors. It’s usually harmless and doesn’t cause complications. In most cases, it goes away on its own or can be managed with over-the-counter medication or ointments. Call your healthcare provider if you develop other symptoms and nipple pain, such as lumps in your breasts or discharge from your nipples.