What is the Cause of Nipple Pain? Understanding and How to Manage It?

Nipple pain, also known as mastalgia, is a common issue that can affect anyone, including women and men. It can range from mild tenderness to sharp, intense discomfort. While often harmless and caused by friction or hormonal changes, persistent or unusual pain may signal underlying issues requiring attention [1]. For example, one study found that nipple pain is one of the most common reasons people seek medical attention for the breast area, especially among those who are breastfeeding [2]. This article explains the most frequent causes, symptoms, diagnosis, and treatments for nipple pain.

Causes of Nipple Pain

Nipple pain can be an uncomfortable and sometimes concerning experience. It’s important to understand the potential reasons to know when self-care is sufficient and when medical consultation is necessary [1]. Here are some common causes of nipple pain:

1. Friction and Chafing: Friction is one of the most frequent causes of nipple pain. It often occurs when the nipples rub against clothing, especially during physical activities such as running or cycling. This repeated rubbing can lead to soreness, chafing, and even bleeding in severe cases (known as “jogger’s nipple”) [3]. Properly fitting clothing and protective measures, such as nipple guards or petrolatum jelly, may help reduce friction-related discomfort.
2. Ill-Fitting Clothing: Ill-fitting bras or tops can exacerbate nipple pain by creating unnecessary pressure and friction. Tight or poorly designed bras can irritate the sensitive skin of the nipples, leading to discomfort. Choosing well-fitted, supportive bras made of soft, breathable fabrics may help prevent this issue [4].
3. Exercise and Sports: Physical activities can increase the risk of nipple pain due to friction and movement. Sports that involve repetitive motions, such as running, or those causing significant breast movement, can induce breast skin strain that leads to pain and discomfort [5]. Athletes often experience this issue and may benefit from specialised clothing designed to minimise friction and moisture.
4. Menstrual Cycle (Cyclic Nipple Pain): Many women experience nipple pain as a symptom of premenstrual syndrome (PMS). Hormonal fluctuations, particularly increases in estrogen and progesterone, can lead to breast swelling and tenderness, including nipple discomfort. This pain typically resolves once menstruation begins. This is considered a normal, expected variation.
5. Hormonal Level Fluctuations: Hormonal changes throughout the menstrual cycle, pregnancy, and menopause can lead to nipple pain. These fluctuations may cause the breasts to swell and become tender, resulting in discomfort with varying intensity. Even certain medications can impact hormone levels and, subsequently, breast sensitivity [7].
6. Pregnancy: During pregnancy, hormonal and physical changes in the breasts can lead to increased sensitivity and pain in the nipples. Many women report heightened nipple sensitivity as an early sign of pregnancy, which may continue throughout the gestation period [1].
7. Breast Growth and Changes: Breast development during puberty, pregnancy, or hormonal therapy can cause nipple pain. As breast tissue expands and changes, the nipples may become sensitive or painful due to increased blood flow and hormonal activity [8].
8. Eczema or Dermatitis: Skin conditions, such as eczema or contact dermatitis, can cause irritation and pain around the nipples. Symptoms may include redness, itching, and flaking skin [9]. Identifying and avoiding triggers, such as certain soaps, lotions, or fabrics, can help manage these conditions [9].
9. Infection (e.g., Mastitis): Infections can lead to nipple and breast pain, particularly in individuals who are breastfeeding [1]. Conditions, such as mastitis (an infection of the breast tissue), can cause significant pain, swelling, and redness. Mastitis usually presents with flu-like symptoms and fever [10]. Prompt medical attention is necessary for infections to prevent complications.
10. Bacterial or Fungal Infection (e.g., Thrush): Bacterial or fungal infections, such as thrush (a yeast infection caused by Candida), may also cause nipple pain. Thrush may occur in breastfeeding individuals, leading to sharp, burning pain, and visible changes in the skin around the nipple and areola [1]. Treatment typically involves antifungal medications for both the individual and the infant if breastfeeding is the source of the infection [1].
11. Nipple Piercing Complications: Nipple piercings can lead to complications, such as infections, allergic reactions, or scarring. Proper aftercare and hygiene are essential to prevent pain and complications following a nipple piercing [8]. Individuals experiencing persistent pain, signs of infection, or excessive swelling after a piercing should consult a doctor.
12. Breast Cancer: While nipple pain is rarely the sole symptom of breast cancer, it may occur alongside other signs such as a new lump, changes in breast shape or size, persistent changes in the skin (e.g., dimpling or thickening), or unusual nipple discharge. It is crucial to seek medical evaluation for any persistent or concerning symptoms to rule out serious conditions, especially since early detection significantly improves outcomes.

Diagnosis and Management of Breast and Nipple Pain

Here are key points highlighting the proper diagnosis and management of breast and nipple pain:

• Proper Observation and Self-Examination: To manage nipple pain, it is crucial to engage in regular self-examinations and observe any changes in your breasts or nipples. Familiarity with your normal breast appearance and feel (including changes during your menstrual cycle) may help you notice any unusual changes, which could be signs of a potential issue [6]. For instance, if you are experiencing persistent pain, it is essential to communicate this to your doctor during your routine check-ups.
• Identifying Possible Triggers: If you are dealing with nipple pain, maintaining a diary of symptoms and possible triggers could be beneficial. Noting down when and exactly where the breast or nipple pain occurs can help you identify patterns, which may be related to hormonal fluctuations, external irritants, or physical activity [6]. Sharing this information with your doctor can aid them in diagnosing the cause of the nipple pain and tailoring an effective treatment plan.
• Monitoring Changes Over Time: It is vital to monitor the duration and intensity of your nipple pain, along with any other associated symptoms like redness or swelling. Having this comprehensive record can help your doctor understand your condition better and enhance the effectiveness of your treatment plan.

When to See a Doctor:

Risk vs. Self-Management

While many causes of nipple pain are benign and respond to simple self-care, there are specific signs that warrant a medical consultation. The benefit of seeking medical care is a definitive diagnosis and timely treatment, particularly for infections or rare serious conditions. The risk of delaying care for certain symptoms is an exacerbation of the underlying issue.

Here are important signs that indicate when to see a doctor for nipple pain:

1. Persistent or Worsening Pain: If your discomfort continues for an extended period (more than a few weeks), or if it significantly interferes with your daily activities, consult with your doctor. Persistent pain could indicate an underlying issue that requires further medical evaluation and treatment [6].
2. Suspected Infection: If you observe signs of an infection such as fever, body aches, chills, redness, swelling, or unusual discharge from the nipple or breast, seek medical help immediately. Infections, if left untreated, can lead to serious complications [10].
3. Alarming Changes in Breast Appearance: If you notice any significant, new changes in your breast or nipple appearance, such as a firm lump that persists after your period, changes in the skin texture (e.g., dimpling, puckering, or ‘orange peel’ texture), or bloody or clear nipple discharge, call for immediate medical attention [6]. These could be symptoms of conditions that warrant a thorough evaluation.

Tips to Help Prevent Nipple Pain

To help prevent nipple pain, consider these practical tips that focus on maintaining comfort and promoting breast health:

• Minimising Friction: One of the primary avoidable causes of nipple pain is friction. Opt for clothing made from soft, breathable fabrics and ensure a proper fit. Wearing sports bras with adequate support, applying a protective balm or nipple guards during physical activities can also help reduce irritation [3].
• Proper Hygiene and Skincare: Maintaining proper hygiene and skincare around the nipple area can significantly reduce instances of pain. Use mild, pH-neutral, hypoallergenic soaps and avoid harsh body washes or lotions to keep the area clean and healthy and prevent infections or irritations [9].
• Managing Hormonal Fluctuations: For pain related to the menstrual cycle, lifestyle changes, such as maintaining a healthy diet, regular exercise, and stress management, may help reduce the severity of cyclic breast and nipple pain [6]. Over-the-counter pain relievers or prescribed hormonal therapies may also be options in severe cases, as directed by a physician [6].

Remember, the path towards comfort lies in understanding what causes your discomfort in the first place, recognising it early, and taking proactive steps to minimise triggers and maintain breast health. By doing so, one can navigate through instances of nipple pain more effectively and improve overall well-being.

Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider, such as a Primary Care Physician or Gynecologist, for diagnosis and treatment of persistent, severe, or concerning nipple pain.

Frequently Asked Questions (FAQs)

What causes pain in the nipple area?

Pain in the nipple area can be caused by a variety of factors including friction from clothing, hormonal changes (related to the menstrual cycle, pregnancy, or menopause), breastfeeding-related issues like mastitis, infections (bacterial/fungal), or in rare cases, some types of breast cancer [1], [6].

Why do I have a sharp pain in my nipple?

Sharp nipple pain can be caused by various factors, including temporary hormonal shifts, friction, an infection such as thrush (especially during breastfeeding), or a benign growth in your breast [1], [6]. If the sharp pain is persistent, severe, or accompanied by other symptoms like discharge, a medical evaluation is recommended.

How can I reduce nipple sensitivity?

You can reduce nipple sensitivity by wearing soft, breathable fabrics, avoiding harsh soaps and body washes, and applying a moisturising nipple cream or barrier balm [9]. For sensitivity related to hormonal cycles, managing stress and maintaining a healthy lifestyle may also help [6].

Why does the point of my nipple hurt?

Pain at the point of your nipple could be due to friction from clothing, hormonal fluctuations, or an underlying condition like mastitis or a skin condition like eczema [1], [9]. If the pain is focused on the tip and presents with burning or flaking, consider a possible fungal or bacterial infection, which requires professional treatment [1].

References

[1] Amir, L. H., Baeza, C., Charlamb, J. R., & Jones, W. (2021). Identifying the cause of breast and nipple pain during lactation. BMJ, 374, n1628. https://doi.org/10.1136/bmj.n1628

[2] Puapornpong, P., Paritakul, P., Suksamarnwong, M., Srisuwan, S., & Ketsuwan, S. (2017). Nipple pain incidence, the predisposing factors, the recovery period after care management, and the exclusive breastfeeding outcome. Breastfeeding Medicine, 12(3), 169–173. https://doi.org/10.1089/bfm.2016.0194

[3] Niazi, A., Rahimi, V. B., Soheili-Far, S., Askari, N., Rahmanian-Devin, P., Sanei-Far, Z., Sahebkar, A., Rakhshandeh, H., & Askari, V. R. (2018). A Systematic Review on Prevention and Treatment of Nipple Pain and Fissure: Are they curable? Journal of Pharmacopuncture, 21(3), 139–150. https://doi.org/10.3831/kpi.2018.21.017

[4] Laageide, L., Radke, S., Santillan, D., & Powers, J. (2020). 12812 Understanding the causes and treatments of nipple pain secondary to breastfeeding. Journal of the American Academy of Dermatology, 83(6), AB110. https://doi.org/10.1016/j.jaad.2020.06.530

[5] Norris, M., Mills, C., Sanchez, A., & Wakefield-Scurr, J. (2020). Do static and dynamic activities induce potentially damaging breast skin strain? BMJ Open Sport & Exercise Medicine, 6(1), e000770. https://doi.org/10.1136/bmjsem-2020-000770

[6] Tahir, M. T., Vadakekut, E. S., & Shamsudeen, S. (2025). Mastalgia. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK562195/

[7] Humane, A., & Singh, S. (2022). Labetalol-associated raynaud’s phenomenon of the nipple: A rare case report with review of literature. Journal of Obstetrics and Gynaecology of India, 72(6), 533–535. https://doi.org/10.1007/s13224-022-01708-w

[8] Adekeye, A., Lung, K. C., & Brill, K. (2023). Pediatric and adolescent breast conditions: A review. Journal of Pediatric and Adolescent Gynecology, 36(1), 5–13. https://doi.org/10.1016/j.jpag.2022.11.001

[9] Li, R., Zhang, L., Tian, C., Ma, L., & Li, Y. (2022). Successful management of a breastfeeding mother with severe eczema of the nipple beginning from puberty: A case report. World Journal of Clinical Cases, 10(28), 10155–10161. https://doi.org/10.12998/wjcc.v10.i28.10155

[10] Laageide, L., Radke, S., Santillan, D., & Powers, J. (2020). 12812 Understanding the causes and treatments of nipple pain secondary to breastfeeding. Journal of the American Academy of Dermatology, 83(6), AB110. https://doi.org/10.1016/j.jaad.2020.06.530