Rash Below The Breast: Causes, Symptoms & Effective Treatments

A rash below the breast is a common skin concern that often develops due to the warm, moist environment created by skin folds rubbing together. This condition is technically known as Intertrigo and is more prevalent in individuals prone to excessive sweating or those with larger breasts [1]. The rash typically presents as redness, itching, or cracked skin and stems from irritation, inflammation, or infection, particularly fungal overgrowth (candidiasis). While most cases are benign and respond well to primary care, the rash requires treatment with proper hygiene and care, as untreated or severe instances can progress to secondary bacterial infections or, rarely, may indicate an underlying condition like inverse psoriasis or Paget’s disease [2].

Common Causes of Rashes Under the Breast

Several factors can lead to a rash developing below the breast. Below are some of the most common causes, along with their key symptoms:

1. Intertrigo (Friction Dermatitis) – Intertrigo is a common inflammatory skin condition caused by the combination of friction, moisture, and lack of ventilation in skin folds. It leads to symmetrically-distributed red, raw, itchy, and sometimes oozing rashes beneath the breasts with a burning or stinging sensation [1]. It often serves as a precursor to yeast or bacterial infections.
2. Candida (Yeast Infection/Candidiasis) – Candida is a fungal infection caused by the overgrowth of the Candida albicans yeast in warm, moist areas like under the breasts [3]. It is the most frequent infectious cause of inframammary rashes. Symptoms include a deep red, itchy rash, often with characteristic satellite lesions (small, detached pustules or spots) surrounding the main rash, and sometimes a white, curd-like discharge or foul odour [3].
3. Heat Rash (Miliaria Rubra or Crystallina) – Heat rash occurs when sweat ducts become blocked, trapping sweat under the skin. It causes small red bumps or clear blisters, often with itching, stinging, or a prickly heat sensation under the breast area. This is most common in hot, humid weather.
4. Eczema (Atopic Dermatitis or Irritant Contact Dermatitis) – Eczema under the breasts can cause dry, scaly patches of red, intensely itchy skin that may crack or ooze. It’s often triggered by local irritants (like residual soap or deodorant), excessive sweat, or allergens, and tends to be chronic or recurring [4].
5. Allergic Reactions (Contact Dermatitis) – Allergic reactions from new detergents, fabrics, bra elastic, or topical cosmetic products can lead to contact dermatitis. This causes redness, swelling, itching, and sometimes blisters or peeling where the allergen has come into contact with the skin.
6. Inverse Psoriasis – Inverse psoriasis typically affects skin folds and appears as smooth, shiny, well-demarcated, bright red patches, often located under the breasts. It often lacks the flakiness of other psoriasis types but may crack or feel sore and irritated [5].
7. Paget’s Disease of the Breast –  Paget’s disease is an extremely rare type of breast cancer that primarily affects the nipple and surrounding areola, but the rash can extend to the under-breast area [6]. It may initially appear as a persistent, unilateral (one-sided), red, scaly rash resembling eczema, accompanied by itching, burning, discharge, or nipple changes [6]. Any persistent, non-healing, or unilateral nipple/areola change requires urgent dermatological or breast specialist evaluation.

Bacterial infections (often secondary to untreated intertrigo), tinea corporis (ringworm, a fungal infection causing circular, scaly patches with clear centres), and hormonal changes (e.g., in pregnancy or with certain medications) that affect sweat gland activity can also contribute to rashes under the breast. Accurate clinical diagnosis through medical intervention is key to seeking targeted treatments to alleviate symptoms and prevent complications.

Symptoms of a Rash Under the Breast

A rash under the breast can be an uncomfortable and distressing condition, presenting with various symptoms that may impact daily life. It’s crucial to be aware of these signs to ensure prompt diagnosis and effective treatment.

Common symptoms of a rash under the breast include:

• Redness or discolouration of the skin
• Itching, which can range from mild to severe
• Swelling or inflammation in the affected area
• Pain, tenderness, or a prickling sensation
• Maceration (skin softening due to constant moisture), cracked, broken, or weeping skin
• Discharge or an unpleasant odour (often associated with fungal or bacterial involvement)

If you notice any of these symptoms, it’s essential to monitor them closely, initiate basic dry-keeping measures, and consider seeking professional medical advice for an accurate diagnosis and appropriate treatment plan, especially if symptoms worsen or persist beyond a week.

Effective Treatments for a Rash Under the Breast

Treating a rash under the breast effectively involves addressing the underlying cause and alleviating symptoms. Treatment options, which are often recommended by a physician after diagnosis, include:

1. Topical Antifungals: Creams such as clotrimazole, miconazole, or ketoconazole are effective against fungal infections like candidiasis. These creams are available over-the-counter or can be prescribed by a doctor if the infection is widespread or recurrent [3].
2. Topical Corticosteroids: Low-potency creams, such as hydrocortisone, help reduce inflammation and itching associated with conditions like intertrigo and eczema [1]. They are often used in combination with an antifungal for inflammatory intertrigo but should be used sparingly and only as directed by a healthcare professional due to the risk of skin thinning.
3. Barrier Creams/Powders: Zinc oxide-based creams or moisture-wicking, talc-free powders help keep the area dry, preventing the growth of fungi and bacteria that thrive in moist environments [1]. Starch-based powders should be avoided as they can feed yeast.
4. Antibiotics: Topical or oral antibiotics are necessary if a secondary bacterial infection is confirmed (e.g., Impetigo).
5. Proper Hygiene and Skin Care: This is the cornerstone of management. Washing the area regularly with a mild, pH-neutral or anti-dandruff cleanser and ensuring it is completely dry are essential to prevent infections.
6. Clothing Management: Wearing clean, dry, breathable fabrics and well-fitting bras with moisture-wicking properties can help reduce moisture accumulation, thus preventing rashes.

Home Remedies and Self-Care Tips: Supportive Care

Incorporating self-care practices and home remedies can complement medical treatments for rashes under the breast.

• Keep the Area Dry: Keeping the affected area dry is crucial, as moisture significantly worsens conditions like candidiasis and intertrigo. After showering, gently pat the area completely dry, or use a hairdryer on the cool setting to ensure all moisture is removed.
• Soothing Compresses: Applying a cool, damp cloth can help soothe acute itching and reduce inflammation.
• Avoid Irritants: Regular washing with mild soap/cleanser and avoiding perfumed lotions or harsh body washes can prevent further irritation.
• Consider Natural Soothers: Aloe vera gel, known for its natural cooling and anti-inflammatory properties, can be applied to soothe irritation [7]. Ensure the gel is pure and free from alcohol or fragrances. However, do not apply any oil or thick cream if the rash is already weeping or if a severe fungal infection is suspected, as this can trap more moisture.

How to Prevent Rashes Under the Breast

Preventing rashes under the breasts involves a combination of good hygiene practices, proper clothing choices, and managing overall health.

1. Hygiene and Drying: Regularly clean and gently but thoroughly dry the area under the breasts, using mild, unscented soaps. Ensure the skin folds are completely dry after bathing or exercise.
2. Clothing: Wear loose, breathable clothing, such as bras made from moisture-wicking materials like synthetic blends (e.g., performance fabric) or cotton, to efficiently draw moisture away from the skin.
3. Weight Management: Maintaining a healthy Body Mass Index (BMI) can significantly reduce skin fold formation and irritation, preventing conditions like intertrigo [1].
4. Barrier Protection: Apply a talc-free, anti-chafing powder or cream to absorb moisture and reduce skin-on-skin friction, especially before physical activity or in humid weather.

A rash below the breast is commonly caused by fungal infections (candidiasis) and skin fold irritation (intertrigo). Recognizing the symptoms, such as redness, itching, and a distinct odour, is crucial for prompt, targeted treatment. The cornerstone of management is keeping the area clean and dry. Preventative measures, including good hygiene practices, wearing breathable clothing, and maintaining a healthy weight, can help prevent recurrence. If symptoms persist or worsen despite one week of diligent self-care, or if you notice any unusual lumps or unilateral changes, it is essential to seek medical advice from your doctor or a dermatologist for proper diagnosis and treatment, ensuring relief and reducing the risk of complications associated with these skin infections.

Disclaimer: This article is for informational purposes only and should not be considered medical advice. It is not a substitute for professional medical assessment, diagnosis, or treatment. Please consult a qualified healthcare professional before starting or changing any treatment.

Frequently Asked Questions (FAQs)

What causes a rash under the breasts?

Common causes of rashes under the breasts include Intertrigo (friction and moisture), fungal infections (like Candida or ringworm), bacterial infections, eczema, and allergic contact dermatitis.

How can I treat a rash under my breasts at home?

To treat a rash under the breasts at home, the primary steps are to keep the area clean, completely dry, and free from friction. For suspected mild yeast infections, use an Over-The-Counter (OTC) antifungal cream (like clotrimazole) and wear breathable, moisture-wicking fabrics. If the rash does not improve within a week, see a doctor.

When should I see a doctor for a breast rash?

Consult a doctor for a breast rash if it persists or worsens despite diligent home treatment (e.g., keeping it dry) for 5-7 days, shows signs of severe infection (e.g., spreading cellulitis, pus, fever), is accompanied by unexplained lumps or nipple/areola changes, or is intensely painful.

Can wearing tight bras cause rashes under the breasts?

Yes, tight bras can significantly trap moisture and increase friction, creating ideal conditions for rashes like intertrigo or fungal infections to develop. A properly fitted bra that provides support and uses moisture-wicking material is highly recommended.

Are rashes under the breasts a sign of breast cancer?

Rarerly. Most rashes under the breasts are benign. However, Paget’s disease (affecting the nipple/areola) and Inflammatory Breast Cancer can cause redness and swelling that might initially resemble a rash. Consult a doctor immediately if you notice a persistent, non-healing, unilateral rash, or any changes in breast shape/texture.

How can I prevent rashes under my breasts?

To prevent rashes under the breasts, wear moisture-wicking, well-fitted bras, ensure skin folds are kept thoroughly dry after washing or sweating, use a talc-free anti-chafing product, and maintain good hygiene.

References

[1] Romanelli, M., Voegeli, D., Colboc, H., Bassetto, F., Janowska, A., Scarpa, C., & Meaume, S. (2023). The diagnosis, management and prevention of intertrigo in adults: a review. Journal of Wound Care, 32(7), 411–420. https://doi.org/10.12968/jowc.2023.32.7.411

[2] Breast Rash. (2021, February 5). National Breast Cancer Foundation (NBCF) | Donate Online. https://nbcf.org.au/about-breast-cancer/detection-and-awareness/breast-rashes/

[3] Douglas, P. (2021b). Overdiagnosis and overtreatment of nipple and breast candidiasis: A review of the relationship between diagnoses of mammary candidiasis and Candida albicans in breastfeeding women. Women S Health, 17. https://doi.org/10.1177/17455065211031480

[4] Reynaert, V., Gutermuth, J., & Wollenberg, A. (2023). Nipple eczema: A systematic review and practical recommendations. Journal of the European Academy of Dermatology and Venereology, 37(6), 1149–1159. https://doi.org/10.1111/jdv.18920

[5] Ullah, A., Zeb, H., Khakwani, Z., & Murphy, F. T. (2019). Hydroxychloroquine-induced inverse psoriasis. BMJ Case Reports, 12(2), bcr-224619. https://doi.org/10.1136/bcr-2018-224619

[6] Paget Disease of the Breast. (2012, May 21). Cancer.Gov. https://www.cancer.gov/types/breast/paget-breast-fact-sheet

[7] Hekmatpou, D., Mehrabani, D., Dehghani, F., Vahidi, E., & Ghaffari, P. (2019). The effect of Aloe vera topical application on the healing of pressure ulcers in hospitalized patients. BMC Complementary and Alternative Medicine, 19(1). https://doi.org/10.1186/s12906-019-2708-5