Cracked Nipples Symptoms, Causes & Common Questions

Plugged breast duct

If you're making milk faster than it's getting expressed, it can get backed up in the duct. When this happens, the tissue around the duct may become swollen and inflamed and press on the duct, causing a blockage.

You can safely treat this condition on your own by continuing nursing and draining your breast as much as possible after each feeding. If you develops a fever or significant discomfort, contact your physician.

Physiologic breast discharge

Physiologic breast discharge is any fluid that comes out of the nipple area in your breast.

You should visit your primary care physician to evaluate the discharge and discuss treatment options.

Non-specific breast pain

Nonspecific breast pain, also called mastalgia or mastodynia, refers to tenderness or pain in the breast with no obvious cause. It almost always proves to have a benign (non-cancerous) cause.

Breast pain is most common in women aged 35 to 50 and still experiencing menstruation. Fibrocystic changes are common in this age group, where tiny, fluid-filled sacs form within breast tissue and might be felt as small, tender, but non-cancerous lumps.

Birth control pills, hormone replacement therapy, caffeine, and soy can cause breast tenderness in women of any age. A breast infection can cause painful lumps.

A medical provider should be seen, in order to rule out any serious condition and get treatment for the discomfort.

Diagnosis is made through patient history; physical examination; mammogram or breast ultrasound; and sometimes biopsy.

A breast infection will be treated with antibiotics. Large, painful cysts may have the fluid drained or be surgically removed. Lifestyle improvements regarding diet and exercise are often helpful, as well as adjustments to birth control pills or hormone therapy.

High prolactin hormone level

Hyperprolactinemia means the pituitary gland secretes too much prolactin, the hormone responsible for producing milk in a new mother. The condition can appear in both women and men.

It can be caused by pregnancy; by an ovulatory disorder; by some psychiatric medications; or by a prolactin-secreting tumor of the pituitary (prolactinoma.)

Women with other reproductive disorders, such as polycystic ovary syndrome (PCOS,) are most susceptible. Hyperprolactinemia is also seen in those with hypothyroidism and chronic renal failure. Many patients on hemodialysis have elevated prolactin levels.

Symptoms in both women and men include reduced libido (sex drive) and infertility. Men may show breast enlargement and women may develop breast milk.

If not treated, hyperprolactinemia can result in loss of bone density in both women and men.

Diagnosis is made through blood testing to measure hormone levels, and sometimes MRI of the pituitary gland underneath the brain.

Treatment may include "watchful waiting," or a period spent observing the symptoms to see if they change; drug therapy; or surgery.

Breast infection (mastitis)

Mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth and redness of the breast. Mastitis most commonly affects women who are breast-feeding (lactation mastitis), although sometimes this condition can occur in women who aren't breast-feeding.

You should visit your primary care physician to confirm the diagnosis and discuss treatment options, such as antibiotics.

Rarity: Uncommon

Top Symptoms: fatigue, nausea, breast pain, signs of breast inflammation like redness, swelling or fever, fever

Symptoms that always occur with breast infection (mastitis): breast pain, signs of breast inflammation like redness, swelling or fever

Urgency: Primary care doctor

Breast abscess

Breast abscess is a complication of mastitis, which is an inflammation of the breast tissue. An abscess is a pocket of pus that forms within the breast, usually just under the skin.

Most susceptible are women who are breastfeeding. Bacteria can be transferred into the milk ducts from the skin or from the infant's mouth. Women not breastfeeding can be infected through a sore nipple or from a nipple piercing.

If a milk duct is blocked through trauma, compression, or incomplete emptying, bacteria can gain a foothold and an abscess can form.

The abscess forms a hot, reddened, painful lump in the breast. There will be flu-like symptoms of fever, chills, fatigue, and body aches.

Diagnosis is made through physical examination and sometimes a milk sample.

Treatment is with antibiotics along with rest, fluids, and over-the-counter pain relievers. Unless otherwise directed by the medical provider, it is safe to continue nursing the baby. If the abscess persists, it may be drained under local anesthesia with a needle and syringe.

Allergic contact dermatitis of the chest

Allergic contact dermatitis means the skin has touched something that provoked an allergic reaction, causing inflammation and irritation.

"Contact" means the allergic reaction came from touching something, not from consuming something. The first exposure to the substance sensitizes the immune system, and then the second exposure actually causes the symptoms.

The most common causes of allergic contact dermatitis are:

• Nickel, a metal often used in belt buckles, the buttons on pants, and jewelry, including piercing jewelry.
• Poison ivy.
• Various types of perfumes, including those founds in soaps, fabric softeners, and detergents.
• Of course, there are many more.

Symptoms include red, itching, scaling, flaking skin that may be painful due to the irritation and inflammation.

Diagnosis is made through first avoiding contact with any suspected substance, to see if the dermatitis clears. Patch testing can be done if the results are not certain.

Treatment involves fully avoiding the allergy-provoking substance and using topical steroid cream as prescribed. Cool compresses and calamine lotion can help to ease the discomfort.

Rarity: Common

Top Symptoms: chest redness, chest itch, scabbed area of the chest

Symptoms that always occur with allergic contact dermatitis of the chest: chest redness

Urgency: Self-treatment

Why do I have cracked nippled while breastfeeding?

Nipple injury usually is due to incorrect breastfeeding technique, particularly poor position or latch-on. Other factors may include harsh breast cleansing, use of potentially irritating products, and biting by an older infant. In addition, skin conditions such as dermatitis as well as bacterial or fungal infections are more common in women who are breastfeeding or lactating. Any of these conditions can lead to cracked, painful, or bleeding nipples.

Why I do have cracked nipples with pus?

If you have cracked nipples with pus, it is very likely that you have an infection in the breast tissue or milk ducts. Women who are lactating or breastfeeding are at higher risk for infection of the nipple or breast, but anyone can get a breast infection. The presence of pus suggests a bacterial infection, which is also common among women who are breastfeeding or lactating. Cracking of the nipples may be a symptom of the infection. It is also possible that the nipples were cracked from breastfeeding or other trauma, and then became secondarily infected.

What do cracked nipples mean when I'm not breastfeeding?

Chafing is a common cause of cracked or bleeding nipples in men, especially men who participate in endurance sports. Chafing of the nipple can occur in women as well. Other possible causes of cracked nipples include benign conditions of the breast, such as eczema, dermatitis caused by contact irritation, and nipple adenoma. However, cracked nipples can also be a sign of breast cancer (Paget disease of the breast) or skin cancers (such as squamous carcinoma of the epidermis, basal cell carcinoma, and superficial spreading malignant melanoma).

Can I still breastfeed with cracked nipples?

Most doctors recommend continuing to breastfeed with cracked nipples, as long as the pain is tolerable. If one nipple is cracked, it is possible to breastfeed on the other side to give the cracked nipple a chance to heal. It is also possible to pump breast milk while the nipples heal, and then continue breastfeeding. Typically, cracked nipples during lactation and breastfeeding indicate there is a problem with infant positioning or latch. Education on proper positioning and attachment of the infant may be the best intervention for alleviating nipple pain.

Can cracked nipples become infected?

Yes. The protective barrier of the skin is disrupted as nipples become cracked, which increases the susceptibility to infection. It is common for women who are lactating or breastfeeding to experience cracked nipples from improper positioning, improper latch, or possible trauma from biting in older infants. Bacteria in the infant's mouth can then enter the breast tissue and cause an infection. It is also possible for women who are not breastfeeding or men to experience cracked nipples that then become secondarily infected. If you suspect you have a nipple infection, seek medical treatment.

Questions your doctor may ask about cracked nipples

• Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
• Did you suffer from any complications during pregnancy or childbirth?
• When did you have your most recent child?
• Are you currently pregnant?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.