Dermatologists weigh in on this frustrating skin condition.
Basically, anywhere on your body can sometimes feel itchy, but some places are a little more unsettling than others.
If you’ve ever experienced itchiness, or irritation on your breasts or even your nipples, you know the frustration of needing to scratch a place you can’t easily access in public. Unfortunately, there are various reasons and treatments for itchy breasts, so it might take time to figure out the issue.
But that doesn’t mean the situation is hopeless. Below, dermatologists break down the potential causes and offer advice for itchy breasts.
Eczema is a common reason.
“Eczema of the breast is a common cause of itchy breasts and nipples,” said Dr. Azadeh Shirazi, a dermatologist based in La Jolla, California. “The tissue and skin is more sensitive and more prone to irritation.”
The most common form of eczema is atopic dermatitis, which typically manifests as itchy, dry, irritated skin around creases like the backs of the knees and elbows. It can, however, occur on the breasts and nipples as well. There’s also contact eczema, or contact dermatitis, a similar itchy flare-up that stems from contact with an irritant.
“Itchy breasts or nipples can be caused by an irritant dermatitis, such as excessive rubbing or chafing on harsh fabrics,” said Dr. Lauren Penzi, a New York-based dermatologist. “It can be caused by a true allergic contact dermatitis to certain ingredients in soaps, fabrics, laundry detergent, etc.”
She pointed to a study that found Cl+Me-isothiazolinone, cobalt chloride, thimerosal, nickel sulfate, and 4-tert-butylphenol-formaldehyde resin were common causes of nipple eczema. These ingredients are sometimes used in clothing, cleaning products, cosmetics and other personal care items.
“For those who may be experiencing a sensitivity to something they are coming into contact with ― which can be a new detergent, a new bra or undergarment, a new soap or clothing ― it can help to avoid fragrance or certain ingredients that can be irritating on the skin,” said New York City dermatologist Dr. Marisa Garshick.
She recommended sensitive skin-friendly detergents like All Free and Clear and skincare brands like Vanicream, which offers products free of fragrances, dyes, lanolin, parabens and formaldehyde. Also, be mindful of the synthetic fabrics and dyes in the clothing you buy.
“I recommend washing new undergarments before wearing them as many manufacturers use chemicals that leach out onto the skin, causing itching and rashes,” Shirazi said.
The issue can also be a result of body and skin changes.
“Itchy breasts are often caused by dry skin, breast growth ― due to pregnancy, puberty or weight gain, for example, ― hormonal changes, mastitis, yeast infection and breastfeeding,” said Dr. Hadley King, a dermatologist in New York City. “Nipples often get dried out and irritated from breastfeeding.”
Be mindful of irritation from friction or rubbing, as this can also lead to itchiness. Sometimes, itchy breasts may also have to do with seasonal changes, especially in the colder months.
“Extreme temperatures like a really hot shower or cool, dry weather can all lead to skin irritation, itching, and inflammation,” Shirazi noted. “The breasts and nipples are often forgotten, and we tend to skip moisturizing this delicate area.”
Garshick also encouraged moisturizing year-round, especially when your skin feels dry and inflamed.
“In these cases, using a moisturizing cream or ointment can be helpful to nourish the skin as well to provide a protective barrier to keep moisture in and minimize potential friction and external irritation,” she said. “Thick creams such as Cerave moisturizing cream or Vaseline Healing ointment work well for this.”
In rare cases, itchy breasts may indicate something more serious.
“There is a rare but important entity called Paget’s disease of the breast that can present like an eczema of the nipple,” Penzi said. “It usually presents as persistent scaling, eczematous, or ulcerated lesion involving the nipple-areolar complex.”
Paget’s disease typically only affects one nipple, so pay attention if you notice irritation on only one side.
“Itching and rashes can be a sign of Paget’s disease of the breast linked to underlying breast cancer where cancer cells from an existing breast tumor travel through the milk ducts to the nipple and areola,” Shirazi echoed.
Inflammatory breast cancer is another rare diagnosis that can sometimes lead to itchiness. Other symptoms may include swelling, discoloration, tenderness and other rapid changes in the breast over a period of weeks.
It’s important to contact a doctor if things don’t improve.
“There are lots of common causes of itchy breasts and nipples that are not concerning or indicative of a more serious underlying condition,” King explained. “But if common causes are ruled out, and the itching does not improve, particularly if it is unilateral and accompanied by a rash, then it’s important to have this evaluated by a doctor in order to make sure that it’s not breast cancer.”
A dermatologist can help you determine the cause of this issue and the best course of treatment. In the rare case of cancer, you may need a biopsy to confirm the diagnosis. Even if cancer is not a factor, seek medical attention if your itchiness doesn’t improve over time or respond to traditional treatments.
“If at-home treatments are not sufficient, it is best to see a board-certified dermatologist as a prescription topical may be needed, such as a prescription topical steroid or topical non-steroid anti-inflammatory,” Garshick said. “In some cases, an oral medications such as steroids, JAK inhibitors or injectable medications, such as Dupixent, can be helpful as well. For some individuals, where there is a concern for a contact allergy, it can help to consider patch testing, a type of allergy testing.”
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