This might seem like an unusual sounding topic, but one search on the web shows that it is a more common complaint for women than you might think.
Pregnancy is associated with changes in the skin for many women. These skin changes may be new skin issues caused by pregnancy or they may be flare-ups of pre-existing skin conditions.
Here are five potential causes of itchy nipples.
1) Atopic dermatitis
This may be the most common culprit of itchy breasts and nipples in women.1 Atopic dermatitis is a type of eczema that can be caused by a variety of triggers including extremes in temperature (too hot or too cold), stress, dry skin, irritating substances or allergens in soaps or detergents, hormonal changes, or infection.2 Atopic dermatitis can be treated by identifying and avoiding the things that cause itching. Sensitive soaps and detergents are free of ingredients that can irritate the skin. Antihistamines such as Benadryl or Claritin and steroid ointments are used to alleviate irritated and itchy skin, but pregnant women need to talk to their doctor before using these medications.2
2) Weight gain and skin stretching
The weight gain experienced during pregnancy is normal for the healthy growth and development of a baby. Pregnancy causes the breast to grow bigger. The stretching skin of the breast can cause symptoms of itchy breasts or nipples.1 It is important to wear non-irritating fabrics and bras. Moisturizing the skin and nipples with a non-irritating cream may also help to relieve itching.3
Breastfeeding can cause nipple irritation, dermatitis, and infection. Mastitis is an inflammation of the breast that affects 3% to 20% of women. It can occur anytime during breastfeeding, but it often occurs in the first 6 weeks.4 The inflamed breast may be enlarged, hot, swollen, red, and lead to clogged milk ducts. A bacterial infection can also be present.4 Mastitis may result from an infected nipple, maternal fatigue or stress, irregular breastfeeding patterns, illness, or unnecessary pressure on the breast from a bra.4 Women who have mastitis are encouraged to breastfeed more frequently, massage the affected breast(s), and express milk by hand or by breast pump after breastfeeding. Women are also encouraged to rest, eat a nutritious diet, and apply heat packs to the breast before breastfeeding to help milk flow and apply cold packs after breastfeeding to reduce pain and swelling.4 For more serious cases of mastitis, women should visit their doctor. A doctor may prescribe a pain reliever or an antibiotic.4 Mastitis may cause women to stop breastfeeding earlier than expected, or it can result in infection so it is important to seek medical help if symptoms of mastitis are not relieved after 1-2 days of conservative measures such as increasing the frequency of breastfeeding, massaging the breast(s), and applying cold and hot packs to the breasts.4
Bacterial or yeast infections of the breast can occur in women during and after pregnancy. Infection can be a cause of atopic dermatitis of the breast and mastitis as mentioned previously. Infection is caused by bacteria on the skin that enter the breast tissue through a sore or cracked nipple.5 Yeast infections can be caused by wearing tight bras for too long or not adequately drying off after showers.1 Antibiotics and continued breastfeeding can help treat infections of the breast.5
5) Paget’s disease
Paget’s disease of the breast is typically the least common cause of itchy nipples.1 That being said, it is a very serious diagnosis. It is a rare cancer of the nipple and areola of the breast that causes sore and itchy nipples.The nipple has an eczema-like rash that does not respond to typical treatments. The rash may be crusty or have yellow discharge.6 It is important to speak with a doctor who can exam, ultrasound, and biopsy the breast to identify if the itching is caused by Paget’s disease or a more benign diagnosis. Paget’s disease of the breast is treated with radiation therapy and breast-conserving surgery or mastectomy.6
This article provides additional information on common skin conditions during pregnancy.