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Sore Nipples

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Overview

Nipple pain or soreness is a common complaint amongst women all over the world. The pain is usually localised in the breast tissue around the nipple area. It may or may not be accompanied by other symptoms such as breast pain, nipple discharge, redness, itching etc.   

Types of Sore Nipples

Soreness can occur in either one or both the nipples based on the underlying cause. In most cases, nipple soreness is a symptom of an underlying benign condition. However, if it does not abate in a few days with basic home remedies, seeking medical advice is recommended. 

About The Condition

Any form of discomfort in the nipple area is defined as sore nipples. In many cases, it is caused due to friction. It can also be a result of mastitis and abscess. Both these conditions are common among nursing women. In the case of menopausal women, it can also be a sign of a rare form of cancer called “Paget’s disease of the nipple”, which causes inflammation and pain localized to the nipple. 

If you observe any additional symptoms such as excessive cracking, bleeding, open wounds, heat or redness, nipple pain only on one side, lumps, fever or chills and unusual nipple discharge (especially if discharge is bloody or brown), consult your doctor immediately.  

Risk factors for Sore Nipples

Few of the risk factors that can increase the probability of developing sore nipples are: 

  1. Breastfeeding (especially in the first 30 days postpartum) 
  2. Wearing tight constrictive clothing/bras 
  3. Menopausal women 
  4. Infection
  5. Mastitis 
  6. Medication 

Symptoms

Common symptoms that my accompany sore nipples include: 

  1. Bleeding nipples 
  2. Tenderness/sensitivity 
  3. Swelling 
  4. Hardened area in the breast 
  5. Unusual nipple discharge 
  6. Redness and heat 
  7. Retracted nipple 
  8. Bruising 
  9. Fever 
  10. Nausea 
  11. Fatigue  

In case of additional symptoms, consult your doctor to identify any possible underlying conditions. 

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Diagnosis of Sore Nipples

After an initial physical, your doctor would take a detailed account of any medications that you are currently taking, any recent dietary changes, and if you feel you could be pregnant. Your doctor would also make note of any physical activity that could lead to friction injuries.  

In case you have additional symptoms along with sore nipples, your doctor might also recommend the following diagnostic test to detect any condition causing soreness: 

  1. Ductography: If you are experiencing nipple discharge along with soreness, your doctor might perform ductography to detect any blockage in the milk ducts.  
  2. Mammogram: This is an imaging test to detect any abnormal growth within the breast tissue. 
  3. Skin Biopsy: If your doctor suspects any form of cancer such as Paget’s disease of the nipple, a skin biopsy might be performed to detect the presence of cancer/abnormal cells in the tissue. 
  4. Prolactin level test: This test is performed to check for abnormal levels of prolactin in the body. This hormone is responsible for milk production. Abnormal levels can indicate a tumour in the pituitary gland. 
  5. Thyroid Hormone test: This test is performed to confirm the normal functioning of the thyroid gland.  
  6. Imaging scans: Your doctor might also perform advanced imaging scans such as a MRI or a CT scan in case of inconclusive diagnosis or to confirm the same.   

Treatment for Sore Nipples

Your doctor would recommend a treatment plan depending on the underlying cause of the nipple condition.  

  1. Friction injuries: Simple lifestyle changes and use of softer and correct fitting garments 
  2. Infection: A course of antibiotics or antifungal cream based on the nature of infection 
  3. Benign tumour: May or may not need surgical removal. Follow up tests to monitor any changes or growth might be recommended 
  4. Hypothyroidism: Hormone medication to manage the right levels of thyroid hormones 
  5. Ectasia: Initial line of treatment includes home remedies such as regularly applying warm compress. If the condition persists, surgical removal of the affected milk duct might be recommended. In case ectasia is accompanied by or results in an infection, your doctor might also prescribe a course of antibiotics 
  6. Pituitary tumour: Pituitary tumour is usually benign. Although if it is interfering with your daily life, your doctor might treat it using medications, radiation treatment or in severe cases, surgical removal of the tumour 
  7. Paget’s disease of the breast: Based on the severity of this type of cancer, your doctor might treat it using radiation therapy or in some cases recommend undergoing a mastectomy  

Prevention

Many of the underlying conditions that results in sore nipples can’t be controlled. However, some basic measures you can take to reduce the risk are 

  1. Wear proper fitting bras, use good fitting sports bra while exercising to prevent friction injuries. 
  2. Consult your doctor regarding medications that could affect hormone levels. 
  3. If you are breastfeeding, consider changing your technique. 
  4. Use products that can prevent chafing.   

FAQs

1. Why are my nipples sore and sensitive?

Sore nipples can be a sign of many underlying conditions. Most commonly if it is the only symptom, sore nipples are a result of chafing or friction injuries. These injuries are sustained by engaging in rigorous physical activity or wearing tight-fitting clothes made of coarse fabric. If you are experiencing additional symptoms such as bleeding or unusual discharge from the nipple, consult your doctor immediately to treat any underlying cause. 

2. Are sore nipples an early sign of pregnancy?

Early in the pregnancy you may experience soreness, sensitivity and or observe an increase in size of your breasts. If the symptoms don’t fade in a couple of weeks, consult your doctor to confirm or detect the underlying cause.

3. How do you know if your nipples are infected?

If you observe any redness in or near your nipple area, and it is hot to touch, it is likely that you have an infection. The affected area would also be painful to touch. If the symptoms don’t go away in 72 hours after applying warm compress, consult your doctor for the necessary treatment. An untreated infection can lead to a potentially life-threatening abscess 

 
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