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Understanding Nipple Pain: Common Causes and When to See a Doctor
Nipple pain (mastalgia localized to the nipple) has multiple etiologies:
- Hormonal Fluctuations: Pregnancy, lactation (poor latch, engorgement), menstrual cycle, perimenopause.
- Mechanical Irritation: Tight bras, rough fabrics, running (jogger's nipple), sexual activity.
- Infection: Bacterial (mastitis, cellulitis), fungal (candidiasis/thrush—common in breastfeeding).
- Dermatologic Conditions: Eczema, psoriasis, contact dermatitis, Paget's disease (rare, malignant).
- Systemic/Medical: Thyroid disorders, diabetes, medication side effects, breast cancer (rarely isolated nipple pain).
Red Flags (Seek Prompt Evaluation)
- Unilateral, persistent, worsening pain
- Nipple discharge (bloody, serous, purulent)
- Skin changes: retraction, scaling, ulceration, erythema
- Palpable mass
- Associated systemic symptoms
Most nipple pain is benign and treatable. A clinical breast exam and targeted imaging (if indicated) provide reassurance or early detection.
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