Nipple Pain: Common Causes and When to Seek Medical Evaluation

Nipple pain (mastalgia localized to the nipple) has many potential causes, ranging from benign to serious. Because I cannot provide a medical diagnosis, the following is for informational purposes only.

Common Causes

• Hormonal changes: Menstrual cycle, pregnancy, perimenopause.
• Friction or irritation: Ill-fitting bras, rough fabrics, exercise (jogger's nipple).
• Skin conditions: Eczema, contact dermatitis, psoriasis, fungal infection (thrush).
• Breastfeeding-related: Poor latch, engorgement, mastitis, cracked nipples, vasospasm (Raynaud's of the nipple).
• Infections: Periductal mastitis, abscess.
• Medication side effects: Hormonal therapies, certain antidepressants.
• Trauma: Injury, piercing complications.
• Benign breast conditions: Duct ectasia, intraductal papilloma.
• Rarely, malignancy: Paget's disease of the breast (often with nipple changes: scaling, crusting, discharge, inversion).

When to See a Healthcare Provider

Seek evaluation if nipple pain is accompanied by:

• Persistent pain unrelated to menstrual cycle
• Unilateral (one-sided) pain that doesn't resolve
• Nipple discharge (especially bloody or clear spontaneous)
• Skin changes: scaling, crusting, thickening, dimpling, inversion
• Palpable lump in the breast
• Fever, redness, warmth (signs of infection)
• Pain interfering with daily activities or sleep

A clinical breast exam, imaging (mammogram, ultrasound), or biopsy may be needed for diagnosis. Early evaluation ensures appropriate treatment and peace of mind.