Persistent Crusting on Nipples: Possible Causes and Treatments

Nipple crusting, with the nipple appearing larger than usual?

I have had scabbing on my nipples since high school, and even when I remove it, it keeps coming back.
One side has a smaller area of scabbing, while the other side is much more severe.
I previously consulted a doctor who said it was an eczema issue and prescribed medication, but why does the scabbing keep recurring?

Mao, 20~29 year old female. Ask Date: 2016/08/12

Dr. Wu Jianting reply Breast and Thyroid

1.
The size of the nipples varies from person to person and is influenced by individual physiology.

2.
Skin lesions of the nipples should focus on ruling out malignancies, although the likelihood is low.
If there are recurrent eczema lesions, a skin biopsy may be considered.

3.
The final diagnosis and recommendations should be based on actual clinical evaluation.
Thank you for your inquiry.

Reply Date: 2016/08/12

More Info

Persistent crusting on the nipples can be a concerning symptom, and it's important to understand the potential causes and treatments available. Based on your description, it seems that you have been experiencing this issue for quite some time, starting from high school, and it has not resolved despite previous medical advice.
The crusting you are experiencing could be attributed to several conditions, including eczema, dermatitis, or even infections. Eczema, or atopic dermatitis, is a common skin condition that can cause dry, itchy, and inflamed skin, leading to crusting. Contact dermatitis, which can occur due to irritation from soaps, detergents, or even certain fabrics, may also be a culprit. In some cases, fungal infections or bacterial infections can lead to crusting and should be ruled out.

Another possibility is a condition known as Paget's disease of the nipple, which is a rare type of breast cancer that can present with symptoms such as crusting, scaling, or flaking of the nipple skin. While this is less common, it is essential to consider it, especially if the crusting is persistent and accompanied by other symptoms such as changes in the appearance of the nipple or discharge.

Given that you have already consulted a physician who suggested eczema and prescribed topical treatments, it may be beneficial to seek a second opinion, especially if the condition has not improved. A dermatologist, who specializes in skin conditions, would be well-equipped to evaluate your symptoms more thoroughly. They may perform a physical examination and possibly a biopsy if they suspect a more serious underlying condition.

In terms of treatment, if eczema or dermatitis is confirmed, the typical approach includes the use of topical corticosteroids to reduce inflammation and itching. Additionally, maintaining proper skin hydration with emollients can help prevent flare-ups. If an infection is suspected, antifungal or antibiotic treatments may be necessary.

It's also important to consider lifestyle factors that could be contributing to your symptoms. For example, avoiding known irritants, wearing breathable fabrics, and practicing good hygiene can help manage and prevent crusting.
In summary, persistent crusting on the nipples can stem from various causes, including eczema, dermatitis, infections, or even more serious conditions like Paget's disease. Given the duration and persistence of your symptoms, I recommend consulting a dermatologist for a comprehensive evaluation and tailored treatment plan. They can provide you with the most accurate diagnosis and effective management strategies to alleviate your symptoms and improve your quality of life.

Similar Q&A

Understanding Nipple Discharge: Causes and Treatment Options

Hello Doctor, a few years ago, I had skin inflammation on my right chest, and it took about a month of medication prescribed by my doctor to heal. Since then, my right nipple has been slightly swollen compared to the left, and it feels hard with irregular bumps. About a year ago,...

Dr. Hong Zhengsheng reply Dermatology
Hello: According to medical literature, if there is nipple discharge and crusting in both females and males, it is recommended to perform a biopsy for pathological examination, which can assist the physician in making a further diagnosis. However, based on your description, it is...

How to Address Persistent Itching and Skin Issues on the Nipple?

Hello doctor, recently the weather has been fluctuating between hot and cold. I noticed that my nipples and areolas have been itchy, and I unconsciously scratched them, which seems to have broken the skin. After applying medication, there hasn't been any improvement. I have ...

Dr. Zhou Jiazhen reply Breast and Thyroid
Dear Hong Hong: 1. This is often a case of eczema. 2. Sometimes it can be an allergic reaction caused by contact with items such as underwear or cleaning products, so it may be helpful to switch those out. 3. Additionally, hormonal imbalances in the body may also play a role,...

Persistent Itching and Peeling of Nipples: Causes and Solutions

I often experience itching in my nipples, and afterwards, the skin tends to peel. I previously consulted a doctor who mentioned it might be a fungal infection and prescribed medication to alleviate the itching and peeling, but it may not completely cure the condition. It has been...

Dr. Lin Kecheng reply Surgery
Nipple itching accompanied by peeling of the epidermis could potentially be due to a fungal infection or an allergy to the material of the bra. Applying topical ointments may alleviate the symptoms, but it may not completely cure the condition. A small biopsy at the lesion site b...

Understanding Nipple Eczema and Fungal Infections: Causes and Treatments

Hello Dr. Wu, Since around May of last year, I have been experiencing itching, scaling, and some serous discharge from both nipples. I have visited dermatology and breast surgery several times, and the doctors suspect it might be nipple eczema or a fungal infection. I have been ...

Dr. Wu Yuxin reply Dermatology
Without actually seeing the lesion, it cannot be confirmed. If it is causing significant distress, it is advisable to seek medical attention as soon as possible.