Painful and Swollen Nipples: Causes and Treatments

Nipple pain with redness and swelling?

Hello Doctor: A few days ago, my left nipple suddenly became red, swollen, and painful.
It hurts a lot when my clothes rub against it.
The nipple itself is red and swollen, but the areola appears unchanged and there is no accompanying itching, burning sensation, or flaking.
This coincided with my menstrual period.
After a few days of applying medication and seeing a dermatologist, along with taking medication, there has been significant improvement in about three to four days.
The stabbing pain has decreased, and the redness and swelling have subsided; it now appears slightly red but much better than when it first occurred.
There is only a slight odd sensation when touched (not pain, and no itching, just a feeling that there is a wound there).
Although there has been improvement, I am still worried after researching online and would like to ask for your opinion and advice.
Thank you.

lina, 30~39 year old female. Ask Date: 2018/09/26

Dr. Yuan Tianmin reply Breast and Thyroid

Based on the issue, it appears to be a subcutaneous infection.
Medication can help, but there is a chance of recurrence.

Reply Date: 2018/09/26

More Info

Understanding the causes and treatments for painful and swollen nipples is crucial, especially when experiencing symptoms like redness, swelling, and pain. Based on your description, it seems that you have been experiencing localized symptoms on your left nipple, which have improved significantly after a few days of treatment. This is a positive sign, but it is understandable that you still have concerns.

Possible Causes
1. Infection: One of the most common causes of nipple pain and swelling is an infection, such as mastitis, which can occur in breastfeeding women but can also affect others. Symptoms often include redness, swelling, and pain, and may sometimes be accompanied by fever.

2. Dermatitis: Contact dermatitis can occur due to irritation from clothing, soaps, or other substances. This can lead to redness, swelling, and discomfort. Since you mentioned that the pain worsened with friction from clothing, this could be a contributing factor.

3. Hormonal Changes: Hormonal fluctuations, particularly during menstruation, can lead to breast tenderness and swelling. This aligns with your mention of the timing of your symptoms coinciding with your menstrual cycle.

4. Trauma or Injury: Any trauma to the breast area, even minor, can cause localized pain and swelling. This could be from physical activity or even from tight clothing.

5. Benign Conditions: Conditions such as fibrocystic breast changes can also cause pain and swelling in the breast tissue, although these are typically more diffuse rather than localized.

Treatment and Management
Given that you have already seen a dermatologist and have started treatment, it is essential to continue following their advice. Here are some general recommendations that may help:
1. Topical Treatments: If the condition is due to dermatitis or irritation, continue using any prescribed topical treatments. Over-the-counter hydrocortisone cream may also help reduce inflammation if recommended by your doctor.

2. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and reduce inflammation.

3. Avoid Irritants: Wear loose-fitting clothing to minimize friction against the nipple area. Avoid harsh soaps or lotions that may irritate the skin.

4. Monitor Symptoms: Keep an eye on your symptoms. If you notice any worsening of redness, swelling, or if you develop a fever, it is essential to seek medical attention promptly.

5. Follow-Up: Since you have seen improvement, it is still advisable to follow up with your healthcare provider if symptoms persist or if you have any new concerns. They may recommend further evaluation, such as imaging studies, if necessary.

When to Seek Further Medical Attention
If your symptoms do not continue to improve or if you experience additional symptoms such as:
- Increased redness or swelling
- Fever or chills
- Discharge from the nipple
- Persistent pain that does not respond to over-the-counter medications
It is crucial to consult with your healthcare provider for further evaluation. They may consider additional diagnostic tests to rule out any underlying conditions.

Conclusion
In summary, while your symptoms have improved, it is essential to remain vigilant and proactive about your health. Understanding the potential causes and following appropriate treatment protocols can help alleviate your concerns. Always feel free to reach out to your healthcare provider with any questions or worries you may have, as they can provide personalized advice based on your specific situation.

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