Itchy and Sensitive Nipples: Causes and When to Seek Help

Unilateral nipple and areola itching with increased sensitivity?

I can't recall the exact onset time, but I know it has been two to three years.
One winter, both of my nipples became dry, itchy, and peeled.
After applying body lotion, it healed.
However, in the summer, I wanted to use a breast firming essence that I had used frequently before to prevent sagging, but every time I applied it, both areolas became very itchy, so I had to stop using it.
Later on, I noticed that my left nipple became less sensitive and no longer itched, while my right nipple became more sensitive than before, especially the nipple and the upper right areola, which easily itches.
This may be due to frequent scratching, as there is some pigmentation on the upper right areola.
The nipple itself usually does not hurt, but if it gets too cold or if I touch it for too long or too hard, it can feel a bit painful.
Previously, the sensitivity of both nipples was the same...
I initially thought it was a skin condition, but now I've heard it could also be a precursor to breast cancer, which worries me.
I would like to ask what these symptoms might indicate.
I have never given birth or breastfed, and there are no lumps in my breasts.
My nipples have never had any discharge, and I rarely use body lotion, but they are no longer peeling.
Should I first visit a dermatologist, a gynecologist, or a breast surgeon at a hospital? Thank you.

Songben Xiaojie, 30~39 year old female. Ask Date: 2018/10/24

Dr. Yuan Tianmin reply Breast and Thyroid

It is advisable to first consult a dermatologist for itching of the nipple and areola.

Reply Date: 2018/10/24

More Info

Itchy and sensitive nipples can be concerning, especially when accompanied by changes in sensitivity and skin texture. Based on your description, it seems you have experienced a range of symptoms over the past few years, including dryness, peeling, itching, and variations in sensitivity between your left and right nipples. While it is understandable to worry about the possibility of serious conditions such as breast cancer, it is important to consider a variety of potential causes for your symptoms.

Possible Causes
1. Dermatitis: The symptoms you described, such as itching and peeling, could be indicative of a form of dermatitis, which is an inflammation of the skin. Contact dermatitis, for instance, may occur due to an allergic reaction to a product you applied, such as the yam breast essence you mentioned. This could explain the localized itching and sensitivity.

2. Eczema: Another possibility is eczema, which can cause dry, itchy patches on the skin, including the nipples. Eczema can be triggered by various factors, including stress, allergens, and irritants.

3. Hormonal Changes: Hormonal fluctuations can also affect breast tissue and sensitivity. Even without having been pregnant or breastfeeding, hormonal changes related to your menstrual cycle or other factors could contribute to changes in nipple sensitivity.

4. Infections: Fungal or bacterial infections can lead to itching and irritation. If the skin around the nipples is compromised, it may be more susceptible to infections.

5. Paget’s Disease of the Nipple: Although less common, Paget’s disease is a type of breast cancer that can present with symptoms such as itching, redness, and flaking of the nipple skin. This condition typically occurs alongside other breast changes, so it is important to rule it out.

When to Seek Help
Given the duration and nature of your symptoms, it is advisable to seek medical attention. Here are some steps you can take:
1. Start with a Dermatologist: Since your symptoms include skin-related issues like itching and peeling, a dermatologist would be a good starting point. They can assess your skin condition and determine if it is dermatitis, eczema, or another skin issue.

2. Consider a Gynecologist: If the dermatologist rules out skin conditions, you may want to consult a gynecologist. They can evaluate any hormonal factors that may be contributing to your symptoms.

3. Breast Specialist: If there are any concerns about breast cancer or if your symptoms persist despite treatment, a breast specialist or a surgeon specializing in breast health can provide further evaluation. They may recommend imaging studies, such as a mammogram or ultrasound, to assess the breast tissue.

Conclusion
In summary, while your symptoms could be related to a benign skin condition, it is essential to take them seriously, especially given the changes in sensitivity and the duration of your symptoms. Starting with a dermatologist is a practical approach, and they can guide you on whether further evaluation by other specialists is necessary. Remember, early intervention is key in addressing any potential issues, and it is always better to err on the side of caution when it comes to your health.

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