Areola Peeling and Nipple Discharge: Causes and Treatments

Areola peeling with nipple discharge?

Hello Doctor, a few days ago I noticed that the left side of my bra has become dirty, with some yellow discharge sticking to it.
There is also peeling around the areola that has persisted for about a week.
The nipple itself is not painful or itchy, but there is a slight stinging sensation if I rub it with a tissue or wear a bra for an extended period.
I have a history of mild eczema.
Could this be a manifestation of eczema? If so, can I use petroleum jelly or a topical steroid (0.05%) to improve it?

nv hai, 10~19 year old female. Ask Date: 2020/09/26

Dr. Wu Yuxin reply Dermatology

No lesions were observed, making it difficult to determine the issue.
If this is causing significant distress, please seek medical attention promptly.

Reply Date: 2020/09/26

More Info

Understanding areola peeling and nipple discharge can be concerning, especially when accompanied by symptoms like discomfort or changes in appearance. Based on your description, it seems you are experiencing two main issues: yellowish discharge from the nipple area and peeling of the areola. Let's break down the potential causes and treatments for these symptoms.

Possible Causes
1. Eczema or Dermatitis: Given your history of mild eczema, it is possible that you are experiencing a flare-up in the area around the areola. Eczema can cause dryness, peeling, and irritation, leading to discomfort. The yellowish discharge could be a result of irritation or inflammation in the skin.

2. Infection: The presence of yellow discharge could also indicate an infection, such as a bacterial infection or a condition known as periductal mastitis, which is inflammation of the ducts beneath the nipple. This condition can occur in women who are breastfeeding or have had a history of nipple trauma.

3. Hormonal Changes: Hormonal fluctuations, especially around menstrual cycles, can lead to changes in breast tissue and discharge. However, this is less likely to cause peeling skin.

4. Other Skin Conditions: Conditions such as psoriasis or fungal infections could also cause similar symptoms.

Treatment Options
1. Moisturizers: Using a gentle moisturizer like Vaseline (petroleum jelly) can help soothe the skin and prevent further irritation. This is particularly useful if the peeling is due to dryness.

2. Topical Steroids: A low-potency topical steroid (like the 0.05% you mentioned) can be effective in reducing inflammation and irritation associated with eczema. However, it is important to use it sparingly and not for prolonged periods, as overuse can lead to skin thinning and other side effects.

3. Antibiotics: If an infection is suspected, a healthcare provider may prescribe topical or oral antibiotics to treat the underlying infection.

4. Avoid Irritants: Ensure that you are wearing a well-fitting, breathable bra to minimize friction. Avoid harsh soaps or lotions that could further irritate the area.

5. Consult a Healthcare Provider: Since you have ongoing symptoms, it is advisable to consult a healthcare provider for a thorough examination. They can determine whether the symptoms are due to eczema, an infection, or another condition. A provider may also perform tests to rule out any serious issues.

When to Seek Immediate Care
- If the discharge becomes bloody or has a foul odor.

- If you develop a fever or experience significant pain.

- If the peeling worsens or spreads beyond the areola.

Conclusion
In summary, while your symptoms could be related to eczema, they may also indicate an infection or another skin condition. Using Vaseline and a low-potency steroid may provide relief, but it is crucial to consult with a healthcare provider for an accurate diagnosis and appropriate treatment. Early intervention can help prevent complications and ensure proper care for your breast health.

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