Itchy and Painful Nipples: When to Seek Medical Advice

Itching of the nipples and areola?

I would like to ask the doctor, about two years ago, my nipple was very itchy, and I kept scratching it.
Now, after two years, the nipple and the area around it occasionally hurt, and this only happens on the left side.
Additionally, my left breast is noticeably larger and droopier than the right one, and the areola is also significantly larger than the right side.
I had a small ultrasound at a major hospital last year, and there were no abnormalities.
Should I still get a breast ultrasound, or is it unnecessary to worry about?

Aqi, 20~29 year old female. Ask Date: 2023/08/18

Dr. Yuan Tianmin reply Breast and Thyroid

Getting a breast ultrasound is likely a very good choice.

Reply Date: 2023/08/18

More Info

Itchy and painful nipples can be a concerning symptom, especially when accompanied by changes in breast size and shape. Given your description, it is essential to consider several factors and potential underlying conditions that could be contributing to your symptoms.

Firstly, the itchiness and pain in the nipple area could be due to a variety of causes, including dermatological conditions such as eczema, contact dermatitis, or even fungal infections. These conditions can lead to inflammation and irritation, resulting in itching and discomfort. If you have been scratching the area, this could further exacerbate the irritation and lead to pain.

The asymmetry you mentioned, with the left breast being larger and the areola more prominent than the right, could be a normal anatomical variation. However, significant changes in breast size or shape, especially if they are new or accompanied by other symptoms such as pain, should not be overlooked. Conditions such as fibrocystic breast changes, cysts, or even benign tumors can cause changes in breast tissue and should be evaluated.

Since you have already undergone a breast ultrasound that did not reveal any abnormalities, it may be reassuring, but it does not entirely rule out the need for further investigation. If your symptoms persist or worsen, it would be prudent to seek further medical advice. A follow-up ultrasound or a mammogram may be warranted, especially if there are any new symptoms or if the pain becomes more pronounced.

Additionally, hormonal changes can also affect breast tissue and lead to symptoms like pain and changes in size. If you are premenopausal or experiencing changes in your menstrual cycle, this could be a contributing factor. Hormonal fluctuations can lead to breast tenderness and changes in breast density, which might explain some of the symptoms you are experiencing.

In terms of when to seek medical advice, it is generally recommended to consult a healthcare professional if you experience any of the following:
1. Persistent or worsening pain in the breast or nipple area.

2. New or unusual changes in breast size or shape.

3. Any discharge from the nipple, especially if it is bloody or clear.

4. Symptoms that do not improve with over-the-counter treatments or home remedies.

In conclusion, while your previous ultrasound results were normal, the persistence of your symptoms, particularly the pain and changes in breast appearance, warrants further evaluation. It is always better to err on the side of caution when it comes to breast health. Consulting with a healthcare provider, such as a primary care physician or a breast specialist, can help determine the next steps in your care and ensure that any underlying issues are addressed appropriately.

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