Itchy Left Nipple and Areola Skin Breakdown: Causes and Concerns

Itchy left nipple and broken skin on the areola?

Hello doctor, about five years ago when I was 20 years old, I noticed a small white bump on my left nipple.
After I tried to remove it, my nipple became irritated, and the areola also got scratched.
At that time, applying medication helped, but recently my nipple has been feeling itchy again.
I run regularly, and it might be due to my bra rubbing against the areola, causing it to get scratched again.
This has been a continuous cycle where it gets scratched, forms a scab, and then gets scratched again (only part of the areola is affected).
Currently, if I don't touch my nipple, it doesn't itch.
I'm really worried that it might be breast cancer, especially since it's only on one side.

Niming, 20~29 year old female. Ask Date: 2015/09/22

Dr. Zhou Jiazhen reply Breast and Thyroid

It resembles eczema and is treated by a dermatologist, but if symptoms persist, a biopsy may sometimes be necessary.

Reply Date: 2015/09/22

More Info

It sounds like you are experiencing a persistent issue with your left nipple and areola, which has been causing you discomfort and concern. Based on your description, it seems that the skin breakdown and itchiness may be related to friction from your bra, especially during activities like running. This can lead to irritation, which may cause the skin to break down, scab over, and then break down again in a cycle.
The initial white bumps you mentioned could have been a condition known as Montgomery glands, which are normal sebaceous glands found on the areola. If they were manipulated or irritated, it could have led to the skin issues you are currently experiencing. It’s also possible that you could be dealing with a condition such as eczema or contact dermatitis, which can cause itchiness and skin breakdown, especially in sensitive areas like the nipple and areola.

While it’s understandable to be concerned about breast cancer, especially with changes in the breast area, the symptoms you describe—itchiness and localized skin breakdown—are more commonly associated with dermatological issues rather than malignancy. Breast cancer typically presents with other symptoms such as a lump, changes in breast shape or size, or unusual discharge. However, it’s always best to err on the side of caution and consult a healthcare professional for a thorough examination.

In terms of management, here are some recommendations:
1. Avoid Irritation: Since you mentioned that the area becomes irritated from friction, consider wearing a well-fitted, supportive sports bra that minimizes movement and friction during physical activities. Look for bras made from soft, breathable materials.

2. Moisturize: Keeping the area well-moisturized can help prevent dryness and irritation. Use a gentle, fragrance-free moisturizer or ointment to soothe the skin. Avoid products that may contain irritants or allergens.

3. Avoid Scratching: It’s important to avoid scratching the area, as this can exacerbate the irritation and lead to further skin breakdown. If the itchiness is bothersome, consider using a topical corticosteroid cream (with a doctor's recommendation) to reduce inflammation and itching.

4. Monitor Symptoms: Keep an eye on the area for any changes. If you notice any new lumps, persistent changes in the skin, or if the irritation does not improve with self-care measures, it’s crucial to seek medical attention.

5. Consult a Dermatologist: If the problem persists, consider seeing a dermatologist who can provide a more accurate diagnosis and treatment plan. They may recommend a biopsy or other tests if there are any concerning signs.

6. Consider Allergies: If you suspect that your bra or any products you use (like laundry detergent or fabric softeners) may be causing an allergic reaction, try switching to hypoallergenic options.

In conclusion, while your symptoms are likely related to friction and irritation, it’s essential to monitor the situation closely and consult a healthcare provider if you have any concerns, especially regarding breast cancer. Early intervention can help address any underlying issues and provide peace of mind.

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