What Causes Sore Nipples in Men?

Sore nipples are common in men, and the cause is usually ordinary: something rubbing the skin, or a hormone shift that makes the tissue under the nipple tender. Where it hurts gives a clue. Pain on the surface of the skin points to irritation, while tenderness deeper under the nipple points to the hormone side. A sore nipple on its own is rarely dangerous, though a few changes deserve a prompt check.

Friction and Skin Irritation

Clothing sliding over the nipples with every stride can chafe the skin and even crack it, which is why runners call the problem jogger’s nipple.1Cleveland Clinic. Preventing Nipple Chafing (Jogger’s Nipple) Heavy or rough fabrics rub the most, especially cotton that gets heavy and wet with sweat.2Cleveland Clinic. Preventing Nipple Chafing (Jogger’s Nipple)

Chafed skin is sore on the surface. It looks red and dry, may flake, and can crack into small splits that bleed. Usually both nipples are affected after the same activity, such as a long run or workout. The feeling is a sting or burn, often sharpest in the shower. Because the problem is in the skin, there is no lump underneath, which is a useful way to tell it apart from gland growth.

Prevention is simple. Lightweight, moisture-wicking shirts that fit well, or even a little snug, cut the back-and-forth rubbing.3Cleveland Clinic. Preventing Nipple Chafing (Jogger’s Nipple) A plain adhesive bandage or a nipple guard over each nipple puts a barrier between skin and fabric.4Cleveland Clinic. Preventing Nipple Chafing (Jogger’s Nipple) A layer of petroleum jelly before a run reduces the friction that rubs skin raw.5Cleveland Clinic. Preventing Nipple Chafing (Jogger’s Nipple) Cycling, surfing, and other repetitive sports can chafe the same way, and a chest strap, a harness, or a new backpack can rub one spot over and over.

If the nipple is already chafed, stop the rubbing first. Cover it, or switch shirts until the skin heals. Wash gently with water, pat dry, and use a plain, fragrance-free ointment. Scented soaps, harsh detergents, and rough fabrics keep the skin irritated. A rash on one nipple that hasn’t cleared in a few weeks should be seen by a doctor.

Eczema can affect the nipple too. It can appear on its own, but it is more common in people who have or had eczema elsewhere on the body.6DermNet. Nipple eczema7DermNet. Nipple eczema Unlike chafing, eczema itches, and it can weep or crust.

Breast Gland Growth From Hormone Shifts

Doctors call harmless growth of male breast gland tissue gynecomastia. It happens when estrogen, the main female-type hormone, outweighs testosterone’s effect on the breast.8Prescriber Update. Drug-induced Gynaecomastia Men naturally make some estrogen, so the balance between the two hormones is what matters. Soreness right beneath the nipple can be an early sign that gland tissue is growing.9Phoenix Gynecomastia Center. What Causes Sore Nipples in Men

The growth usually feels like a firm or rubbery disc, often about the size of a coin, sitting right under the nipple and centered on it. It may be on one side or both, and one side can grow before the other. The area is tender to touch, or when a shirt brushes it, especially early on. Fat feels different: soft, spread across the chest, with no defined disc.

That difference matters because some men have a soft, wide chest from fat and no gland tissue at all. This isn’t caused by a hormone shift in the breast. Fat is usually painless, since no growing tissue is pressing on the nipple area, so real tenderness points more toward gland tissue. A man can have both at once, which is common with weight gain, so a soft chest doesn’t rule out a firm disc underneath. A doctor can sort this out by pressing gently around the nipple, and imaging can settle it when the exam is unclear.

The hormone shift can come from more estrogen, less testosterone, or a substance that blocks testosterone’s effect. Some shifts happen naturally at certain ages, and medicines, steroids, and some health conditions can also tip the balance. Each is covered below.

Soreness follows a pattern. Tenderness is usually worst in the first months, while the tissue is actively growing. Once growth stops, the soreness often fades even if a small lump remains. A lump that keeps growing or gets harder should be checked by a doctor.

Puberty and Getting Older

Breast gland growth during puberty clears up on its own in more than 9 out of 10 boys within 3 years.10PubMed Central. Gynecomastia in adolescent males: current understanding of its etiology, pathophysiology, diagnosis, and treatment Watching and waiting, with reassurance, is usually the right approach rather than treatment.11PubMed Central. Gynecomastia in adolescent males: current understanding of its etiology, pathophysiology, diagnosis, and treatment

Tenderness under one or both nipples often appears in the early to middle teen years and is a normal part of puberty for many boys. Loose shirts, or a layer underneath, can make it less painful and less noticeable. A doctor should see a boy whose lump is very large, keeps growing past the late teens, or comes with other unusual changes.

At the other end of life, testosterone drops with age while estrogen can stay the same or even rise.12Glassman Plastic Surgery. Gynecomastia in Older Men: Causes & Treatments That imbalance can make the nipples sore in older men.13Banner Health. Why Are My Nipples Sore? 7 Causes of Male Nipple Pain

Weight adds to this. Body fat is where much testosterone gets turned into estrogen, so weight gain can add to the shift.14Centre for Surgery. Steroid Gyno: Why Steroids Cause Gynecomastia and What Fixes It Losing weight may ease the imbalance, though it doesn’t reliably shrink gland tissue that is already there. An older man with new soreness should also mention any recent medicines, since many are taken at this age.

Medicines, Testosterone Therapy, and Steroids

Medicines can cause breast gland growth in several ways: by raising estrogen, acting like estrogen, lowering testosterone, blocking testosterone, or raising prolactin.15Prescriber Update. Drug-induced Gynaecomastia For most drugs blamed for breast growth, the evidence is weak, while the link with very high doses of the heartburn drug cimetidine is stronger.16PubMed Central. Gynecomastia and drugs: a critical evaluation of the literature The water pill spironolactone can cause breast pain, especially in men with liver cirrhosis.17PubMed. Treatment of mastalgia with tamoxifen in male patients with liver cirrhosis: a randomized crossover study

Many people who take these drugs have other things going on, such as age, weight gain, or liver problems, that could also cause breast tenderness. Timing is the most useful clue: soreness that began after starting a medicine or raising its dose is more suspicious than soreness that was there beforehand.

Prescribed testosterone therapy can cause nipple tenderness and breast growth.18PubMed Central / Journal of Sexual Medicine. Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism The body turns some of the extra testosterone into estrogen, mostly in body fat.19Centre for Surgery. Steroid Gyno: Why Steroids Cause Gynecomastia and What Fixes It Anabolic steroids add to this by shutting down the body’s own testosterone, leaving a heavy imbalance.20Dr. Mazaheri. Can Bodybuilding Cause Gynecomastia? Prevention & Treatment

For bodybuilders, soreness or itching under the nipple during a cycle can be an early warning of gland growth. Tissue that forms can stay after the steroids are stopped and may need surgery to remove. Being honest with a doctor about steroid use matters, since it changes what they check and advise.

Bring a full list of prescriptions, supplements, and gym products to the doctor. Never stop a prescribed medicine on your own; ask whether a switch or dose change is possible. Soreness from a medicine often eases after it is changed, though lasting tissue may remain.

Health Conditions Behind the Hormone Shift

Men with liver cirrhosis sometimes have breast pain, likely from excess estrogen.21PubMed. Treatment of mastalgia with tamoxifen in male patients with liver cirrhosis: a randomized crossover study High levels of prolactin, a hormone made in the brain’s pituitary gland, can cause breast enlargement in men.22Yale Medicine. Hyperprolactinemia Erectile problems, less muscle, and thinning body hair can appear alongside it.23Yale Medicine. Hyperprolactinemia

Other symptoms help point to the underlying problem. Low sex drive, erection trouble, or fatigue along with breast tenderness can suggest a hormone problem. Yellowing skin, a swollen belly, or heavy drinking point toward the liver. Headaches or vision changes alongside breast growth are worth mentioning, since they can go with prolactin problems.

Infection and Piercings

A breast abscess, a pocket of pus, is rare in men.24PubMed Central. Male breast abscess: A rare entity When one forms under the nipple, ordinary skin bacteria like staph are the usual cause.25PubMed Central. Subareolar Breast Abscess in a Male: A Case Report Antibiotics are commonly used early in treatment.26PubMed Central. Subareolar Breast Abscess in a Male: A Case Report Infections after nipple piercing are reported in men as well as women.27PubMed Central. Bacterial infections in patients with nipple piercings: a qualitative systematic review of case reports and case series

Infection looks different from friction or hormone soreness. The skin is red, warm, and swollen, and the pain gets worse over days instead of settling. There may be pus, a bad smell, or fluid coming from the nipple or a piercing. Fever or feeling unwell suggests the infection is spreading and needs quick care. Don’t squeeze a lump or drain it yourself, since a doctor may need to drain it properly.

With a pierced nipple, clean the piercing as advised and keep your hands off it. Avoid tight clothing that rubs or catches the jewelry. If redness spreads or pus appears, seek care rather than removing the jewelry without advice.

When a Sore Nipple Could Be Serious

Male breast cancer is uncommon, but these signs call for a prompt check:

These signs show up early in men because the breast is small.32PubMed. Imaging characteristics of malignant lesions of the male breast Most lumps are not cancer. Gland growth, fatty lumps, and small cysts can all look like cancer, which is why testing matters.33PubMed. Imaging characteristics of malignant lesions of the male breast A tender, rubbery lump centered under the nipple on one or both sides is typical of gland growth. Soreness that came on with a clear trigger, such as running or a new medicine, is usually benign. Pain itself is more common with harmless causes than with cancer.

Book a visit within a couple of weeks for any lump that is hard, fixed, or off-center. Bloody discharge from the nipple also needs prompt checking. Don’t wait for pain to appear, since cancer often isn’t painful.

What Happens at the Doctor’s Visit

The doctor will ask when the soreness started, and about medicines, supplements, steroids, alcohol, and weight. A gentle exam of both breasts and both armpits takes a few minutes. Blood tests may check testosterone, estrogen, prolactin, and liver function.

Mammograms and ultrasounds are used for men’s breast lumps alongside a physical exam.34PubMed. Male breast disease: clinical, mammographic, and ultrasonographic features Imaging tells harmless from worrying lumps more reliably than a doctor’s hands alone.35PubMed. Mammography and ultrasound in the evaluation of male breast disease A mammogram catches about 95 in 100 cancers, and an ultrasound rarely flags a harmless lump as cancer.36PubMed. Mammography and ultrasound in the evaluation of male breast disease

To prepare, write down when the soreness began and anything that makes it better or worse. Note whether one or both sides are affected and whether the lump has changed. Bring your medication list, and mention any family history of breast cancer.

Treatment and How Long It Lasts

Treatment depends on the cause. Chafing and eczema heal within days to weeks once the skin is protected and soothed. Puberty-related soreness is usually watched, since it tends to settle on its own. Medicine-related soreness often eases after a doctor adjusts the drug. Tissue that has lasted a long time and become firm may need surgery to remove.

Drug treatment is usually considered only when tissue is recent, painful, or distressing, since it works best before the tissue has turned firm and fibrous. These drugs act on hormone effects in the breast and are prescribed by a doctor, so they are not something to start on your own. If medicine doesn’t help, surgery remains an option.

After surgery for breast gland growth, nipples may feel extra sensitive or numb for the first 3 months.37Boston Gynecomastia Specialists. Experts Gynecomastia Treatment in Boston Sudden sharp pains during this time usually mean nerves are healing.38Boston Gynecomastia Specialists. Experts Gynecomastia Treatment in Boston

In the meantime, over-the-counter pain relievers can help during flare-ups if they are safe for you. A soft, close-fitting undershirt reduces brushing against sensitive nipples. Cold packs wrapped in cloth can ease sore, swollen tissue for short periods.