Nipple pain is almost always caused by something identifiable and treatable, whether that’s friction from clothing, hormonal shifts, breastfeeding mechanics, or skin irritation. The fix depends entirely on the cause, so the first step is narrowing down what’s behind your discomfort.
Friction and Chafing
One of the most common culprits is simple mechanical friction. Bras, shirts, or sports gear rubbing against nipple skin can leave it dry, raw, chapped, or discolored. This is especially common in runners (sometimes called “jogger’s nipple”) and other athletes, but it can happen to anyone wearing rough fabric or a poorly fitting bra.
If friction is your problem, the fix is creating a barrier between your skin and the irritant. Petroleum jelly applied before exercise lets fabric glide over the skin instead of dragging against it. Many runners also cover their nipples with adhesive bandages or specialized nipple tape. For everyday prevention, swap cotton shirts and bras for synthetic, moisture-wicking fabrics that fit snugly. Loose shirts shift around more and create more friction. Tight, soft sports bras tend to cause the least irritation. Talcum powder can also help by keeping the area dry, since moisture amplifies chafing.
Hormonal Causes
Nipple soreness that comes and goes on a predictable schedule is usually hormonal. Many people notice tenderness in the days before their period, during puberty, during pregnancy, or around menopause. This type of pain, called cyclical mastalgia, is linked to shifts in estrogen and progesterone during the second half of the menstrual cycle. Some research suggests it involves having relatively less progesterone compared to estrogen during that phase, though the hormone prolactin may also play a role.
Hormonal nipple pain is generally temporary and resolves on its own as hormone levels shift. Over-the-counter pain relievers and a well-fitting, supportive bra can help manage discomfort in the meantime. If the pain is severe or disrupts your daily life, it’s worth bringing up with a healthcare provider, since hormonal treatments can sometimes help.
Skin Irritation and Contact Dermatitis
Nipple skin is thin and sensitive, making it prone to reactions from everyday products. Soaps, laundry detergents, perfumes, preservatives in lotions, and antibacterial products are all common triggers for contact dermatitis, a localized skin reaction that causes redness, itching, flaking, or a rash.
If your nipple pain started around the same time you switched detergents, body wash, or lotion, try eliminating the new product first. Fragrance-free, dye-free versions of laundry detergent and soap are the safest bets. Rinse the area with plain water rather than scrubbing with soap, and avoid applying anything with fragrance or preservatives directly to the nipple.
Breastfeeding-Related Pain
Nipple pain during breastfeeding is extremely common, especially in the first few weeks. The most frequent cause is a shallow latch, where the baby isn’t taking enough breast tissue into their mouth. This concentrates pressure directly on the nipple instead of distributing it across the areola. A lactation consultant can evaluate your baby’s latch and positioning, which often resolves the pain within a few feeds.
Beyond latch issues, breast pads, soaps, and breast pump parts can all irritate nipple skin. Minimizing pump use when possible and making sure pump flanges fit correctly both help reduce mechanical damage.
Healing Cracked or Sore Nipples
For nipples that are already cracked or raw from breastfeeding, keeping the skin moist promotes faster healing. Hydrogel dressings (cooling gel pads placed over the nipple between feedings) have shown strong results. In a randomized trial of 106 breastfeeding mothers, those using hydrogel dressings had significantly greater pain reduction by day 10 compared to those using lanolin ointment, discontinued treatment sooner, and had zero breast infections versus eight in the lanolin group. Lanolin remains a popular option and is generally safe, but the evidence suggests hydrogel dressings may be more effective for pain relief.
A warm saline soak is another simple remedy. Mix half a teaspoon of salt into 8 ounces of warm water and soak the nipple for about a minute after feeding, then pat dry. Make a fresh batch daily to avoid bacterial contamination, and rinse before the next feeding if your baby seems bothered by the taste.
Thrush
If you’ve been breastfeeding comfortably for weeks and nipple pain suddenly appears, or if soreness persists despite a good latch, a fungal infection called thrush may be the cause. The telltale signs are pink, flaky, shiny, itchy, or blistered nipples, sometimes with deep shooting pains in the breast during or after feedings. Check your baby’s mouth for white patches on the tongue, cheeks, or gums, since thrush passes back and forth between parent and infant. Both of you typically need treatment at the same time.
Mastitis
A plugged milk duct feels like a tender, sore lump in one breast. If that lump comes with flu-like symptoms (fever, chills, body aches, fatigue) and the breast feels warm, red, or swollen, it may have progressed to mastitis, a bacterial breast infection. You might also notice a yellowish discharge from the nipple.
Current clinical guidelines from the Academy of Breastfeeding Medicine recommend a few things that may surprise you. Do not try to “pump to empty” the affected breast. Overfeeding from that side or aggressive pumping perpetuates a cycle of excess milk production and worsens swelling. Instead, feed your baby on demand and hand-express small volumes for comfort. Ice and anti-inflammatory pain relievers help reduce swelling. Avoid deep massage of the breast, which causes more inflammation and can injure tissue. Antibiotics are reserved for confirmed bacterial mastitis, not the earlier inflammatory stage, because unnecessary antibiotics can actually disrupt the breast’s normal microbial balance and make things worse.
Nipple Vasospasm
If your nipple pain is worst when you’re cold, and you notice the nipple tip turning white, then blue or purple before returning to its normal color, you’re likely experiencing vasospasm. This happens when blood vessels in the nipple constrict suddenly, cutting off blood flow temporarily. The pain is often described as an intense burning or throbbing. It’s more common in people who are breastfeeding, but it can happen to anyone, especially those with Raynaud’s phenomenon (a condition where small blood vessels overreact to cold).
Keeping warm is the most immediate fix: warm compresses applied right after feeding or after cold exposure, avoiding unnecessary cold air on the chest, and layering clothing. Magnesium supplements (300 to 600 mg daily) can help relax blood vessels. Fish oil capsules and evening primrose oil may also improve blood vessel function over time.
When Nipple Pain Signals Something Serious
Most nipple pain is benign, but certain symptoms deserve prompt medical attention. Paget’s disease of the breast is a rare form of cancer that starts in the nipple and can look a lot like eczema. The key differences: it almost always affects only one breast, and it doesn’t respond to typical skin treatments. Watch for flaky or scaly skin on the nipple, crusty or hardened skin that oozes, straw-colored or bloody discharge, a nipple that turns inward, thickening skin on the breast, or a lump beneath the surface. A burning sensation and itching are common, which is why it’s sometimes mistaken for dermatitis for months before diagnosis.
Any unexplained bloody nipple discharge, a new lump, or skin changes that persist for more than a few weeks on one side warrant evaluation. These symptoms don’t automatically mean cancer, but they need to be ruled out.