Nipple pain is almost always caused by something benign: friction from clothing, hormonal shifts, or skin irritation. In a large study of over 10,000 women referred to a breast clinic, only 0.4% of those whose sole symptom was breast pain turned out to have cancer, a rate similar to that of women with no symptoms at all. So while nipple pain can feel alarming, the cause is usually straightforward and treatable.
Friction and Skin Irritation
The most common culprit is simple friction. Bras, sports tops, and shirts rub against the nipple during movement, leaving the skin dry, chapped, discolored, or raw. Runners are especially prone to this (sometimes called “jogger’s nipple”), but it can happen to anyone wearing a poorly fitting bra or rough fabric. Switching to softer materials, using adhesive nipple covers during exercise, or applying a thin layer of petroleum jelly before a workout usually solves the problem within days.
Contact dermatitis is another frequent cause. Your nipples may hurt, itch, and develop a rash after exposure to laundry detergent, body wash, lotion, or perfume. The fix is identifying and eliminating the irritant. If you recently switched products and then noticed soreness, switching back is the obvious first step. A fragrance-free, hypoallergenic detergent often clears things up.
Hormonal Causes in Women
If your nipple pain comes and goes on a monthly pattern, hormones are the likely explanation. Breast tenderness and swelling are closely tied to ovulation and the second half of the menstrual cycle (the luteal phase). During this phase, rising estrogen relative to progesterone triggers fluid retention and cell changes in breast tissue, causing soreness that peaks in the days before your period and disappears once bleeding starts. Research tracking hundreds of menstrual cycles confirmed that tenderness and swelling were completely absent during the first half of the cycle and only appeared after ovulation.
This cyclical pattern is one of the most reliable clues that your pain is hormone-related. Women who have anovulatory cycles (months where no egg is released) tend not to experience this tenderness at all, which reinforces the hormonal link. Tracking when the pain occurs relative to your period can help you and your doctor distinguish this from other causes.
Pregnancy brings its own version of nipple sensitivity. Hormonal surges in early pregnancy can make nipples tender, sore, or hypersensitive to touch weeks before other pregnancy symptoms appear.
Breastfeeding-Related Pain
For people who are nursing, nipple pain is extremely common and has several possible causes. The most frequent is a poor latch, where the baby isn’t positioned correctly on the breast, creating excessive pressure on the nipple. This typically produces sharp pain at the start of each feeding. A lactation consultant can often resolve this in a single visit by adjusting positioning.
A yeast infection on the nipple (candidiasis) causes intense burning or stinging pain during and after feeding. The nipple may look pinkish, shiny, or develop flaky, eczema-like patches, but there’s no fever or deep redness. Women who’ve recently taken antibiotics, have a history of vaginal yeast infections, or have nipple damage from a poor latch are at higher risk.
Mastitis is a more serious concern. It involves pain, redness, warmth, and swelling in a specific area of the breast, often accompanied by fever and flu-like symptoms. A blocked milk duct can feel like a firm, tender lump with redness over it. If a blocked duct or mastitis isn’t treated early, it can develop into a breast abscess, a painful collection of pus that may cause bruising-like discoloration.
Nipple Pain in Men
Men experience nipple pain too, and friction is the leading cause, especially during endurance sports. Beyond that, gynecomastia (enlarged breast tissue) can make nipples sore or tender to the touch. You might feel a movable lump beneath the nipple that’s sensitive when pressed.
Gynecomastia results from an imbalance between testosterone and estrogen. It’s especially common during three life stages: shortly after birth, during puberty, and after age 50. Certain medications can trigger it as a side effect, including some drugs used for heartburn, heart conditions, prostate enlargement, and fungal infections. Excess body fat can also increase breast size, though this involves fat tissue rather than glandular growth.
When Nipple Pain Signals Something Serious
Pain alone is rarely a sign of breast cancer. In the study of over 10,000 symptomatic women, those referred with pain as their only symptom were 20 times less likely to have cancer than those referred with a lump. That said, certain changes alongside pain warrant attention. These include:
- A new lump in or near the breast
- Nipple discharge that’s bloody or straw-colored
- Skin changes such as flaking, crusting, oozing, or hardening that looks like eczema
- A nipple that turns inward when it didn’t before
- Thickening or puckering of the skin on the breast
These are hallmarks of Paget’s disease of the breast, a rare form of cancer that starts in the nipple. It typically affects only one breast and begins with what looks like a stubborn patch of eczema on the nipple before spreading to the areola. A burning sensation, itching, and discharge are common early signs. Because it mimics dermatitis, it’s sometimes misdiagnosed for months.
How Nipple Pain Is Evaluated
If your nipple pain is mild, clearly tied to friction or your menstrual cycle, and goes away on its own, imaging usually isn’t necessary. For persistent or unexplained pain, ultrasound is the first-line investigation. It can identify specific causes like fluid-filled cysts or benign growths. Mammography or MRI may follow if the ultrasound shows something that needs a closer look, and a biopsy is reserved for anything that appears suspicious on imaging.
Simple Ways to Relieve Nipple Soreness
For friction-related pain, prevention is the best treatment. Wear moisture-wicking, well-fitted clothing during exercise. Apply petroleum jelly or anti-chafing balm to the nipples before activities that involve repetitive motion. Nipple covers or soft bandages provide an extra barrier. If your nipples are already raw, keeping them moisturized and avoiding further irritation for a few days usually allows healing.
For hormonal tenderness, a supportive bra that reduces breast movement can make a noticeable difference during the luteal phase. Over-the-counter pain relievers help with acute discomfort. For contact dermatitis, switch to fragrance-free laundry detergent and unscented body products, and avoid applying anything directly to the nipple area until the irritation clears.