Nipple pain in males is a common experience, and the causes for this sensitivity range from simple external factors to more complex internal physiological shifts. While often a temporary and benign symptom, understanding the source of the pain can guide appropriate self-care or prompt a necessary medical evaluation. Determining the cause helps clarify whether the issue is surface-level irritation or something deeper.
External Irritation and Mechanical Causes
The most frequent source of male nipple pain is mechanical friction, often termed “jogger’s nipple.” This common condition occurs when the skin repeatedly rubs against clothing during extended physical activities like long-distance running or intense workouts. The constant abrasion, especially when combined with sweat and salt, can irritate the skin, leading to redness, stinging, and bleeding.
Wearing certain fabrics, particularly rough materials like cotton, can worsen this effect because they absorb moisture and become more abrasive. Poorly fitting shirts, whether too tight or too loose, also increase the likelihood of chafing by failing to minimize movement across the chest. To prevent this irritation, many people use a protective barrier, such as petroleum jelly or specialized anti-chafing products, applied directly to the nipple area before exercise. Using adhesive bandages or specialized nipple covers creates a physical separation between the skin and the fabric.
Beyond exercise, contact dermatitis can cause pain and soreness due to a reaction to environmental substances. New laundry detergents, fabric softeners, or certain soaps and body washes can trigger an allergic or irritant reaction on the skin of the nipple and areola. This can manifest as an itchy, scaly, or red rash, sometimes with weeping or crusting. Avoiding harsh, fragranced products and ensuring clothing is rinsed thoroughly during washing can help resolve this type of skin irritation.
Hormonal Shifts and Tissue Swelling
A more persistent or deeper pain in the nipple area often points to internal physiological changes, primarily involving hormonal balance. The most common underlying cause is gynecomastia, which is the benign enlargement of glandular breast tissue in males. This condition must be distinguished from pseudogynecomastia, which is breast enlargement due to excess fat tissue from obesity.
True gynecomastia is caused by an imbalance in the ratio of androgens (like testosterone) to estrogens, increasing the action of estrogen on the breast tissue. This hormonal shift stimulates the growth of glandular tissue, which often feels like a firm, button-sized lump directly under the nipple. The resulting tissue growth or inflammation causes the tenderness or pain.
This condition frequently occurs during periods of significant hormonal fluctuation throughout a person’s life. Up to 70% of adolescent boys experience some degree of temporary gynecomastia during puberty as their bodies adjust to rising hormone levels. It is also common in older adulthood, particularly after age 50, as testosterone levels naturally decline.
Certain medications can induce or contribute to the hormonal imbalance leading to gynecomastia. Drug classes known to have this potential side effect include some anti-ulcer medications, specific antifungal agents, certain anti-anxiety drugs, and anti-androgens used for prostate conditions. The pain can present in one breast (unilateral) or both (bilateral), though unilateral pain often warrants a closer medical look to rule out other causes.
Signs Requiring Medical Evaluation
While most causes of male nipple pain are not serious, certain accompanying symptoms should prompt a consultation with a healthcare provider. A medical evaluation is necessary if the pain is severe, persistent, or localized to only one side without an obvious cause like friction. This ensures that any potential underlying condition is identified early.
A lump or mass felt in the breast tissue is a warning sign, especially if it feels fixed, hard, or is located eccentrically rather than directly under the nipple. Any discharge from the nipple should also be immediately discussed with a doctor, particularly if the fluid is bloody, clear, or occurs without squeezing. Skin changes on or around the nipple are another indicator that requires attention.
These changes include unexplained dimpling of the skin, scaling, redness, or ulceration that is not improving with simple self-care. If the nipple pain is accompanied by systemic symptoms like an unexplained fever or chills, this suggests a possible infection or abscess in the breast tissue. Although male breast cancer is rare, these specific symptoms are consistent with the signs doctors look for when ruling out serious conditions.