The head-scratching dilemma of itchy nipples and breasts

We’re used to casually scratching itchy skin — on the arms, legs, scalp, or elsewhere — on an everyday basis. No big deal, right? But if you find you’re routinely reaching to scratch your nipples or breasts, something might be up.

It’s not a common problem, but when it happens, itchiness across the bra area can prove truly disruptive. From sweat to rare cancers, many issues can explain it — and it’s always worth paying attention to.

Even if it’s not serious, “it can be very uncomfortable,” says Dr. Lori Benjes, a dermatologist with Harvard University Health Services. “It can also be very upsetting, since it can interfere with women’s ability to feel completely comfortable with their bodies and intimacy.”

Annoying but not alarming

These situations might prompt itchiness that leads you to scratch:

Eczema and psoriasis. These inflammatory skin conditions result from immune system glitches, which produce bumps and irritation (in eczema) or scaly plaques (in psoriasis). Both of them can itch intensely, and when they occur on the breasts — which isn’t usual — they can make for a miserable time.

Exposure to soaps or detergents. Cleansing products often contain irritating chemicals, and some people develop contact dermatitis — red, flaky, itchy skin caused by direct exposure to these products. If the rash doesn’t resolve after you stop using the product you suspect is at fault, it might be worth consulting a dermatologist, Dr. Benjes says.

Contact dermatitis can also have an allergic basis. The resulting rash is often “well-defined with clearer edges,” she says. “It doesn’t happen a lot on the breast, but if it persists, sometimes we need to rule out a contact allergy.” The first step is to stop using all your regular soaps and detergents, then add one back at a time. For stubborn, recurrent rashes, a dermatologist might perform a patch test, exposing tiny skin areas to every product you use to determine if you’re allergic.

Sweaty bras. Elastic in bras can occasionally cause an itchy allergic reaction, but the real threat is trapped perspiration. A large number of women work out and then go back to what they were doing, wearing a bra damp with sweat, creating conditions ripe for itchy breasts.

“Some people also don’t cool down from their workout before a shower and are still sweating when they’re done showering, prolonging their exposure to moisture and predisposing them to a rash,” she adds. “We want you to exercise, but getting out of sweaty clothing immediately after your cool-down needs to be a priority.”

Pregnancy and breastfeeding. When your belly swells during pregnancy, your breasts tend to as well — but stretched skin can be itchy skin. “There also might be a hormonal component,” Dr. Benjes says.

Meanwhile, breast milk residue or a baby’s saliva can irritate the delicate skin of the nipple, though “most people who breastfeed don’t get itchy nipples,” she notes.

Causes you shouldn’t ignore

Occasionally, breast itching isn’t just skin deep; it can point to certain conditions that warrant a closer look:

Infections. The aforementioned sweaty bras are also a conduit for yeast infections to crop up on or under the breasts. But trapped perspiration isn’t the only thing that can lead to itch-producing breast infections, which can also develop in glands and milk ducts. “We also see cellulitis of the breast, which looks just like it does on the leg,” with redness, pain, swelling, and warmth, Dr. Benjes says.

Breast surgery. Whether you’ve had a breast biopsy, mastectomy, or breast reduction or augmentation surgery, the skin of your chest is likely to come in contact with surgical tape or other materials that can trap moisture or cause irritation. Scar tissue that forms after your operation can also itch as your skin recovers.

Radiation treatment. Radiation beams can damage skin cells, leading to inflammation. Called radiation dermatitis, it results not only in firmer skin, but often discomfort that can include itching.

Breast cancer. Two rare malignancies, Paget’s disease and inflammatory breast cancer, show up on the skin in unusual ways — not as a lump. Early signs of Paget’s disease include redness, flaking, and itching of the nipple. Inflammatory breast cancer can produce intense itching as well as cause breast skin to become thick and pitted like an orange peel.

Any skin changes on the breast that don’t improve over weeks should be evaluated by a doctor to rule out these forms of breast cancer and provide relief, Dr. Benjes says.

Image: © Tharakorn/Getty Images