Eczema on Nipples – What Causes It & How to Treat It

Nipple eczema is a type of inflammation that shows up as red, dry, itchy, or scaly skin on the nipple or areola (that’s the darker skin around the nipple). It might also burn, sting, or even crack and bleed. Some moms describe it as a rash that never quite heals, especially if they’re breastfeeding or pumping regularly.

What Causes Eczema On Nipples?

It can be linked to a skin condition called atopic dermatitis, which often runs in families. It can be triggered by things like:

• Friction from nursing bras, breast pads, or breast pumps
• Contact irritants like laundry detergent, soaps, body washes, or nipple creams
• Allergies to skincare products, lanolin, or fabrics
• Hormonal changes during pregnancy or postpartum
• Heat and moisture trapped under breast pads
• Existing eczema elsewhere on the body that flares up in new places
• High breast pump suction
• Certain foods (like dairy, gluten, or sugar) trigger allergic reactions
• Stress, which is a well-known eczema trigger
• Sometimes eczema may show up or get worse when your baby starts solids, possibly due to allergens in their saliva.
• It can also flare in response to materials like spandex, latex, or dyes in clothing.

How To Tell If It’s Eczema – Or Something Else

A rash on your nipple isn’t always just eczema. Sometimes, other conditions can look very similar, and it’s important to know when to ask your doctor to take a closer look.

When To See Your Doctor

• The rash is only on one side and doesn’t improve after a couple weeks
• There’s a lump under or near the nipple
• You see bloody or clear discharge
• It’s painful or getting worse

In rare cases, a persistent rash could be a sign of Paget’s disease of the breast, a rare form of breast cancer. Don’t panic—but do get checked out if your gut says something isn’t right.

Also worth ruling out: thrush. This yeast infection can cause burning, shiny, or flaky nipples and may require antifungal treatment. A culture test by your healthcare provider can help confirm it.

Should I Still Breastfeed If I Have Eczema On My Nipples?

Yes, you can keep breastfeeding. It’s totally safe for your baby. In fact, many moms with nipple eczema go on to nurse successfully after finding the right treatments and supports.

That said, comfort matters. If the eczema is painful or cracked, it can make nursing feel unbearable. The good news is that most treatments are compatible with breastfeeding, especially if used right after a feeding and wiped off before the next latch.

Let your doctor or midwife know you’re breastfeeding before using any cream. Some may recommend a gentle steroid or healing balm. Ask whether a breast swab is needed first—Staph bacteria can sometimes cause or worsen skin irritation and might require a different treatment.

And if nursing becomes too painful despite everything, pumping and bottle feeding expressed milk is a valid option. A lactation consultant (IBCLC) can help you create a plan that protects both your comfort and your milk supply.

How To Treat Nipple Eczema Safely

Most cases of nipple eczema are treatable with a few simple changes and the right kind of care.

Treatment Tips

• Use a fragrance-free, hypoallergenic moisturizer after each nursing session (lanolin-free, unless you know you tolerate it)
• Coconut oil is a natural alternative with antimicrobial properties
• Avoid soaps and harsh cleansers on your chest—warm water is enough
• Apply a prescription cream, like a low-strength steroid, only under medical guidance
• Keep the area dry, but don’t over-wash
• Air out when you can
• Rinse off after swimming in chlorinated water
• Watch out for preservatives in antifungal or medicated nipple creams, as they can be irritating

Some creams, like Motherlove Nipple Cream, are organic, unscented, and safe to leave on before nursing. When in doubt, ask a lactation consultant or pharmacist.

Nipple shields may help protect skin during feedings, but they can reduce stimulation and milk transfer—so they should be a short-term tool, not a permanent fix.

How to Prevent the Recurrence of Nipple Eczema

Once your skin starts to heal, small changes can help prevent another flare-up:

• Switch to unscented, natural laundry detergent
• Avoid fabric softeners and bleach
• Rinse bras and nursing tops twice to remove detergent residue
• Choose undyed, 100% cotton bras and tops
• Change nursing pads frequently (opt for reusable cotton pads if disposables irritate)
• Avoid hot showers and harsh body washes
• Keep moisturizers nearby and apply twice daily
• Manage stress as much as you can—even a few deep breaths or a short break can help

The glands around your nipples (called Montgomery glands) naturally produce oils that keep the area clean and moisturized. Let them do their job—no need to scrub or soap your nipples. Just rinse with water when needed.

When To Call The Doctor

If it’s not getting better with home care, or if it’s getting worse, talk to your doctor. You deserve to nurse without pain, and there are treatments that can help.

Signs You Need Medical Help

• The rash isn’t healing after 1–2 weeks
• It spreads beyond the nipple/areola
• You’re in pain or having trouble nursing
• You suspect it might be something more serious

A dermatologist or lactation consultant can help you sort it out and find a plan that works.

Final Thoughts

You’re doing your best, and that’s enough. Nipple eczema can feel like one more thing you didn’t sign up for, but it doesn’t have to derail your breastfeeding journey. With the right care, your skin can heal, and feeding your baby can become comfortable again. You don’t have to figure it out alone — and you’re not the only mom who’s been here.

References

• Nipple Eczema — DermNet NZ (2018-09). Covers clinical presentation, causes (including atopic and contact dermatitis), and treatment recommendations for nipple eczema.
• Eczema on Nipples: Symptoms, Causes & Treatment — Cleveland Clinic (2021-11-26). A patient-friendly resource explaining how nipple eczema appears, common triggers, and how it’s managed—especially in breastfeeding parents.
• Breast and Nipple Eczema — BreastCancer.org (2024-07-18). Highlights nipple eczema in the context of breast health and includes guidance on distinguishing it from other conditions like Paget’s disease.
• Ask the Ecz-Perts: Caring for Eczema on Nipples and Genital Areas — National Eczema Association (2024-03-29). Features expert advice from a dermatologist, covering treatment strategies for eczema on sensitive areas, including nipples.