Eczema

Eczema of the nipple may sometimes occur as a result of irritation caused by the rubbing of clothes – contact eczema – or of a general skin infection. Some people are born with eczema, and it can occur on the nipple as on any other area of the body.

Once the diagnosis has been confirmed by a specialist, which may, rarely, be done by means of a wedge excision under local or general anesthetic, and the cause of the irritation has been removed, a short course of steroid cream may be necessary. Infection can be treated with antibiotics.

Paget’s disease of the nipple

Paget’s disease normally occurs in women over the age of 45, and is caused by a ductal cancer growing onto the areola. It is quite a rare condition which may be confused with eczema, but which spreads over the areolar region far less quickly and may destroy the nipple completely over a long period of time. If left untreated, it never heals and eventually forms an ulcer.

Wedge excision of the affected area, or the cytological examination of scraped cells under a microscope, will confirm the diagnosis. This is a far more serious disease than eczema and treatment may involve complete removal of the breast. A woman with persistent redness or nipple discharge should always report it to her doctor even if she has eczema elsewhere on her body as the cancer associated with Paget’s disease is not palpable.

Infective ‘mastitis’

This can occur in women who are breast-feeding their babies. It may be caused by the transfer of micro-organisms from the hands to the breast through a cracked or inverted nipple, by an infection passed on from the baby’s mouth, or by blood-borne infection such as a sore throat.

If the ducts become blocked when a woman is lactating, the milk may stagnate within them and an infection can develop. This may cause a dull pain with inflammation, tenderness and swelling or engorgement of the breast, and sometimes an infective discharge from the nipple.

Treatment with antibiotics is usually effective if given early, but breast-feeding will have to stop while these are being taken. Breast milk can be expressed with a breast pump, but, as the milk will contain traces of the antibiotic, it should not be given to the baby. Your midwife will be able to advise you in this situation.

Ulcers

Rarely, ulcers can develop on the nipple during breast-feeding. The baby’s sucking can irritate the skin, leading to pain and bleeding from the affected area.

Washing and drying the nipple carefully after each feed, and the use of Calendula ointment can help to prevent ulcers forming, but once present, frequent washing with a sterile solution and breast-feeding using an artificial nipple should help. If necessary, breast milk can be expressed with a breast pump.

Ulcers are more common in fair-skinned women, particularly those with red hair.

*15/39/5*

Related Posts:

• LOSS OF APPETITE/LOSS OF WEIGHT – PEOPLE WITH CANCER
• TREATMENT OF SYMPTOMS – STAYING AT HOME OR GOING INTO HOSPITAL