My areola itches, what does it mean? Does itchy areola mean breast cancer? Have you ever asked these questions? You are not alone. This problem can affect anyone. It can also affect one breast or both, with the itching ranging from mild to severe. Today we will discuss the possible causes of areola itching along with treatments and home remedies that can stop the itching.
Itchy Areola Causes
The areola is the flat, circular, darker part of the breast surrounding the nipple. It can get itchy for obvious reasons such as healing of a surgical scar sustained from a breast augmentation procedure.
Often times, however, there are less obvious underlying causes of areola itching ranging from benign to serious. Below are some of these causes:
1. Dry Skin on Areola
According to Regina Hampton, MD., a breast surgeon in Lanham, Maryland, itchy areolas may be a sign of dry skin. This tends to be more of a problem during cold weather (winter months). Dry itchy areolas that are not associated with other symptoms may benefit from applying a heavy moisturizer such as Eucerin or Aquaphor.
2. Breast Growth during Pregnancy
Mild itching around the areola and nipple may be the result of the natural growth of breast during pregnancy. This causes the skin to stretch, often culminating in an itch. Massaging the skin around your breasts gently with a cream or oil can help to stop the itching.
3. Contact Dermatitis
Contact dermatitis is another likely cause of itchy areola. This refers to a type of eczema or skin inflammation in which the skin gets red or inflamed – and often itchy in addition to other symptoms – as a result of contact with a certain substance. Contact dermatitis can affect one breast or both. It is either caused by an irritant or an allergen:
- An irritant. A substance that causes direct damage to the protective layer of your skin. Contact dermatitis caused by exposure to irritants are more common and account for 8 out of 10 cases. When caused by an irritant, the term irritant contact dermatitis is used.
- An allergen. A substance that, upon contact with your skin, triggers an allergic reaction whereby your immune system responds to a perceived “attack” with a series of reactions that affect the skin. When an allergy is involved, the term allergic contact dermatitis is used.
Coming back to areola itching, the following substances may be to blame:
- Skin care products. Did you recently start using a new type of skincare product? It could be to blame. The fragrances in certain lotions, shampoos, and perfumes often cause contact dermatitis.
- Chemical irritants in soaps and detergents can also be the underlying cause of itchy areola.
- Clothing. Your bra’s fabric may be the underlying cause of areola itching. Wool and synthetic fabrics are in particular known to trigger contact dermatitis. Ill-fitting bras and other clothing items can also irritate the skin and could be the culprit for areola itching. Friction from running and other exercises can make the irritation worse.
- Certain medications.
- Contact with plants such as poison ivy, poison oak, and poison sumac.
Men and non-breast-feeding women with contact dermatitis (and thus itchy areola) often have a history of eczema, i.e. easily irritated skin.
4. Fungal Infection (Breast Thrush)
According to Bhupinder Kaur, MD, a dermatologist practicing in Delhi and a medical expert on Med Help, itchy areola could also be a sign of yeast infection.
For breastfeeding mothers, in particular, areola itching is often a sign of thrush. This refers to an overgrowth of the fungus, Candida albicans. This fungus is naturally found in several moist areas of your body, particularly the mouth, genital area, and intestines. It is the same fungus that causes yeast infection in women.
Predisposing factors for thrush include:
- Use of antibiotics
- Pregnancy hormones
- Baby’s or mother’s immune dysfunction
- Warm, humid environment
- A diet that is loaded with dairy products, artificial sweeteners, and sugars (including the sugar in alcohol)
- Nutritional deficiency in Vitamins A, B, C, and K; iron; and folic acid
- Broken skin
- Women with recurrent vaginal yeast infections or bacterial infection such as mastitis and vaginitis are also more susceptible to thrush. Breastfeeding women whose babies use a pacifier or a bottle are also at higher risk.
You should suspect a thrush if an itchy areola is accompanied by nipple pain (usually after a brief moment of pain-free breastfeeding) and sharp pain in your breasts. Your areola will also look red and shiny.
Signs of thrush in babies include little white patches on the tongue, gums, and inside the cheeks; red diaper rash, fussiness, and saliva that has pearly look. It is also common for the baby refuse to nurse or keep pulling the breast while feeding.
Breast Thrush Treatment
If it is ascertained that a thrush is indeed causing the itchy areola, your doctor will prescribe a topical antifungal cream such as clotrimazole, ketoconazole, and miconazole. Apply the cream to the areola and nipple as directed. Nystatin cream or ointment is also often prescribed.
In case these topical treatments are ineffective, oral fluconazole may be given for up to a couple weeks. Fluconazole is the drug of choice where vaginal yeast infection and breast thrust occur concurrently.
If breastfeeding, the baby also needs to be treated. This holds true even if one of the two parties has no symptoms of yeast infection. Treatment for a baby usually involves:
- Nystatin suspension: This is a prescription medication that is swabbed inside a baby’s mouth after every nursing session.
- Gentian violet: This is a non-prescription medication that is also applied to a baby’s mouth over the course of one week or less.
- Antifungal creams such as miconazole and clotrimazole are often prescribed for topical treatment or thrush in babies.
- Oral antifungal medication such as fluconazole can also be prescribed if your doctor deems it necessary.
5. Paget’s Disease
An itchy flaky areola can be a sign of a rare form of breast cancer known as Paget’s disease. Paget’s disease can affect both men and women at any age but it is seen more commonly in menopausal women (50-60 years old). It typically affects one breast only and the symptoms are easily confused with those for eczema.
The initial symptom of Paget’s disease is usually an eczema-like rash characterized by red, inflamed, itchy areola or nipple. Some women experience a burning sensation. After a short while, the skin around the nipple become flaky or crusty.
It is also common for the nipple on the affected side to have a bloody or straw-colored discharge. As the condition progresses, an ulcer or lump may form on the areola. The nipple may also get inverted.
If the diagnosis of an itchy areola points to Paget’s disease, your doctor will determine the most appropriate treatment. Treatment typically involves breast surgery where either mastectomy or nipple excision is performed.
Itchy Areola Treatment
Whether it affects one breast or both, areola itching can make you very uncomfortable. The right treatment for an itchy areola will vary depending on the underlying skin issue. For example, a yeast infection will require antifungal creams or medications whereas a breast surgery is typically necessary for Paget’s disease.
Most cases of mild areola itching e.g. due to contact dermatitis will, however, resolve with the following treatments:
- Hydrocortisone cream. An over-the-counter hydrocortisone cream can help to stop itching on the skin around the areola.
- Antihistamines. Antihistamines may be prescribed for relief of areola itching. The WebMD, however, cautions against using antihistamine lotions without the supervision of a doctor as these often irritate the skin and worsen allergic reactions. Instead used oral antihistamines such as Benadryl.
- Thick Moisturizers and emollients. Applying a moisturizing cream and emollient can help to heal dry and damaged breast skin, and the associated itching of the areola. Moisturizing also helps to protect the skin from further irritation and inflammation.
Home Remedies for Itchy Areola
If the itching is caused by contact with an irritant or allergen, the first step you need to do is to stay away from it. You will also want to ensure that your skin is adequately moisturized as dry skin is a common trigger. There are also various home remedies that can help to relieve or stop the itching. Below is a general guideline on how to take care of an itchy areola at home:
- Stop using soap directly on the nipples and areolas. If you need to rinse the area, use plain water. Switching to a mild soap that is formulated for use on sensitive skin is also recommended.
- Use mild, fragrance-free soaps and detergent for laundry. Also, rinse your bras and other underwear well to wash off any residual irritant soap or detergents.
- Use properly-fitting bras. These should be made of soft fabrics that allow your skin to breathe e.g. cotton. When at home, stay without a bra as long as possible. And of course, don’t ever sleep with your bra.
- Moisturize your nipples and areolas. Extra virgin, cold-pressed coconut oil or a good lotion such as Eucerin is recommended. Some people will also swear to the effectiveness of pure lanolin for itchy areola relief.
- Avoid hot showers and baths. Warm or cool water is your skin’s best friend. The time you take in the shower is just as important. Take too long and you risk over-drying your skin.
- Apply white vinegar. White vinegar is another great home remedy for itchy areola. Simply pour a tablespoon of white vinegar into a cup of cool water, then apply it gently on your areola and nipples with a clean cotton ball.
You should see your doctor right away if the areola itching is confined to one breast only or fails to respond to the above treatments and home remedies.
- Mayo Clinic: Paget’s disease of the Breast
- NHS Choices: Contact dermatitis
- SkinSight.com: Nipple Dermatitis
- TummyCalm.com: Recognizing and Treating Thrush
- WebMD: Contact Dermatitis: Facts About Skin Rashes