What causes pruritus of the nipple?

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Last updated: April 24, 2025View editorial policy

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Differential Diagnosis for Itchy Nipple

  • Single most likely diagnosis
    • Eczema/Dermatitis: This is often the most common cause of itchy nipples, resulting from skin irritation or allergic reactions to soaps, detergents, or other substances.
  • Other Likely diagnoses
    • Breast thrush (candidiasis): A yeast infection that can cause itching, redness, and discomfort around the nipple, especially in breastfeeding women.
    • Paget's disease of the breast: A rare form of breast cancer that can present with eczema-like changes and itching of the nipple.
    • Nipple psoriasis: Psoriasis can affect the nipple area, leading to itching, redness, and scaly skin.
    • Allergic contact dermatitis: An allergic reaction to substances like nickel in jewelry or certain ingredients in soaps or lotions.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Inflammatory breast cancer: A rare and aggressive form of breast cancer that can cause itching, redness, and swelling of the breast.
    • Breast cancer with nipple involvement: Any form of breast cancer that involves the nipple can cause itching, among other symptoms.
  • Rare diagnoses
    • Nipple adenoma: A rare, benign tumor of the nipple that can cause itching and discomfort.
    • Sarcoidosis of the breast: A rare condition where granulomas form in the breast tissue, potentially causing itching and other symptoms.
    • Neurological conditions: Certain neurological conditions, such as notalgia paresthetica, can cause itching sensations in the nipple area due to nerve irritation.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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