Rashes: They can be uncomfortable, unsightly, and sometimes even a little bit worrisome. When sensitive areas like your breasts or nipples are involved? Skin changes can be even more surprising. After all, when you take off your shirt and find flare-ups of blotchy red spots or a painful nipple, it’s easy to spiral into the land of worry.
The truth of the matter is that most skin irritations, rashes, and conditions that occur everywhere else on the body can also show up on your breasts, making breast rashes fairly common (phew). Of course, sometimes, breast rashes have more worrisome causes—and it’s not always easy to tell the difference between the two (read: ‘Do I have a rash on my breasts because I switched laundry detergents or is it something more serious?’).
Curious what could be going on? Here, the most common forms of breast rash—plus causes and treatments for each. And just remember: As a general rule of thumb, you can usually treat any simple rash that lasts less than a few weeks with over the counter topical creams, says Amy Kassouf, M.D., a dermatologist at The Cleveland Clinic. But if your rash persists or you notice swelling, pain, or oozing; or if your rash involves the nipple or areola or is associated with fever or other whole-body symptoms, it’s best to see your doc.
One of the most common rashes that dermatologists see on the breasts is called intertrigo—and it actually usually shows up underneath or between the breasts, explains Dr. Kassoouf. Often, Intertrigo is caused by sweat irritation from the folds of your skin rubbing against each other (which is why it tends to show up on the breasts, where your bra, sports bra, and shirt can all mix). Sometimes, this irritation can even lead to yeast or other bacterial growth, which essentially breaks down the skin. “It is most common when it is very hot outside or when it is very cold and we are bundled up in clothes that keep our core warm and don’t allow the skin to breathe,” says Dr. Kassouf.
The main goal in treatment is to keep the affected skin clean and dry, so keep up with your general hygiene (thorough washing and drying after you shower), she suggests. Using the cool settings on your hairdryer followed by a mix of cortisone cream or an anti-yeast cream such as clotrimazole or a prescription cream can help, she says.
Contact Dermatitis is essentially an itchy rash that happens when your skin comes into contact with something that irritates it (or something you’re allergic to). It’s common on the breasts since it can be related to dyes and fabric finishes in clothing, detergents, and fragrances in the products used to wash clothes, says Dr. Kassouf. It can also be common near your areola if you’re breastfeeding. “I always ask people what they're putting on their nipples since lanolin—which is what hospitals give out in those little tubes—is actually made from sheep's wool, which can be very irritating for some people,” says Allyson Murphy, an international board-certified lactation consultant (IBCLC) in South Orange, NJ.
Your best treatment option here? Simple: Try your best to avoid what you think is causing your rash (which can sometimes be a guessing game). If nothing’s working, touch base with your dermatologist.
A Yeast Infection
Yep, you can get one on your boobs. In fact, thrush (AKA candidiasis, a fungal yeast infection) is fairly commonplace on the areola of nursing mothers — and it can actually affect both babies and nursing moms (though sometimes not everyone gets symptoms), says Murphy. If you do have symptoms, you might notice irritated, shiny, or flaky nipples (they may appear bright red on lighter pigmented skin tones) and your nipples and breasts might be super painful during and between feedings, she says.
Topical or oral antifungals can help, Murphy says, as might going easy on sugar (which can feed the yeast) in your diet for a few days. Make sure to sanitize everything (flanges, bottles, pacifiers) and wash your bras in hot water frequently to help keep infections like this at bay, Murphy says. And if you think you have a yeast infection, touch base with your doctor.
Eczema, Psoriasis, or Other Common Skin Conditions and Rashes
You know allllll of those common rashes you’ve heard of before (hives, scabies, shingles, the list goes on)? They don’t spare the breast area, confirms Dr. Kassouf. “Most of the common rashes will occur on both breasts as well as other areas of the skin,” she says. So: If you notice a rash that’s on your chest and other places of your body, touch base with your dermatologist.
Paget’s Disease of the Breast
Paget’s Disease of the Breast or Nipple is a rare form of breast cancer (it likely accounts for less than 5% of all breast cancer cases in this country and more than 97% of people who get it also have cancer somewhere else in the breast). It happens when cancer cells accumulate in or around your nipple, affecting both the ducts of your nipple and the outside of the nipple and areola. If you have it, you might notice scaly, red, itchy skin, according to the National Cancer Institute. It tends to be more common in women older than 50, and if you do have it, you likely will only notice the rash-type symptoms in one breast, notes Dr. Cate.
If these symptoms match up to your experience, touch base with your doctor ASAP; treatments include removing either some of all of the affected breast.
Inflammatory Breast Cancer (IBC)
First things first: IBC is also rare — it only accounts for only 1 to 5% of all breast cancers, according to The American Cancer Society. But it’s important to know its signs — and they’re actually pretty specific. Sometimes known as “peux d’orange,” if you have IBC, you may have a thickened area of skin that’s dimpled — sometimes resembling the skin of an orange, explains Dr. Kassouf. You might also notice tenderness, itching, or discharge of your nipples, swelling or redness in just one breast, or one breast that looks a lot bigger than the other.
If you think you could have IBC, see your doc ASAP. Imaging and biopsy can ID cancer and steer you toward a treatment plan if you do indeed have it.
Heat rash (AKA prickly heat or miliaria) is a rash that pops up in — you guessed it — hot, humid weather. Why it happens: In short, your sweat ducts essentially trap sweat under your skin, leaving you with red lumps (or even blisters) that might feel “prickly” or super itchy and uncomfortable.
The good news is that heat rash tends to go away on its own when you cool your skin down, though severe forms that come with a fever or swollen lymph nodes can require medical attention.
Breastfeeding moms have likely heard of mastitis — the (often painful) inflammation of breast tissue that can turn to infection. It’s caused by a build-up of milk inside your breasts thanks to a clogged duct (ugh) or something else preventing the seamless flow of milk. You can also get it if you have breaks in your skin or nipples that let bacteria make their way into your body. You’ll know you have it because your affected breast will likely swell, be red, potentially warm to the touch, and you might even develop flu-like symptoms (ugh).
Your healthcare provider or an IBCLC can help you with a treatment plan. Nursing frequently and using a warm compress before you feed can help ease discomfort. Sometimes, if there’s an infection, mastitis does require an antibiotic.