Why Are My Nipples Sore?

Quick Overview

Sore nipples are a symptom of pain or irritation, strictly distinct from nipple hardness. While mastitis or hormonal shifts can trigger both, a sore nipple on its own usually points to an issue with the skin or breast tissue itself. Hardness without pain is typically a harmless muscle reflex.

Sore nipples can come with stinging, redness, or visible skin changes, in addition to the pain or sensitivity itself. People commonly describe their nipples as:

Very touch-sensitive
Stabbing or throbbing
Painful or tender
Red and swollen
Itchy

Most often, sore nipples are caused by hormonal changes, friction from clothing, or skin irritation. Rarely, they’re a sign of something more serious, like breast cancer, and any soreness that comes with discharge or a lump should be checked by a doctor promptly.

Causes of sore nipples

woman with sore nipple touching her breast

1. Hormonal changes

Hormonal shifts during periods, puberty, perimenopause, or while using hormonal contraception can all cause breast and nipple soreness, usually most noticeable in the days before a period.

This is the same hormonal pattern that can cause nipple hardness (covered in Why Are My Nipples Always Hard?). Still, for most women, soreness is the more noticeable symptom, especially around the areola and under the arm.

2. Friction from clothing

Bras and shirts that press against the nipples can cause dryness, redness, and chafing, particularly during running or other repetitive exercise. Taping the nipples or using an oil-based balm before exercise can help prevent this.

3. Infection

Cracked or damaged nipples are more prone to infection. Two common causes:

Mastitis

Mastitis is a breast infection most often linked to breastfeeding. Unlike simple hardness, mastitis comes with fever, and the breast (not just the nipple) becomes red, hot, and painful. It’s one of the more common reasons sore nipples need same-day medical attention, since it can progress to an abscess if untreated.

Thrush

Thrush is a yeast infection that can affect the nipple, areola, and the baby’s mouth. It typically causes burning or shooting pain that continues after a feed rather than during one, and the nipple or areola may look unusually pink or shiny, sometimes with a rash of tiny blisters. Thrush usually affects both nipples, which can help distinguish it from a one-sided latch problem.

Treatment usually involves an antifungal cream for the nipple, along with oral or topical treatment for the baby, often for 1–2 weeks or more, since thrush can pass back and forth between parent and baby.

4. Pregnancy

Rising hormone levels in pregnancy often make the nipples expand, darken, and become more tender, sometimes as one of the earliest pregnancy signs.

5. Breastfeeding (latch problems)

Most breastfeeding-related nipple pain comes down to latch. A good latch means your baby takes in the whole nipple and areola, not just the nipple tip. A shallow latch can cause pain during feeds and, over time, cracked nipples, which raise the risk of both mastitis and thrush above.

If pain lasts beyond the first couple of weeks of nursing, it’s worth checking in with a doctor or lactation consultant, since most early breastfeeding pain settles within that window.

6. Rashes or allergic reactions

Soaps, detergents, perfumes, and lotions can sometimes cause irritation to the skin around the nipple. If you notice soreness along with scaly patches, sores, or ongoing redness, it might be a sign of dermatitis instead of just irritation. The good news is that it usually responds well to anti-inflammatory creams!

Rare Illness & Cancer Warning

Nipple pain can sometimes be a signal of Paget’s disease of the breast. This is a rare type of cancer that affects the skin around the nipple, accounting for only 1–4% of breast cancer cases.

Because it closely resembles a common skin condition, it is often mistaken for eczema or dermatitis at first. Symptoms to watch for include:

A scaly, eczema-like rash on one nipple that spreads to the surrounding area.
Itching, burning, or discharge.
A flattened or inverted nipple, or a lump.

The Clinical Rule of Thumb: If you have a rash that isn’t improving with standard treatments after a couple of weeks, check in with your healthcare provider instead of just trying a stronger moisturizer. Your health is paramount.

When to see a doctor about sore nipples

Most sore nipples resolve with a fit change, a few days of rest from friction, or a basic skincare adjustment.

See a doctor if:

The soreness is on one side only and lasts more than two weeks.

There’s a rash, scaling, or crusting that doesn’t improve with a moisturizer or anti-inflammatory cream.

You notice discharge, especially if it’s bloody or clear from a single duct.

The nipple has changed shape (flattened or pulled inward) recently.

There’s a lump in the breast or underarm.

You have fever, redness, and breast pain while breastfeeding. (Possible mastitis: same-day attention recommended.)

How to treat sore nipples

Treatment depends on the cause. A better-fitting bra or top often resolves friction-related soreness. Dermatitis is usually treated with anti-inflammatory steroid creams. Mastitis and thrush need a doctor’s diagnosis and prescription treatment (antibiotics or antifungals, respectively).

If a workup points to breast cancer, treatment options can include:

Surgery to remove the tumor or, in some cases, the breast
Radiation therapy, using high-energy rays to target cancer cells
Chemotherapy
Hormone therapy, which blocks the hormones that fuel some types of breast cancer
Targeted therapies that interfere with specific changes in cancer cells