Eczema is an umbrella term for several inflammatory skin conditions, including atopic dermatitis, allergic contact dermatitis, and irritant contact dermatitis. For many people, including more than 5,200 members of MyEczemaTeam, the breast is a common area for eczema to develop. Breast eczema may cause itchiness, irritation, scaliness, and pain and can make breastfeeding challenging. Although there isn’t a cure for eczema, several treatment options can help manage flare-ups.

Causes of Breast Eczema

It is not exactly clear what causes eczema, but common environmental irritants, household products (such as shampoos, detergents, and perfumes), stress, and food allergens may trigger the rash associated with eczema, including breast eczema. Women who have a history of asthma or hay fever or who are pregnant or breastfeeding are at a higher risk of developing breast eczema.

Eczema is one of the main causes of itchy nipples and irritated skin around the areola (the darker skin surrounding the nipple). The rash can be the result of allergic reaction or contact dermatitis from clothing, soaps, lotions, or other substances that touch the skin.

Symptoms of Breast Eczema

Breast eczema can appear anywhere on, between, or under the breasts, as well as the nipple and chest area. Typical symptoms include:

• Itchiness
• Dry, flaky, scaly skin
• Discolored (red, purple, brown, or grayish) skin
• Oozing
• Bleeding when scratched
• Thickened skin

Eczema disrupts the top layer of the skin, making it easier for bacteria and other pathogens to get in and cause infection. Signs of infection include oozing, weeping, discolored, or swollen skin, as well as pain and fever.

Rarely, nipple or breast eczema symptoms that don’t go away with treatment can be a sign of Paget’s disease, an unusual type of breast cancer. Paget’s disease of the breast or nipple is a rare inflammatory cancer that makes up about 5 percent of breast cancer cases. It predominantly affects women but sometimes occurs in men. Signs of Paget’s disease typically include:

• Skin discoloration
• Abnormal nipple discharge
• Itching and burning
• Thick, crusty skin
• Bleeding
• Involvement of only the breast (usually)

If you have signs and symptoms of eczema on your breast or nipple that do not clear up with treatment, it is important to ensure you have the right diagnosis. It’s a good idea to have your rash or itchy skin evaluated by your doctor, a dermatologist, or another health care professional. If Paget’s disease is diagnosed or suspected, a mammogram should be done to look for an underlying cancer of the breast.

Treatment Options for Breast Eczema

Flare-ups of breast eczema typically go away when the cause or trigger is identified and removed. For mild to severe cases, topical treatments may help reduce symptoms and clear up the affected skin.

Topical treatments include:

• Steroid ointments prescribed by a doctor, such as mometasone furoate (Elocon) and methylprednisolone aceponate (Advantan)
• Over-the-counter hydrocortisone cream
• Fragrance-free moisturizers and lotions to hydrate skin and restore its barrier
• Topical immunomodulators such as tacrolimus (Protopic)

Along with causing pain, itchiness, and discomfort, eczema can lead to feelings of embarrassment and self-consciousness. Wearing a bra when you have eczema can also cause chafing and discomfort. Here are a few proactive tips to help alleviate eczema symptoms and prevent flare-ups:

• Take short, lukewarm showers.
• Keep soap and shampoo away from the nipples.
• Wear unpadded bras.
• Use fragrance-free products around the breast area.
• Wash bras by hand using a mild soap. Detergents can often be an eczema trigger.
• Rinse breasts and skin thoroughly after swimming.

A MyEczemaTeam member asked for advice on treating the raw skin underneath her breast. Several members replied with what has worked for them:

• ”Have you tried Sudocrem? It helps me when I have raw skin.”
• “Have you tried extra virgin olive oil?”
• “I used antibiotic cream and my eczema healed.”
• “I like ointments instead of creams.”
• “I use body butter and nontoxic lotion. I have also done oatmeal baths.”

Breastfeeding With Eczema

Trying to breastfeed a baby during a flare-up of breast eczema can be painful enough to make you want to discontinue breastfeeding, which can lead to complications such as engorgement and mastitis (inflammation of the breast). Treatment is important, but many women may be concerned about using topical steroids when they are breastfeeding. If applied properly, steroids can help heal breast eczema quickly, allowing you to continue breastfeeding your baby comfortably.

Recommendations for using topical steroids while breastfeeding include the following:

• Allow nipples to air-dry.
• Apply a small amount of ointment or cream between feedings.
• Stop using the topical steroid when the eczema goes away.
• Do not use a strong steroid ointment for longer than two weeks.
• Talk with your doctor about over-the-counter hydrocortisone cream, which may often be used if symptoms recur.

You’re Not Alone

MyEczemaTeam is the social network for people with eczema and their loved ones. Here, more than 42,000 members come together to ask questions, offer support and advice, and connect with others who understand life with eczema.

Do you get eczema on your breast? What tips do you have for others? Share your thoughts and experience in the comments below or start a discussion on MyEczemaTeam.