Three months ago, I started feeling burning sensations in my left nipple. The feeling comes in random waves throughout the day. I’ve had a breast exam and mammogram – all clear. My doctor thinks it’s nothing. Should I get a second opinion? — Mrs. V.
Mrs. V. isn’t the only woman bothered by a burning sensation in the nipple. Many women report nipple pain and burning just before their menstrual period. But such pain is regular and predictable; it starts before your period, and ends shortly after, returning again the next month.
What about nipple burning that’s random, rather than regular?
Nipple burning and cancer
First, understand that only about five to ten percent of breast cancer diagnoses include pain (or burning) as one of the symptoms. And of those women with nipple pain or burning who are later diagnosed with breast cancer, the diagnosis is nearly always Paget’s disease of the breast, a rare cancer whose chief symptom is a scaly rash.
So statistically speaking, a burning sensation in the nipple unaccompanied by any skin change or underlying lump is almost certainly not related to breast cancer.
That doesn’t mean it should be taken lightly. Pain is a sign your body is in distress, so the underlying cause needs to be identified. Pain is also uncomfortable! Clearly you’d like to find some relief.
Nipple burning due to external causes
Your nipples are extremely sensitive, and a burning sensation can signal external irritation, just as a blister on your foot can result from a shoe that doesn’t fit quite right.
Potential external causes for nipple burning include:
- A bra that doesn’t fit quite right
- A change in laundry detergent or shower gel
- Dry skin/chapping
- Chemical exposure, such as swimming in a chlorinated pool
- Rough sex
If there’s burning in just one nipple, not both, that doesn’t rule out environmental causes. All breasts aren’t created equal; one may be more sensitive than the other.
Nipple burning and hormones
Even if nipple burning is felt in an irregular way (i.e., not period-related), hormones might still be the culprit. If you’re nearing menopause, hormonal levels can fluctuate wildly. This fluctuation can cause that same type of burning nipple pain you might have experienced in the past around your period, only now it’s much more random.
Nipple burning and infection
Other reasons your nipple might feel painful or hot include an infection in its early stages, such as mastitis; or a blocked milk duct under the nipple. However, this type of pain is generally accompanied by swelling and redness. So if you’re experiencing only a burning nipple, with no further symptoms, it’s unlikely an infection or blocked duct is the cause.
Nipple burning and nerve damage
If you’ve been treated for cancer and received radiation and/or chemotherapy, it’s possible that you could have sustained some nerve damage in your breast. This damage might manifest itself as burning or pain in the nipple. Ask your oncologist if you might have neuropathy, which is the clinical term for this type of nerve damage.
What should you do about nipple burning?
First, establish that it’s nothing serious. If your doctor says: “I don’t think it’s serious,” ask why. Has s/he ruled out Paget’s disease and infection? Can s/he suggest what might be causing the pain? The best way for you to get emotional resolution around this issue is to find out what’s causing the pain.
Physical relief might be tougher, but here are some things to try:
- Rule out external causes, like a chafing bra or harsh detergent;
- Determine if you have an infection; if so, drugs will help;
- If you’re perimenopausal (approaching menopause), ask your doctor about drugs to smooth our any hormone issues.
Nerve damage is usually untreatable, but hang in there; as quickly as this burning appeared, it may disappear.
Breast cancer survivor and award-winning author PJ Hamel, a long-time contributor to the HealthCentral community, counsels women with breast cancer through the volunteer program at her local hospital. She founded and manages a large and active online survivor support network.