There are several factors that can lead to nipple discomfort in men, and the good news is that it’s usually preventable and treatable. Here are some reasons you might experience tender or painful nipples, and what you can do about it.
Cause of Sore Nipples: You’re Wearing the Wrong Workout Clothes
“Friction of clothing associated with running or exercise is one of the most common causes of nipple pain in men. Aptly named ‘runner’s nipple,’ the condition speaks for itself,” says Dr. Robert Glatter, MD, an assistant professor of emergency medicine at Northwell Health and attending emergency physician at Lenox Hill Hospital.
Tingling or increased sensitivity in the nipple can also happen, as well as chafing or skin breakdown with potential bleeding, he says. “Other than running, I also see this in patients who engage in exercises with lots of vertical and/or horizontal movements including soccer, rugby, plyometrics, boxing, as well as Zumba occasionally,” says Glatter.
Wearing a tight-fitting shirt or tank top that is not made from Lycra can lead to this chafing, as well as cotton T-shirts and tank tops, he says.
Spandex might be better for stretching or yoga, where you’re not sweating as profusely. (To some extent, the shape of the nipple also matters. “A nipple that is pointier with a greater ability to contact clothing is more often at risk for chafing," says Glatter.)
The fix? Newer synthetic fabrics such as Dri-Fit hug the body closely, reducing the chance of friction occurring in the first place. "I find that most of my patients prefer this type of fabric in selecting their athletic wear. I also find that most men prefer a looser-fitting shirt which can reduce the chance for nipple chafing,” he says.
Some men may even apply protective coverings known as Nip Guards or even Band-Aids as a makeshift approach, he explains.
Cause of Sore Nipples: New Clothing or a Fabric Allergy
Even if you’re not an athlete, you can still get nipple friction and chafing. “Newly purchased clothing can be especially sensitive to a man’s nipples. Cotton fabrics that are coarse in nature as well as chemically treated may lead to greater sensitivity, manifested as an outright allergy or contact dermatitis,” he says. “If you have a history of eczema or dry skin, it’s more likely to occur."
In extreme cases, you might notice hives, oozing blisters, dry skin, burning, and swelling. “Exposed nipples may develop redness or scaling, with potential formation of fluid-filled blisters that may resemble a burn. If this develops, it’s a good idea to avoid wearing that item of clothing, apply cool compresses, and speak with your physician,” says Glatter.
It's also a good idea to limit how often you wear wool, which can create a buildup of sweat and moisture and lead to irritation, he says. “Wool sweaters are notorious for causing excess nipple sensitivity; a simple solution is to wear a Dri-Fit shirt underneath, which not only protects your nipples, but also absorbs moisture which may lead to skin breakdown and secondary infection,” Glatter explains. Even if you don't wear wool on your skin as is — which, let's be honest, who does — it's a good idea to layer up.
Cause of Sore Nipples: Nipple Infection
A nipple infection also can develop from irritation from self-grooming and either trimming or using a razor on nipple hairs. “Sharp scissors can lead to lacerations or puncture-type injuries. Injury to the nipple and aureolar tissue can lead to significant bleeding and pain, since the tissue has lots of blood vessels and nerves coursing through it,” says Glatter.
Infection may also develop as a result of such injuries. “If you develop warmth in the area, along with tenderness and swelling, it’s advisable to see your doctor as soon as possible. The presence of a fever or chills makes it more urgent in nature, and a visit to your local ER is advised,” he says. It’ll be a bit more difficult to treat, but it’s still nothing to worry about. “Antibiotics will be necessary to treat the skin infection in your nipple. A 7-10 day course of treatment is typical,” he explains.
Cause of Sore Nipples: Gynecomastia
“Gynecomastia happens when there’s excess fatty tissue in the breasts of males,” says Glatter. It can come from a few physiological reasons, such as an imbalance in the ratio between estrogen and testosterone, as well as from lifestyle factors, such as medications or alcohol use, he says.
“It’s not uncommon to see gynecomastia in adolescents. The good news is that it commonly resolves on its own in 1-2 years, without medications or need for surgical intervention,” says Glatter.
While it’s less common in adult men, they can still get it, and risk increases with age, according to the Mayo Clinic. About one in four guys between 50 and 69 are affected by the condition.
“Medications can also be a cause of gynecomastia in about 10-20% of cases. Medications to treat anxiety, such as Valium or Xanax, belonging to class of medications known as benzodiazepines, are often culprits,” he says.
(Simply discontinuing the medication will reverse any changes seen in 1-2 months.)
What’s more, “gynecomastia may also develop from excess alcohol intake, as there are phytoestrogens in alcohol. Gynecomastia is often a sign itself that a person may be drinking heavily, without ever telling the doctor,” says Glatter.
Medical treatment of gynecomastia can definitely be effective, but it’s important that you start treatment in the first 1-2 years once noted in a physical. “If drugs are not effective after 6-12 months, or if gynecomastia is more long standing, breast reduction surgery is another option,” he says.
Cause of Sore Nipples: Cysts
Men can develop cysts, as well as an underlying infection of breast tissue, if nipples are dry or chafed, either due to cold weather or a history of eczema, says Glatter. This leads to cracks and small openings in exposed skin on the nipples and allows skin bacteria to enter.
“This is a set-up for mastitis or cellulitis, which can require antibiotics and warm compresses as treatment,” says Glatter.
Cause of Sore Nipples: Breast Cancer
If none of the above apply, nipple pain could be a sign of something more serious. “A painless lump or thickened breast tissue in rare cases may be a sign of breast cancer in males," Glatter says. "It’s important to emphasize that breast cancer in men is not common, and is in fact, quite rare." (Less than 1 percent of all breast cancer develops in males, according to the National Breast Cancer Foundation.)
Lumps are usually painless, but are sometimes accompanied by tenderness. Once the cancer has spread, swelling can be found under the armpit, in lymph nodes, or around the collar bone. In extreme cases, guys can develop open sores if the cancer has progressed.
Cause of Sore Nipples: Paget Disease of the Breast
A rare form of cancer, Paget disease usually affects the nipple and areola, causing flaky, crusty or itchy skin surrounding the area. These symptoms are similar to other conditions like eczema, so the disease may be misdiagnosed, according to the National Institute of Health. Most people with Paget disease also develop cancerous tumors in their breast tissue. Doctors aren’t sure what causes the condition.
If nipple sensitivity and pain do not improve or resolve, it’s time to go to your doc. Glatter also advises guys to get in the habit of doing a self-exam of their breasts, nipples, and surrounding tissue every month to spot any issues that could develop into a more serious problem down the road.
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