Hi,
There are many causes of swollen and itchy nipples and hormonal changes, including pregnancy/breastfeeding or chafing, are 2 of the possible causes.
A good review of the history and physical examination of my patient will help to elucidate the cause of the swelling and itch. How long has the itching and swelling been? Has it coincided with any particular event in your life? Examples include
- Physical events like new clothing that feels rougher? Too tight bras? If the answer is yes, then the chances of chafing will be higher
- The start of a new exercise regime or workout resulting in more friction around the nipple area?
- If it is hormonal, or due to pregnancy, are the symptoms of swelling and itchiness “seasonal”? Does it only come on just before the menstrual cycle? If my patient is pregnant, how far along the pregnancy is she? The itch and swelling due to pregnancy are due to engorgement of the breasts to prepare for breastfeeding, as such, it tends to happen later during the pregnancy.
I will next proceed to a physical examination. Chafing of the nipples is due to friction and sometimes abrasions may be seen around the nipple area. If the cause is hormonal, I may expect to find that my patient’s breasts are swollen or engorged concurrently.
The above are just methods I use in my clinic to help diagnose the cause of the itch and swelling. As mentioned, there are other causes of nipple swelling and itchiness, including sinister causes. As such, if the issue has been ongoing or persistent, I would recommend a review by your family physician for a more complete examination.
