Nipple and Areolar Eczema in the Breastfeeding Woman

Abstract

Eczema of the nipple and areola can occasionally develop in the breastfeeding patient and is associated with sore, burning, and painful areolae and nipples. Management includes elimination of any precipitating allergens and irritant and the judicious use of appropriate topical corticosteroid preparations. Patients must also be offered effective pain control and support. The proper diagnosis and management of eczema of the nipple and areola in breastfeeding patients will prevent premature and iatrogenic weaning.

Caring for new mothers: diagnosis, management and treatment of nipple dermatitis in breastfeeding mothers

“…Three main categories include endogenous atopic dermatitis, irritant contact dermatitis, and allergic contact dermatitis. Patients with endogenous atopic dermatitis consist of those women with a pre‐existing tendency to develop eczema 9 . Irritant contact dermatitis occurs as a result of an irritating agent on the skin.…”

“…Dermatologists are perfectly suited to manage nipple pain, in particular nipple pain related to nipple dermatitis, as they have much expertise in diagnosing and treating inflammatory dermatoses. Furthermore, patients with a history of atopic dermatitis and other underlying dermatological conditions, who are generally followed by a dermatologist, are more prone to experience nipple dermatitis during breastfeeding and develop secondary infections with such organisms as Candida albicans and Staphylococcus aureus 9 . The objective of this review article is to educate dermatologists on appropriate diagnosis, management, and treatment of nipple dermatitis among nursing mothers.…”

Diagnosis and Management of Candida of the Nipple and Breast

“…Many women with eczema of the areola have had a prior history of eczema. Subsequent development of contact dermatitis from exposure to the infant's mouth has also been reported in breastfeeding mothers who have introduced solid foods in their baby's diet 2 . Raynaud's syndrome of the nipples causes vasospasm of the nipple, 4 leading to severe, throbbing, burning pain.…”

Eczema in pregnancy

“…34 About 50% of these will have atopic eczema; other causes include food contact sensitivity or irritation as the baby is weaned on to solids. Moderate to low potency topical steroids and emollients are used to treat eczema in this area, although these should be applied after breast feeding and washed off thoroughly before the next feed.…”