Pain of the nipple N64.4

Unusual, miest chronic pain syndrome affecting only the nipple region. Painful nipples can have many causes.

Basically, one must distinguish between:

• hormonal

and

• non-hormonal nipple pain.

Hormonal (hormonal changes during menopause can also cause nipple pain) and pregnancy-related nipple pain, or nipple pain during breastfeeding, belongs in the hands of a gynecologist.

Non-hormonal nipple pain also affects men. Here one distinguishes the nipple pain

• with and
• without visible or palpable changes in the nipple region.

It is not uncommon for the nipple region to be sensitive to touch but clinically unchanged. This constellation is most frequently due to rough or abrasive textiles. The atopically predisposed patient may also be affected in this way.

In case of visible changes of the nipples, e.g. redness, permanent scaling or permanent oozing, the findings must be clarified in time. Eczematous changes are most frequent (see nipple eczema). In particular, atopic nipple eczema may remain isolated to this region. DD. Paget's disease of the nipple must be excluded. Eczematous changes of the nipple can also be an expression of a scabies mite infection.

Nipple adenoma or leiomyoma may also cause nipple pain.

1. Eigelshoven S et al (2006) Thelalgia in man: successful treatment with botulinum toxin. Arch Dermatol 142:1242-1243