Although psoriasis can occur anywhere on the body, it rarely develops on the nipples. However, other skin diseases on the nipples can resemble psoriasis. It’s important to know whether your symptoms are psoriasis or another medical condition.

Psoriasis on the nipples can take a toll on your quality of life. Having symptoms of psoriasis or another skin condition in a delicate area, such as your nipples or genitalia, can be distressing as well as uncomfortable. An accurate diagnosis and appropriate treatment are essential for your overall comfort and mental health.

This article discusses how to identify symptoms of psoriasis on the nipples and treatments that may provide relief.

Plaque Psoriasis on the Nipples

Psoriasis on the nipple and the areola — the darker skin that surrounds the nipple — isn’t classified as a particular form of psoriasis. Very little medical research specifically addresses psoriasis of the nipples. Some clinical documentation (healthcare providers’ notes in medical records) suggests that psoriasis on the nipples is likely a form of localized plaque psoriasis, the most common type of psoriasis.

“OMG I’m miserable 😭. My skin burns, and it hurts to bathe. I even broke out on my nipples. I’m covered,” wrote a MyPsoriasisTeam member.

“Plaque psoriasis on elbows, buttocks, groin and private area, knees, legs, inside nose, nipple, and about 75 percent of my scalp,” one member shared.

Another member described a similar experience: “I’m somewhat frustrated with all this psoriasis. It’s all over: head, arms, fingers, legs, and nipples.”

Psoriasis is an immune-mediated condition that causes skin cells to multiply too quickly. This fast growth leads to thickened skin plaques. Because the immune system doesn’t work properly, these plaques become inflamed. Symptoms of plaque psoriasis on the nipple may include dry and discolored patches of skin, with white scales that can be itchy or painful.

Genital psoriasis — and psoriasis that occurs under the breasts, in the armpits, and in other moist skin folds — is usually a type of inverse psoriasis (also called flexural psoriasis). Inverse psoriasis is characterized by smooth purple, brown, or red skin (depending on your natural skin tone), rather than skin with white or silvery scales.

If you have a rash on your nipples that appears to be psoriasis, talk with your doctor or dermatology provider.

Psoriasis on the Nipples and Breastfeeding

People with psoriasis are prone to the Koebner phenomenon. In this condition, new lesions appear on previously clear areas if the skin is even lightly scratched, injured, or irritated. The soreness and stress that can come with breastfeeding a baby may cause the Koebner phenomenon, with psoriasis lesions forming on the nipples and areola.

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One MyPsoriasisTeam member shared their experience with nipple psoriasis from breastfeeding: “My worst problem was with breastfeeding, as my cracked nipples developed psoriasis, which lasted for years and years.”

Psoriasis isn’t contagious, so you can’t spread it to your baby by breastfeeding. However, a psoriasis flare-up on the nipple could make breastfeeding uncomfortable or painful. This area can also get infected when the skin barrier is disrupted.

Other Skin Diseases That Affect the Nipples

Studies show that psoriasis on the nipples is rare. If you have a rash that resembles psoriasis, your dermatologist will try to rule out other possible skin conditions. Psoriasis on the nipple is diagnosed by examining the affected areas, reviewing your family history, and checking your symptoms.

Your doctor may want to perform a skin biopsy. This involves taking a small tissue sample so the skin cells can be examined under a microscope.

Other skin conditions that may look like psoriasis include nipple eczema, nipple candidiasis, and Paget’s disease of the breast.

Eczema on the Nipples

Eczema is a common skin condition that causes different types of rashes. Eczema on the nipples can be discolored, scaly, and itchy, and it may affect both the nipple and areola. Infants and children are particularly prone to eczema on the nipple, but it can also occur in adults.

Eczema symptoms are typically managed with topical treatments, which are applied directly to the skin. More severe cases of eczema may be treated with systemic medications — drugs that work throughout the body to reduce inflammation and calm the immune system.

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Paget’s Disease of the Breast

Paget’s disease of the breast is a type of breast cancer. This rare disease, which starts in the nipple and usually spreads to the areola, typically develops after age 50.

Paget’s disease of the breast causes itchiness, discoloration, and scaling skin, usually on just one breast. Other distinctive symptoms include a flattened nipple, yellowish or bloody discharge from the nipple, and a lump in the breast.

Treatment typically includes surgery to remove the cancer, followed by chemotherapy, radiation, or hormone therapy.

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Treatments for Psoriasis on Nipples

Psoriasis can be managed with topical and other types of treatments to help control symptoms, including on the nipples. If you’re experiencing psoriasis on the nipples, talk with your dermatologist about topical treatments appropriate for sensitive, thin skin.

If your psoriasis is severe, your doctor may recommend systemic medications that are taken orally (by mouth) or given by injection. If you’re planning a pregnancy, it’s important to tell your doctor. Discuss your treatment options together to ensure that they’re safe during pregnancy, particularly in the first trimester.

Treating Nipple Psoriasis if You’re Breastfeeding

If you’re treating psoriasis on the nipple while breastfeeding, be sure to talk with your doctor about topical treatments that are safe for your infant. Corticosteroid creams or ointments applied to the nipple area could be absorbed by your baby. Some newer creams don’t contain steroids, but their safety regarding breastfeeding is unknown. Review any topical treatments in detail with your healthcare team before using them when breastfeeding.

Due to limited research on the drugs’ impact on infants, the National Psoriasis Foundation recommends avoiding systemic psoriasis medications while breastfeeding.

Testing Topical Products

It’s a good idea to test topical prescription and over-the-counter moisturizers, creams, and lotions before using them on the entire area affected by psoriasis. Testing a topical product first will reduce the negative impact if you have a reaction or an unpleasant side effect.

The American Academy of Dermatology recommends applying a new product to the same small spot of skin twice a day for seven to 10 days. If your skin doesn’t become discolored, itchy, or swollen, the product is likely safe to use.

Find Your Team

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Have you experienced psoriasis on your nipples? What has helped you manage your symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.