Dry white flakes or patches of skin on the nipples are often a result of hormonal changes which can trigger eczema, yeast infections, and colostrum to leak and dry in crusty white patches.
The growing breast tissue can also cause nipple skin to stretch and peel, resulting in white flakes.
Less commonly, infections such as thrush or mastitis can also cause dry white patches on your nipples.
The American Pregnancy Association reminds women that:
“Hormones in your body are preparing your breasts for lactation. The milk ducts are growing and being stretched as they fill with milk early in pregnancy.
All this causes your breasts to be more sensitive, particularly your nipples. This may cause you discomfort.”
Dry, white stuff on nipples during pregnancy is typically normal, but you should consult your healthcare provider if you are experiencing a high fever, red or inflamed breasts, or other worrisome symptoms.
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Crusty Nipples in Pregnancy – 9 Causes
There are a few reasons why you might find white flaky patches of skin on your nipples during pregnancy from a bout of eczema to natural leakage.
Let’s take a look at the most common causes of this condition.
1. Fluid Leakage
In the third trimester of your pregnancy (or midway into the second trimester for some women), a form of early breast milk known as antenatal colostrum can begin leaking from your nipples.
Nursing pads (these are favorites) can help absorb much of this colostrum before it dries and irritates your nipple skin.
If you notice dry and scaly patches on your nipple skin accompanied by cracking and itchiness, it’s likely that you have pregnancy-related eczema.
This is caused by powerful new hormones in the body and typically appears in the first or second trimester.
This can occur even if you have never had eczema before, though women who have had atopic dermatitis in the past are more likely to see this condition in pregnancy.
It’s wise to speak to your doctor about this condition before taking over-the-counter medication.
3. Nipple Thrush
Because pregnancy suppresses the immune system, it’s common for women to develop a yeast infection known as nipple thrush somewhere around the third trimester.
This is caused by the fungus Candida albicans and usually occurs when the nipple skin has cracked or been cut, causing the yeast to thrive in the dark and moist environment.
In addition to dried, flaky skin, nipple thrush often comes with a burning or shooting sensation in your nipple.
Always consult your doctor about appropriate nipple thrush treatment.
4. Extreme Dryness
As early as the first trimester, it’s common for your breasts and nipples to become very dry as the skin begins to grow and stretch.
How you care for your breasts during this time could even be exacerbating this dryness.
It’s wise to clean your breasts with gentle, fragrance-free soap in the shower, though plain warm water is even better.
Gently pat your breasts dry instead of rubbing to prevent further irritation, and keep your nipples well moisturized.
5. Enlarged Montgomery Glands
As your breasts grow, the sebaceous oil glands known as Montgomery glands (the little bumps around your nipples) also become enlarged, which can cause your nipple skin to stretch to the point of peeling.
Applying lanolin cream can help keep the area moisturized.
Again, avoiding soaping your breasts can help combat the peeling and dryness caused by stretching Montgomery glands as many soaps strip the glands of the natural oils that help to protect your nipple skin.
6. Blocked Pores and Ducts
Blocked pores and ducts may occur due to the increased oil production in the Montgomery glands.
When these pores become clogged, it can lead to the accumulation of dead skin cells and oil, creating a plug.
This plug can result in the formation of crusty or flaky nipples.
7. Herpes Infection of the Breast
Herpes infections are caused by the herpes simplex virus (HSV).
While herpes infections are more commonly associated with the oral and genital regions, it’s theoretically possible for the virus to affect the breast tissue, leading to symptoms like redness, swelling, and painful sores or blisters that can burst and form crusty scabs.
However, this is rare. If you suspect a herpes infection, especially during pregnancy, it is crucial to consult with a healthcare professional.
8. Subareolar Abscesses
Subareolar abscesses are localized collections of pus that can develop beneath the areola (the dark area around the nipple).
They often result from blocked milk ducts or infection of the Montgomery glands.
While these abscesses are more commonly associated with breastfeeding, they can occur during pregnancy as well.
The symptoms of subareolar abscesses may include localized pain, swelling, redness, and the presence of a lump or mass beneath the areola.
Treatment may involve antibiotics and, in some cases, drainage of the abscess.
Papillomas are noncancerous growths that can develop in the milk ducts.
While they are often painless, they can cause changes in the breast tissue, and in some cases, they may lead to discharge or skin changes.
When To Be Concerned
While some degree of dryness on the nipples is normal during pregnancy, any significant changes or discomfort should be discussed with your healthcare provider.
Get evaluated right away if you note any of the following:
- Persistent itching, pain, or discomfort
- Changes in color or consistency
- Redness or inflammation
- Bleeding or cracking
- Unexplained changes in breast tissue
Additional Nipple Changes & Conditions During Pregnancy
Your nipples can go through other changes besides flaky skin during pregnancy.
It’s perfectly normal to see things like a change in pigment or experience very tender and sore nipples.
Here are some common and not-so-common nipple changes and conditions during this time.
Itching and Dryness
In the same way period hormones made your nipples feel dry and sensitive, pregnancy hormones significantly crank up this feeling of dry itchiness, which can be made worse by tight bras, perfumed detergents, or overly hot showers.
It’s common for the skin on and around your nipples to feel super tender and swollen due to the increase in blood flow and expanding breast and nipple tissue.
Expect to see the color of your nipples darkening midway through your pregnancy.
Ob/Gyn and women’s health author Dr. Sheryl A. Ross explains that “An increase in estrogen and progesterone causes pigmentation changes in the nipples and areolae.”
They can remain dark even after pregnancy.
Around the third trimester, the nipples will change size and shape, growing larger and more pronounced than before.
This happens due to the surge in estrogen levels, which also causes your breast ducts and tissue to expand.
While seen most commonly in breastfeeding mothers, mastitis can, in rare cases, occur during pregnancy.
This type of infection known as puerperal mastitis is caused by the Staphylococcus aureus bacteria and can present in breast inflammation and pus leaking from the nipple.
Doctors will typically prescribe antibiotics and drainage treatment for this.
Nipple Care During Pregnancy
Taking care of your nipples during pregnancy involves maintaining good hygiene, preventing dryness, and addressing any discomfort or changes in the skin.
Here are recommended nipple care guidelines for pregnant women:
- Gentle Cleansing: Cleanse your nipples and the surrounding area with mild, fragrance-free soap and warm water during your regular shower routine. Avoid using harsh or heavily scented products as they can irritate the skin.
- Hydration: Keep the skin around your nipples well-hydrated by applying a hypoallergenic, fragrance-free moisturizer. This can help prevent dryness and minimize the risk of flakiness or cracking.
- Comfortable Clothing: Wear loose-fitting, breathable clothing to minimize friction and irritation. Choose bras made from soft, breathable materials to provide proper support without causing discomfort.
- Avoid Harsh Products: Avoid using harsh cleansers, strong detergents, or other products with potential irritants. Opt for products specifically designed for sensitive skin.
- Nipple Shield Use: If you experience discomfort or sensitivity, consider using nipple shields made of soft silicone. These can provide a protective barrier between your nipples and clothing.
- Monitor Changes: Keep an eye on any changes in your nipple and breast tissue. If you notice unusual symptoms, such as redness, swelling, pain, or discharge, consult with your healthcare provider for evaluation.
- Breast Support: Invest in a well-fitting, supportive bra. As your breasts undergo changes during pregnancy, proper support can help prevent discomfort and reduce strain on the nipple area.
- Healthy Lifestyle: Maintain a healthy lifestyle by staying hydrated, eating a balanced diet, and getting regular exercise. These factors contribute to overall skin health.
- Consult With a Healthcare Provider: If you have concerns about your nipples or experience persistent symptoms, consult with your healthcare provider.
- Breastfeeding Education: If you plan to breastfeed, consider taking breastfeeding classes to learn proper techniques and positions. This knowledge can be valuable for postpartum nipple care.
Is It Normal for Nipples To Crack During Pregnancy?
Yes. Cracked nipples or nipple fissures in pregnancy happen when the breasts become engorged with milk.
This excess fluid causes your nipple tissue to stretch, which can result in cracked skin on or around the nipples.
Applying fresh breast milk or a warm compress can help to soothe the area.
Should I Moisturize My Nipples During Pregnancy?
Moisturizing your nipples is encouraged during pregnancy to help keep the skin supple for breastfeeding. It can also help soothe dry, itchy, or irritated nipples.
Nipple creams containing pure lanolin (fat from sheep wool) are recommended in addition to all-natural moisturizers such as coconut oil.
Rebecca is a seasoned copywriter and researcher with over a decade of experience, specializing in parenting topics. With a passion for all aspects of raising children, from breastfeeding to potty training.