ECZEMA ON THE AREOLA: SYMPTOMS, CAUSES, AND TREATMENT OPTIONS
Eczema on the areola manifests as an itchy, scaly, irritated rash on the nipple and areola. The areola is the dark area of skin around the nipples. If it feels itchy and we scratch it too hard, it causes damage and thickening of the nipples and areola. This is known as lichenification.

Eczema on the areola is most commonly seen as part of atopic eczema. It is usually caused by irritation from certain clothing items, soaps, detergents, or lotions. Healing often occurs when you identify and eliminate the cause. Choosing hypoallergenic soaps and detergents without perfumes and dyes often help. The family doctor may also prescribe an ointment.
What Is Eczema On The Areola?
Eczema is a condition that causes an itchy rash on your skin. This rash can appear anywhere on your body. For example, eczema can develop on your nipples and your areola. This condition affects babies, children, and adults of both genders.
Eczema on the areola is not dangerous. But a secondary infection can occur, especially if you scratch the rash. Scratching can break down your skin and allow bacteria to get in. It can also cause your skin to become thicker and more complicated over time. This is known as lichenification.
Areola eczema often occurs in people who already suffer from or have suffered from eczema elsewhere in the body. Areola eczema is usually diagnosed in teenage girls with or without a history of atopic eczema. However, it can also affect men and women in infants, children, and adults. In addition, eczema on the areola can sometimes occur in non-atopic women breastfeeding.
Nipple Eczema Or Cancer?
If you have redness or pain around the nipple that looks like eczema and doesn’t go away with treatment, it’s wise to consult your doctor to rule out Paget’s disease. Paget’s disease, also known as Morbus Paget, is a rare form of breast cancer. It usually presents redness, pain, and scaling affecting the nipple and can easily be mistaken for eczema or infection. The disease affects one breast and begins on the nipple or areola.

Be that as it may, Paget’s disease of the nipple is always accompanied by cells with ductal in situ carcinoma, which are either confined to the small ductules immediately behind the nipple or occur more extensively in the retro areolar region. If the ductal cells invade the basal epithelial membrane, an invasive ductal carcinoma develops and thus, in principle, a palpable and (or) radiologically detectable abnormality sooner or later.
Causes Of Eczema On The Areola
Eczema on the areola is caused by:
- Genetic influences.
There is often a hereditary predisposition. This predisposition is usually evidenced by eczema or other atopic conditions, such as asthma, hay fever, and other allergies in your family.
- Environmental factors
Detergents, certain fabrics, soaps, lotions, and perfumes can irritate the skin around your nipple and lead to eczema flare-ups. In addition, sweat can get trapped under your breasts in your bra or shirt, which is irritating.
- Overactive immune system.
The red, flaky rash can occur when your immune system reacts to a substance that is not harmful. For example, you may have an allergic reaction to food or another substance, which can trigger an eczema outbreak.
- Stress
Stress makes you extra susceptible to eczema on the areola and worsens already existing eczema. In addition, mental and physical stress can cause eczema to flare up in a short period.
Symptoms Of Eczema On The Areola
Both the nipple itself and the areola may be red, scaly, wetting, crusty, or cracked. This may be accompanied by itching, pain, or sensitivity. Eczema on the areola is usually present on both breasts.
Eczema increases the risk of secondary infection, often bacterial. For example, about 60-90% of people with eczema have Staphylococcus bacteria on their skin, which can lead to a secondary infection. People with eczema are also at increased risk for sleep problems, anxiety, and depression.
Examination and Diagnosis
A doctor can diagnose eczema by examining your skin and inquiring about your symptoms. The doctor will also consider your medical history. You may already be familiar with eczema. Often, further examination is not necessary.

Treatment of Eczema On The Areola
Medical treatment
Treatment can help manage symptoms and prevent flare-ups. It is essential anyway to protect your nipples from abrasive clothing. Try not to scratch and cover your nipples in case of habitual scratching behavior. Avoid any triggers and switch to neutral detergents, for example. These are detergents that are perfume-free and hypoallergenic.
Prescribe the doctor one of the following ointments:
- R/ Triamcinolone 0.1% ointment. This is an adrenal cortex hormone (corticosteroid): that remedies inflammation and hypersensitivity reactions.
- R/ Betnelan (betamethasone-17-valerate 0.1%) ointment. This drug is an adrenal cortex hormone (corticosteroid). It inhibits inflammation and reduces scaling, itching, and swelling.
- Severe itching may require a more potent corticosteroid to break the cycle of scratching – itching – scratching.
Self-care measures
The following measures may help:
- Wash only with water and avoid soap on the breasts.
- Use a neutral detergent for laundry.
- Paracetamol may help with the pain.
- Protect the area from rubbing from clothing.
- Keep the nipple and nipple courts greasy with Calendula ointment, St. John’s oil, or an easily spread white petroleum jelly (petroleum jelly album).
Breastfeeding mothers can take the following measures:
- Clean the area after feeding with a soft cloth dampened with warm water, then rub with HCA 1% cream. Hydrocortisone inhibits inflammation and reduces scaling, itching, and swelling.
- After this cream is absorbed, keep it greasy with Calendula ointment, St. John’s oil, or an easily spreadable white vaseline (vaseline album) if necessary.
Complications of Eczema on The Areola
Secondary bacterial infection may occur due to fissures or fissures and affected skin in areola eczema. Colonization with Staphylococcus aureus can be further complicated with mastitis (breast infection) or breast abscess if not treated promptly.
Other complications include the possible side effects associated with therapeutic agents used for eczema on the areola, such as atrophy due to overuse of potent corticosteroids or folliculitis (inflammation of hair follicles) from an occlusive emollient.
Prevention

How to prevent eczema on the areola? Here are some suggestions that can help you avoid areola eczema:
- Observe the following measures to prevent nipple and areola eczema:
- Avoid soap and shampoo on the areola area.
- Rinse the breasts well, especially after swimming in chlorinated water.
- Avoid hot and long showers.
- Do not use moisturizers other than special cream for the breasts and nipples.
- Avoid perfumes and flavored body products on the breasts.
- Avoid padded bras if possible, as the foam padding traps particles of washing powders that irritate the skin.
- Hand wash bras (think sports bras!) with natural, hypoallergenic soap, and avoid excess soap in the cup area of the bra. Rinse bras thoroughly and dry them indoors (away from pollen, etc.). Do not tumble dry.
Prognosis
Atopic eczema cannot be cured in 2022. Therefore, treatment is aimed at reducing the symptoms of eczema. Identifying and avoiding triggers can help reduce the risk of flare-ups. Some people suffer from eczema for life. Some periods are more than others. But we can get rid of scars from eczema: How To Get Rid Of Scars From Eczema.
Eczema on the areola often has a chronic course with varying degrees of relapse and remission. The goal is to prevent exacerbations by identifying and avoiding precipitating factors. Observing primary skin care is essential. Mild nipple eczema can generally be well controlled by avoiding soap, a maintenance cream, and intermittent hormone ointment when the eczema is active.