What Causes a Rash on the Breast?

A breast rash can be worrying, especially if there is no clear cause. However, in most cases, a breast rash is not a cause for concern and can be treated at home. 

Rashes can vary in location, shape, and size, and can be accompanied by other symptoms such as itchiness, pain, or discharge.

A healthcare professional should be consulted if the rash does not improve within a few days or if it worsens. 

This article will look at the possible causes of a breast rash and how it can be treated.

Common Causes of a Breast Rash

Rashes on the breast or chest are usually temporary and often self-resolving.

But in some instances, a breast rash may be caused by a more serious condition that requires medical attention.

Skin rash

The skin on the breast is prone to many common and relatively harmless rashes. 

Some common rashes include:

• Psoriasis: Scaly, itchy patches of skin that show up when your immune system goes haywire and attacks your body.

• Scabies: Bites from the mite Sarcoptes scabiei. The bites appear as a line of little bumps on your skin and become itchier at night.

• Shingles: Painful, itchy blisters that are from the same virus that causes chickenpox.

• Yeast: This fungus normally lives on your skin. When there is an overgrowth, it can lead to an itchy rash. This frequently occurs in the folds of your skin. 

• Intertrigo: Intertrigo is when your skin rubs together too much. It can trap moisture and create friction. Besides a red or brown rash, your skin may swell and itch. It may have a funny smell. This can happen in the area under your breast.

• Nipple eczema: Nipple eczema can lead to a rash around one or both of your nipples. The skin around them may get dry and scaly, or you could have a rash that feels moist to the touch. You may notice a burning feeling if you’re nursing.

Some common symptoms of skin rash include:

• Changes in skin color
• Inflammation and swelling
• Itching
• Cracked or broken skin
• Discharge, which may have an odor
• Sores or blisters

Inflammatory breast cancer

Inflammatory breast cancer (IBC) is a rare form of breast cancer that can develop quickly and tends to be aggressive.

It accounts for 1–5% of all breast cancers in the United States.

In people with IBC, the cancer cells block lymph vessels, causing inflammation of the skin. 

IBC symptoms can resemble a rash or skin irritation and can also include:

• Breast swelling
• Thickening of the skin on the breast
• Small ridges or indents that look like orange peel
• Changes in skin color
• Pain, tenderness, or itching
• Feeling of warmth or heaviness in one breast

If you have any concerns that you may have inflammatory breast cancer, contact your healthcare professional for an evaluation right away.

Mastitis 

Mastitis is an inflammation of breast tissue.

There are several different types:

• Lactational mastitis occurs during breastfeeding and is the most common type of mastitis.

• Periductal mastitis is a benign inflammatory condition that is usually seen in women during their reproductive years.

• Idiopathic granulomatous mastitis is a rare condition most likely to occur within five years of giving birth.

Some common symptoms of mastitis include:

• Pain and swelling in the affected breast
• Changes in skin color
• Fever and chills

Breast abscess  

A breast abscess is caused by a bacterial infection.

Abscesses can develop any time the skin around the nipples becomes cracked or broken.

A majority of cases result from breastfeeding, but an abscess can also indicate diabetes or IBC. 

Symptoms include:

• Breast pain
• Skin changes
• Swelling
• Discharge
• Warmth in the breast

Mammary duct ectasia

In people with mammary duct ectasia, the milk ducts lose elasticity and become wider or twisted.

It usually occurs around menopause but can appear at other times. 

The symptoms include:

• Pain and tenderness
• Discharge, which may be white, green-black, or grey
• An inverted nipple
• Breast lump

Paget’s disease of the breast

Paget’s disease of the breast is a type of cancer that affects the skin on the nipple and usually the skin around the nipple, known as the areola.

Paget’s disease is rare and occurs in 1–4%  of all breast cancer cases.

Symptoms of Paget’s disease include:

• Itching or tingling of the nipple or areola
• Skin changes on or around the nipple, such as inflammation, crusting, flaking, or thickening
• Flattening of the nipple
• Yellow or bloody discharge from the nipple

Symptoms

Common symptoms of breast rash include:

• Blisters
• Redness of skin
• Sores
• Swelling and itching
• Formation of pus

A breast rash formed due to an infection may show symptoms such as fever, chills, and pain.

However, rashes from infections tend to get better as your body fights off infection. 

In some cases, rashes do not get better with time and cause concerning symptoms like:

• Persistent itching
• Rash that does not go away
• Swelling and enlargement of breasts
• Tenderness
• Pitted orange peel on the skin
• Bruised red or purple skin that does not get better

Treatment

Skin Rashes

Treatments for many common rashes include avoiding irritants on the skin.

This can include soaps or cosmetics that produce an allergic reaction, particular types of clothing material, or friction from a bra or clothing. 

A medication or topical ointment may be prescribed. In most cases, the rash will resolve with appropriate treatment.

Dermatitis or eczema of the nipple may occur during breastfeeding, as the nipples become irritated by the baby’s mouth, tight clothing, or trapped moisture.

Consulting with a doctor, healthcare professional, or lactation specialist is recommended if you are having breast symptoms and are breastfeeding. 

Inflammatory breast cancer (IBC)

IBC may be asymptomatic until skin changes become noticeable.

Once this happens, prompt treatment is needed as cancer may be advanced.

Experts consider IBC at least a stage 3 cancer at diagnosis. 

Common forms of treatment include:

• Chemotherapy 
• Surgery to remove the cancer
• Radiation therapy
• Hormone therapy

Mastitis 

Anyone with symptoms of mastitis should seek treatment to prevent it.

In some cases, a doctor or healthcare professional may also wish to rule out cancer and other more serious conditions with similar symptoms.

Breast abscess  

Treatment is necessary and usually includes draining the abscess.

A doctor may also carry out tests to rule out breast cancer and diabetes, depending on the full clinical picture.

Mammary duct ectasia

Often no treatment is necessary in the case of mammary duct ectasia, but a doctor or healthcare professional may prescribe antibiotics if an infection is present.

They may also carry out tests to rule out other conditions, such as breast cancer.

Paget’s disease of the breast

Treatment for Paget’s disease depends upon the location of tumors in the breast. 

Possible treatments include:

• Surgery to remove the breast and possibly lymph nodes
• Surgery to remove the nipple and areola only
• Chemotherapy or hormonal treatments
• Radiation to treat any other tumors

Apart from all the above, keeping the skin clean, cool, and dry can help treat many causes of rashes on or between the breasts. 

This can be done by taking the following actions:

• Cleanse the affected area with soap and warm water.
• Apply an unscented moisturizer, antibiotic ointment, or antifungal cream as recommended by your doctor or healthcare professional.
• Avoid scratching the skin.
• Avoid using scented soaps, lotions, or perfumes around the breasts.
• Wear soft, comfortable clothing made from breathable fabrics, such as cotton.
• Consider placing a special soft cloth with antimicrobial materials, like InterDry, between the breasts to reduce itching and rubbing.
• Change sweaty clothes as soon as possible after exercising or being outside in the heat.

When To Seek Medical Attention

Many rashes usually heal on their own or with over-the-counter topical creams.

However, it is important to have a doctor or healthcare professional evaluate your rash to ensure you receive the care you need.

Certain symptoms of a breast rash can be signs of an infection or a more serious disease. 

Red flags that indicate you should see a doctor immediately include:

• The nipple suddenly becomes inverted
• One or both breasts change in size or texture
• The skin on the breast takes on a pitted appearance (like the skin of an orange)
• Pus starts coming from the rash
• Bloody nipple drainage occurs
• You have a fever

If a rash on your chest or breast area is accompanied by trouble breathing, nausea, or other signs of an allergic reaction, seek medical attention immediately.

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