Overview 

Nipple fissures are tiny cracks or cuts in the skin of the nipple. They almost always develop from constant friction, which can be quite painful. This can lead to discomfort and even difficulty with breastfeeding. Nipples can be stressed by other things, such as tight clothing, some sports, and even the act of breastfeeding itself.^1,2

What causes nipple fissures?

There are several ways that nipple fissures can occur: 

• Mechanical Trauma: Skin can be irritated from friction if the baby is not latching well during breastfeeding or if there is chafing during exercise
• Infection: Bacteria or fungi may exacerbate or create new fissures
• Inflammation: An injury or infection may cause swelling and sensitivity
• Hormonal Changes: Hormones during pregnancy and after birth may also predispose the skin to cracks
• Breastfeeding Issues: Latch is not good or the baby is sucking too strongly and creating small tears
• Fabric Irritation: Tight or rough fabrics can rub against the nipples, causing irritation, especially for those participating in a lot of physical activity
• Additional considerations: Dryness, as well as eczema or psoriasis, can contribute^3,1

Symptoms

• Redness and irritation 
• Flaking of the skin 
• Cracks painful 
• Severe cases may present with bleeding⁴

Friction from clothing

• Clothing-related friction is a significant cause of nipple fissures. The act of rubbing fabrics can cause small micro injuries that add a cumulative effect. The usual severity will depend on:
  • Type of fabric: Rougher materials, such as wool, are irritating to a greater extent than softer materials, such as cotton. 
  • Fit of clothing; tighter clothes create more friction, whereas looser clothing is helpful
  • Activity level: High movement activities, such as running, raise friction
  • Breast size: Being larger-breasted can result in more friction⁵

Prevention tips

Correct Latching Technique – Ensure the latch is appropriate in order to prevent trauma. Lactation consultants are available to assist.

• Clothing: Dress in loose, soft, breathable clothing
• Nipple Care: Clean and apply a lanolin cream to the nipples
• Avoid irritating soaps or perfumes
• Choose Protective Fabrics: Select soft, moisture-wicking fabrics
• Barrier Protection: Use of petroleum jelly or anti-chafing products may help
• Find the Right Fit: A properly fitting bra and clothing minimise movement and/or rubbing
• Modification Techniques: The Latch position should be modified, and shields should be utilised to protect the skin
• Moisturise Often: Regular moisturising aids in keeping the skin healthy⁴

Treatment options

• Topical Treatments: Aloe vera or medicated creams are good for swelling and healing
• Hydration and Nutrition: Staying well hydrated and eating well will help your skin recover
• Prevention: Stay away from the irritants for a period of time and allow it to heal
• Rest: Stop picking at the scabs
• Pain Relief: If there is pain, an over-the-counter medication may assist
• Get Medical Attention: If the fissures are serious or don’t heal, consult a doctor⁶

FAQs

How do athletes avoid nipple chafing and fissures?

• Wear moisture-wicking fabric to reduce friction.
• Apply anti-chafing balms or petroleum jelly prior to exercising.
• Choose well-fitting sports clothes to reduce the amount of movement.

When is it important to see a doctor for nipple fissures?

• If the fissures become infected, do not heal, or are painful, it may be worth seeking medical advice.

Can I continue breastfeeding with nipple fissures? 

• Yes, many moms are able to breastfeed even if they have nipple fissures.

Summary

Friction nipple fissures can be easily treated. Understanding the triggers can help maintain healthy, pain-free skin. Preventive and treatment measures require proper clothing choices, hygiene, and early attention to problems.