Overview

If you are experiencing nipple fissures and wondering why that is happening, or have some hint that it could be linked to a lack of vitamins, also called vitamin deficiencies, you have come to the right place. We can help you understand how vitamins A, C, and E play a big role in skin health and the repair of tissues, and their connection to nipple fissures. 

To answer your question, yes, vitamin deficiencies can contribute to nipple fissures. All three have a role in supporting your skin:

• Vitamin A¹ helps with skin growth
• Vitamin C ² is important for collagen production, a protein found in skin that helps with the healing of wounds
• Vitamin E³ has a role in keeping your skin soft and hydrated

Buckle up and get informed about the role of deficiencies of these vitamins in nipple fissures, and also learn what you can to support healing. Stick around as we break it all down step-by-step!

What are nipple fissures?

Nipple fissures are painful cracks or sores on the nipple. They are common among women who are breastfeeding, so research shows that 80-90% of women experience nipple pain and fissures.⁴ 

However, other than breastfeeding, there are other causes such as:

• Dry skin
• Friction
• Dermatological conditions

The most common cause for fissures to appear in breastfeeding woman is incorrectly breastfeeding, improper nipple sucking, washing nipples with soap and in some cases infections caused by bacteria Staphylococcus aureus and Candidaalbicans.⁴

While treating the symptoms of nipple fissures is effective, understanding the root cause is also important. There is a link between nutritional status and skin health, specifically an individual’s intake of key vitamins such as A, C, and E.

The role of vitamin A

The scientific name of vitamin A is retinol, so you may have heard it mentioned this way as well. It is a fat-soluble vitamin, meaning it can be dissolved in fats, and it is found in the fatty parts of foods like butter and fish oil.

Vegetables don’t contain retinol, but some veggies contain carotenoids, which are pigments that can be converted into retinol in the small intestine. 

Vitamin A is found in:

• Animal tissues (mostly liver)
• Fish-liver oils 
• Milk and milk products
• Butter
• Cheese
• Eggs
• Sardines, canned
• Helps skin repair and regenerate.

Vegetables containing carotene (which will eventually be converted into vitamin A):

Carrots, spinach, lettuce, tomatoes, bananas

Roles:

• Antioxidant - our body is full of free radicals, made as byproducts of many reactions constantly happening in our body. These free radicals are not good because they damage cells and need to be removed. That is where antioxidants come in, and vitamin A is one of them
• Helps with the keratinisation (the natural process where your skin makes new cells at the bottom layer, and as they move up, they slowly harden and die, forming a protective outer layer.)
• It makes sure your skin cells grow the right way (so that skin doesn’t get rough or dry)¹
• It can even help reduce oily skin
• Essential for the growth of healthy hair⁵

Vitamin A deficiency

Lack of vitamin A causes changes in epithelial tissues, making skin rough and dry, so there is a higher chance of cracks and infections. Research performed on rats ⁶ found that vitamin A deficiency is associated with delayed wound healing, so nipple fissures and other injuries could 

last longer. A long-term deficiency may lead to blindness because a derivative of retinol is needed for the proper functioning of the retina at the back of the eye. Another condition is xerophthalmia, where dead cells accumulate on the surface of the eye, making it dry. Again, the final consequence is blindness.

The role of vitamin C

Ascorbic acid, or vitamin C as more commonly known is a water-soluble vitamin which occurs mainly in foods of plant origin. The amount of vitamin C is highest in the periods of active growth during spring and early summer. 

Natural sources:

• Citrus fruits (lemons, oranges, grapes, etc.)
• Green vegetables and fruits (spinach, peas, lettuce, apples, pears, cabbage)
• Onions, beetroot, bananas, etc.

Roles:

• Needed for collagen synthesis, or in simple words, its production. Further, collagen is associated with wound healing²
• Antioxidant, similar to vitamin A, that helps skin recover and fight inflammation

Deficiency of vitamin C

Deficiency can slow healing and worsen skin damage, such as fissures, prolonging recovery. Long-term deficiency causes scurvy,⁷ which is characterised by the breakdown of collagen molecules, weakening ligaments, reopened scars and wounds, and many more. The disease has been known for over a hundred years and was recognised among sailors' lifestyles. Luckily, consuming vitamin C-rich food can prevent and cure it. 

The role of vitamin E

Vitamin E, known in science as tocopherols, is a powerful fat-soluble antioxidant helping plants protect their lipids from byproducts of chemical reactions.

Roles:

• Protecting skin and supporting elasticity
• Moisturizes skin
• Reducing inflammation
• Protecting cell membranes

Food rich in vitamin E:

• Nuts, seeds, and vegetable oils 
• Green leafy vegetables and fortified cereals

Deficiency:

Lack of this vitamin is rare in humans; it usually happens in people with inherited conditions preventing them from absorbing the vitamin. However, it can happen; symptoms include dry skin prone to damage.

Who’s at risk of deficiency?

Breastfeeding mothers

When you are a breastfeeding mother, you share your nutrients with your baby, so your body needs more nutrients to support you both. A study published in ‘Nutrients’ (2021) ⁸ revealed that breastfeeding women have lower levels of vitamin A and E. 

People with special diets or issues absorbing nutrients

Certain diet preferences (vegan, paleo) or digestive conditions like celiac disease are associated with lower absorption of nutrients. Research in "Clinical Gastroenterology and Hepatology" ⁹ has linked gut disorders with reduced absorption of fat-soluble vitamins like A and E.

Aging individuals

Older people get more vitamin deficiencies because of factors like:

• Slower absorption
• Taking multiple medications
• Chronic conditions like diabetes

FAQs

What are the signs you might be deficient?

Depending on which vitamin is missing, here are the most common signs you are deficient:

• Dry, irritated skin, which can lead to the development of fissures
• Slow wound healing
• Frequent skin cracking or infections
• Weak immune system

What can you do?

Eat nutrient-rich food

Include nutrient-rich food, especially packed with vitamin A, C and E. There are many simple and quick meals you can prepare. For example, a veggie omelet with spinach and bell peppers will provide vitamin A andC alongside vitamin K, calcium, iron and magnesium. For breakfast, you can prepare a bowl of oatmeal with berries and peanut butter; it will not only energise you, and berries are also rich in vitamin C.

Take care of your skin

Alongside nutritional support, use hydrating creams, serums with hyaluronic acid or some other types of moisturiser. Also if you have sensitive skin, make sure you use the right SPF, even on cloudy days. If you prefer natural products, try chamomile, calendula, green tea or aloe vera-based products. 

Hydration and nipple care tips 

Taking care of your nipples may seem peculiar, but for breastfeeding women, it is essential. Use gentle, safe creams like:

• Lanolin (very popular and safe for breastfeeding)
• Coconut oil (natural and soothing)
• Vitamin E ointment (helps skin heal)
• Aloe vera gel (cooling and calming)
  

How to apply:

• After feeding or showering, gently pat the area dry
• Apply a thin layer of your chosen cream or oil
• Let your skin breathe and avoid covering it with tight bras or sticky dressings right away

When to seek help?

It is important to react if you are experiencing some of the following:

• Fissures that don't heal, even though you are applying creams
• Pain that is consistent
• Signs of inflammation, like redness, temperature, oedema
  

Summary

Nipple fissures are painful cracks or sores on the nipple, usually seen in breastfeeding women however, they can also be caused by dry skin, friction, or skin conditions. In breastfeeding, women cause poor breastfeeding technique and infections. Additionally, there have been some studies linking vitamin deficiencies to fissures. More specifically, vitamin A, C and E because of their role in skin growth and development and later on protection.

Along with breastfeeding mothers, other people such as elderly people, individuals with specific diets or digestive issues, are at risk for these deficiencies. Signs include dry skin, slow healing, and recurring cracks.

To help prevent or heal nipple fissures, eat foods rich in vitamins A, C, and E, like spinach, bell peppers, nuts, and all types of fruits. Furthermore, you can use gentle skincare products, hydrate well, and care for nipples with lanolin, coconut oil, or aloe vera. See a doctor if fissures don’t heal or you notice signs of infection.