Differences between nipple yeast infection and other causes of nipple pain

Do I have a nipple yeast infection or something else?

Nipple yeast infection is sometimes confused with areolar eczema. They can look similar. To treat them properly, it is important to know the difference. Nipple yeast needs moisture, so the infection is found at the bottom of the nipple near the areola and on the part of the areola where the baby feeds. Eczema does not need moisture and can spread away from the areola and onto the breast. The bottom of the nipple is often the least affected part. A nipple yeast infection burns more than it itches, while eczema itches more than it burns. Another cause of nipple and breast pain is vasospasm, a contraction of the blood vessels in the nipple. Like nipple yeast infection, it burns after feeds.

A) Comparing nipple yeast and eczema

Nipple yeast infection and areolar eczema sometimes look similar. Complicating the problem, creams used to treat nipple yeast infection can cause eczema and steroid skin preparations used for eczema can increase the risk of nipple yeast infections. In rare cases, mothers have both conditions at the same time.

To treat these conditions, it is important to tell one from the other. The table below describes the differences between the two.

Table: Comparing Nipple Yeast Infection and Eczema

B) Other causes of nipple and breast pain that can be confused with nipple yeast infection

Nipple vasospasm, a contraction of blood vessels, can be confused with nipple yeast infection because it too, will burn after feeds (Wu 2012). It can also develop when mothers have a nipple yeast infection and may result in a mother believing that her nipple yeast infection is not responding to treatment when in fact it has.

Nipple yeast infection can also be mistaken for:

There is very limited evidence that symptoms of a nipple yeast infection may be caused by an overgrowth of bacteria in the milk ducts (Jiménez 2017).

References

Jiménez E, Arroyo R, Cárdenas N, et al. Mammary candidiasis: A medical condition without scientific evidence? PLoS One. 2017 Jul 13;12(7):e0181071
 
Wu M, Chason R, Wong M. Raynaud's phenomenon of the nipple. Obstet Gynecol. 2012 Feb;119(2 Pt 2):447-9