The breasts in women are prone skin disorders that may cause rashes due to its larger size, temporary structural changes with hormonal influences and daily exposure to irritation from undergarments and clothing. A skin rash is essentially any abnormality of the skin and typically presents with redness, dry, scaling and itchy skin. Sometimes itchy breasts may occur on its own with no rash and this has to be considered separately. Breast rashes may be broadly classified as a rash under the breast and rash on top of the breast near the nipple, or above the breast. The differences in location can be due to specific causes.
Causes of Breast Skin Rash
As with most skin disorders, excessive dryness of the skin is a common cause that is often mistaken for a skin disease. Dryness of the skin is known as xerosis and is largely due to harsh soaps, dry climates and age-related skin changes. It can lead to itching and scaling of the skin and increases the chances of skin infections with repeated scratching. Other causes of a breast rash includes skin diseases that can occur on any part of the body such as :
- Atopic dermatitis which is commonly known as eczema and tends to arise due to allergic factors particularly in a person with a history of allergies from childhood. It may arise or worsen with pregnancy.
- Contact dermatitis is an irritation and inflammation of the skin from exposure to certain substances such as creams, lotions, soaps, some types of fabrics in undergarments and clothing making contact with the breast and even detergents used to wash clothing.
- Submammary candidiasis is a breast fungus that invades the outer layer of the skin. It caused by the Candida species of yeasts and often arises under the breasts within the skin folds that are continuous with the chest. Usually it starts with chaffing of the skin under the breast (intertrigo) which commonly arises with wearing tight fitting bras particularly in women with large breasts.
- Hives (urticaria) is an immune reaction causing patches or lines of raised red skin (weals) that is intensely itchy. It may cause marked swelling of the affected area known as angioedema. The exact cause is unknown but appears to be linked with allergies.
- Breast abscess which is a collection of pus within the breast tissue causing the outer skin to appear raised, red and warm to touch. It is usually painful but even in the absence of pain there is tenderness when pressing over the abscess.
- Mastitis is an infection of the breast tissue more commonly seen in breastfeeding women. The breast appears swollen, red, hot to the touch and painful and the swelling is more generalized than the localized ‘bump’ with an abscess.
Various other diseases of the breast can cause a skin rash which may be oozing and even cause deformities of the breast and nipple. The most notable of these is breast cancer, mammary duct ectasia and Paget’s disease of the breast. Other skin conditions such as seborrheic dermatitis and psoriasis may also affect the breasts but are usually seen elsewhere on the body as well.
Treatment of Breast Rash
Treatment of a breast rash is dependent on the type of rash and causative condition. It may involve a combination of topical applications (cream, lotions, gels and medicated soaps), oral medication (tablets and capsules) and additional therapies such as PUVA light therapy. Therefore treatment measures may differ and it is important to first seek professional advice about the breast skin rash. Some of the general measures to prevent the rash from worsening includes :
- Using loose fitting undergarments and clothing.
- Discontinue any soaps, shampoos or body lotions that may irritate the skin particularly if it is scented.
- Using a suitable hypoallergenic emollient (barrier cream) to protect the affected skin from the environment.
- Avoid scratching as far as possible as this aggravates any condition and can lead to secondary bacterial infections. Keep the nails short and apply thick applications like petroleum jelly at night to avoid abrasion of the skin with unintentional scratching during sleep.
- Always use the treatment prescribed by a doctor. Over-the-counter and prescription medication or applications can be helpful but could mask the condition and worsen it in the long run if it was not specifically prescribed for the condition in question.