Hi XXXXXXX

Welcome and thanks for posting your query to Healthcare Magic.

I can understand your concern for the problem of bleeding nipples.

There can be multiple of causes related to bleeding nipple. In your short query you have not provided the details- as since how long the problem is present. Is it a continuous problem or becomes alright in between. Is there any other associated problem such as hardness or firm feeling over nipples.

Any how the best of the possibilities according to your age could be following:

1. Eczema of nipples and areola: It is mild to moderate allergic phenomenon over nipple area due to allergy to contact of certain things.
In contact allergy it can be initiated by the deodorants or some powder or any scents applied over chest. This leads to itching over the affected area and then due to scratching it leads to cuts around the nipple area which further leads to a cycle of itch- scratch and itch.

2. Irritation by friction: the initiating event is by friction of synthetic clothes aggravated by sweating. It can also be due to the exercise or sweating during jogging or related things. The rest of cascade of cycle is same as above.

3. Due to infections and other skin diseases around nipple area: Certain infections and skin diseases more commonly involve the nipple area. In these conditions there is presence of similar or some kind of skin lesions over the other sites of body.

4. Lastly it can also be due to simple dryness over the area leading to cracked nipples which bleeds on touch. As you have hypothyroidism so it is best possibility of dryness leading to cracked nipples.

All these skin conditions have tendency of waxing and waning. These may be aggravated at a particular instance and may be improved at other times.

Many a time I have seen patients very much worried regarding worst possibility in bleeding nipples. So to guide you for the worst of the side there is also a possibility of skin cancers at nipple area. But in yourself it does not seems to be possibility of same because of your young age. These are generally seen in females and in males too after the age of 50 years. As you are young man of 30 years so it is unlikely of this possibility. So rest assured about this condition.

For the betterment you can follow the instructions below:

- Do not pinch, pop or scratch the nipple area. Even do not try to touch the area unnecessarily.

- Do warm water compresses 3-4 times a day. Take cotton soaked in warm water and apply it for 5 minute each.

- You can apply a combination cream of antibiotic (mupirocin) and mild steroid like fluticasone over the affected area in a very thin layer for 2 times under media advise.

- In between the above application you can apply white petroleum gelly for multiple times a day or as soon as you feel dryness over the area. This would be the most important part in controlling your problem.

- If itching is present then can take antihistamines to lessen the itching like "laratadine" by mouth for 2-3 times per day under media advise.

- Wear cotton clothe and cotton undergarments to be changed two times ad day. Do not wear anything which is synthetic in nature.

- Stay away from the hot and humid environment to prevent sweating. Keep general and local hygiene better. Take two times bath.

- Lastly do not apply anything without medical advise as certain things and chemicals itself can cause worsening of the situation.

Follow the instructions for at least 5-7 days. If the things are not getting better then for the best of diagnosis and treatment I recommend you to XXXXXXX a dermatologist at Medical College level near your area.

Hope I have answered your query. If you have any further questions, I will be happy to help.

"Wish you good health"

Regards,

Dr Sanjay Kumar Kanodia
(MD- Dermatology & Sexually Transmitted Diseases)

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Welcome again to the forum young fellow.

Thanks for your prompt reply.

As per your complete details I can make out the exact diagnosis of the “Jogger’s or cyclist’s nipples”. I have mentioned regarding the same in the point number 2 of previous email.

Long-distance runners of either sex may suffer from irritation of the nipples caused by prolonged friction against a shirt. The problem is more pronounced in persons who wear some sort of lose clothe which repeatedly touches the area. The condition is self-healing and prevention includes the application of petrolatum or powder to the nipples to reduce friction, and the use of a sports brassière.

But in my own personal experience I have seen repeated episodes of the problem despite above measures.

I personally recommend you some additional measures such as:

1. Using cotton pads tightly wrapped around the chest by a compression vest, or some variety of chest binding clothing.

2. Doing your cycling in early hours of day before sunrise to prevent maximal sweating.

3. Do minimum distances which should not cause the frictional trauma or irritation. For this I ask the cyclists to start with minimum lap of 3 km per day and then to increase by 2 km everyday till the time you feel even slightest of the irritation over the nipple area. At the exact distance where you feel the irritation is the deadline. Reduce your lap to that distance to prevent the frictional injury.

4. As soon as you are done with your cycling take bath at the earliest possible.
5. Do warm water compresses even if you do not have any irritation over the affected part.

6. Lastly the point of help is to do cycling shirtless, while it is not a good option for everyone, but is something worth considering, especially in warm weather for men only!!!

The rest of the information and suggestions are the same as in previous Email.

Hope I have answered your query. If you have any further questions, I will be happy to help.

"Wish you good health"

Regards,

Dr Sanjay Kumar Kanodia
(MD- Dermatology & Sexually Transmitted Diseases)

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