Cracks in the nipples

Emerging cracks on the nipples bring a lot of discomfort to the woman, but if you ignore this condition, then problems can become even greater. In this article, we will try to understand the causes of cracks and the way out of the situation.

Causes of the cracks in the nipples

As medical practice shows, the cause of cracks in the nipples can be:

• Ignoring the rules of personal hygiene.
• Frequent washing of the nipples with the use of alkaline soap, which dries the skin of the breast, leading to the formation of cracks.
• Incorrect attachment of the newborn to the nipple during breastfeeding. Incorrect technique of breastfeeding.
• Breast trauma at a time when the newborn begins to cut teeth.
• Incorrectly matched bra.
• Diseases of a dermatological and other nature. For example, diabetes, thrush.
• Low quality of accessories for taking a shower: a hard washcloth or towel.
• Low-quality cosmetic for body care, including bath accessories. Allergic reaction to shower gel, cream and so on.
• Trauma in the chest.
• Decrease in the immune status of a woman.
• Neoplasm in the chest.
• Continuous contact with poor-quality water: an open reservoir, chlorinated pool water.
• Low-quality and incorrectly matched to the size and model of underwear and all clothing in general.
• Sunburn "topless" is so fashionable among modern girls. Solarium.
• Overheating or supercooling of the chest. Clothes are picked up "not in the weather."
• Frequent stress.
• Violation of metabolic processes.
• Avitaminosis. Shortage in the body of a number of vitamins and minerals.
• Taking antidepressants and some other groups of drugs.
• Prolonged use of hormonal contraceptives.
• Individual hypersensitivity of nipples.
• Incorrect use of means for sucking breast milk.

[1]

Pathogenesis

If the integrity of the epidermal layer of the nipple is disturbed, the fissure can go deep inward right up to the Malpighian layer. If the appropriate measures are not taken immediately, the edges of the crack begin to thicken, the blood vessels fall down, as if sealed, while the elements of the lymphatic system remain accessible to the external environment for at least the next 48 hours. It is this fact that contributes to the invasion of pathogenic flora with the development of inflammatory processes.

[2], [3]

Symptoms of the cracks in the nipples

Symptoms that should disturb a woman and get her to seek help from a specialist:

1. Visually observed cracks in the skin of the nipple. They can be either single or multiple, deeply penetrating and superficial, of various sizes.
2. Ranks can cover blood crusts.
3. Feeling of discomfort in the affected area.
4. When you try to touch (hand or cloth clothes) there is a sharp pain that can give to the area of the collarbone, arm and shoulder blade.
5. There is edema in the paranasal region.
6. The nipples can be enlarged in size.
7. Hyperemia of the skin around the nipple.
8. Bleeding of cracks.
9. Subfebrile or febrile temperature is possible.
10. Development of mastitis.

First signs

The first thing that a woman begins to feel is discomfort in the nipple area.

1. Start tingling and tingling in the area of the nipples.
2. There is itching.
3. Hyperemia of the nipple and adjacent tissues.
4. If no timely measures are taken, pain symptoms, swelling and bleeding of the wound appear.
5. Further infection of cracks.

[4]

Forms

Deep cracks in the nipples

If deep cracks in the nipples are visualized, treatment should be started as soon as possible. After all, in such a situation, the main thing is not only to stop the disease, but also to prevent infection in the wounds, which can lead to:

1. Development of the inflammatory process in the tissues of the breast.
2. Soreness when feeding a newborn baby.
3. Increased pain in decanting breast milk.
4. Damage to the subcutaneous capillary mesh, which leads to bleeding from the cracks.
5. Infiltration of tissue structures.
6. Appearance of abscesses.
7. The formation of erosion sites.

Gradually, infection of wounds can lead to the development of other diseases. For example, such as mastitis.

[5], [6]

Non-healing cracks on the nipples

If a woman does not take adequate and timely measures to solve the problem, she will be pursued by non-healing cracks on her nipples.

This is because during the next feeding the nipple is again injured, and in the intervals between the feedings the existing wounds simply do not have time to heal. At such clinic without the help of the qualified expert (the obstetrician - the gynecologist or the pediatrist) to not manage.

Purulent fissures on the nipples

Pus in the wound is a clear sign of infection. Purulent fissures on the nipples cause an unbearable pain in any woman, especially the nursing mother, at any touch. The process of feeding gradually forms a fear of pain in the nursing mother, which is transmitted to the child and can not but affect it.

In this case, abscesses can be not only superficial, but go deep into the mammary gland. This is not only a dermatological problem. But the most dangerous in such a clinical picture is the consequences that the patient expects, if it is too late to seek the help of a specialist.

When breastfeeding pus along with the milk will be delivered to the baby's body.

Complications and consequences

If a woman feeds her newborn with her milk, and there is a problem with the integrity of the skin of the nipple, the consequences of such a combination are very deplorable.

When feeding with the mother's milk, the blood can also enter the baby's body. If an infection gets into the wound, it, along with the blood, gets into the baby's body, infecting it. The child's organism can refuse such food. Not getting enough nutrients, he remains hungry. This entails problems with weight gain, inhibition of development, poor psychological mood: the baby becomes more capricious, does not sleep well.

The consequences for a woman lead to infection of the wound, further development of mastitis. Severe pains in the chest prevent the young mother from expressing breast milk qualitatively, which leads to his stagnation in the chest and, as a consequence, the formation of lactostasis.

[7], [8], [9]

Complications

Complications that are possible with the progression of a crack on the nipples can cause a serious problem with a woman's health:

1. Development of lactostasis.
2. Inflammation of mammary glands (mastitis).
3. The growth of erosion areas.
4. The appearance of problems with lactation.

In the future, the symptoms of the disease can force a young mother to stop breastfeeding.

[10], [11], [12]

Diagnostics of the cracks in the nipples

Cracks in the nipple are perfectly visualized. And this is the first thing that catches your eye when examining the mammary glands. Follow-up diagnosis is performed by a doctor - mammologist or gynecologist.

1. A woman will have to answer a number of questions:

• How long has discomfort
• How frequent is feeding.
• How long the baby sucks his chest.
• How a woman cares for her breasts.
• Her medical history.
• And a number of others.

1. The specialist conducts a visual examination of the nipple, as well as assesses the condition of the mammary glands.

• Presence of swelling and hyperemia of the skin.
• Presence of bleeding wounds.
• Are there foci of suppuration.
• Seals in the area of the mammary gland.

1. Laboratory research.
2. Instrumental diagnostics.
3. Differentiation of the problem.

[13], [14]

Analyzes

Clinical analysis of urine, which allows answering the question about the presence or absence of an inflammatory process in the patient's body, as well as a number of other characteristics by which an experienced specialist is able to draw conclusions on the state of woman's health.

Blood test: blood formula, hemoglobin level, blood clotting characteristics and so on.

If necessary, a study is made of the secretions that appear from the nipple. The consistency, shade, transparency is assessed, as well as a bacterial analysis of the liquid, which allows to identify the invading pathogenic flora and establish its belonging.

[15], [16]

Instrumental diagnostics

Instrumental diagnostics can include such techniques:

1. Ultrasound examination of the mammary glands (ultrasound).
2. Mammography is an x-ray method for examining mammary glands.
3. If necessary, magnetic resonance imaging can be prescribed.

These techniques allow you to assess the situation with the breast, milk ducts and nipple.

Differential diagnosis

Differential diagnosis is carried out by an experienced qualified specialist.

He analyzes the results of laboratory studies, excludes diseases that are not included in the diagnostic results, correctly diagnoses and paints adequate treatment.

Treatment of the cracks in the nipples

The doctor, first of all, assesses the severity of the defeat of the halo and on the basis of this describes the treatment of cracks in the nipples.

If the cracks just appeared, a woman suffices to rub the halo one day with antiseptic and wound healing remedies three times during the day. It can be both pharmacological agents and plant-derived products.

If the problem worries a woman for more than five days, then, most likely, the wounds are already infected, and in them the reproduction of bacteria or microscopic pathogenic fungi progresses. It almost always ends with purulent inflammation (mastitis), which should be treated with antibiotics. For the period of treatment, the young mother will have to stop breastfeeding.

The role of antibiotics can be prescribed drugs, both local and general action.

To local antibiotics include: dexpanthenol, purelane with lanolin, cindol, pentanol-D, Sudokrem, beponen, paste or ointment zinc, desithin, radevit and a number of others.

General antibiotics include: penicillins, cefaclor, rovamycin, tetracyclines, erythromycin, spiramycin, cefamandol, clarithromycin and others.

In such a situation, operative treatment (opening of the abscess, sanitation of the cavity, setting of drainage) is possible.

Nipple Foam Care

Any woman, especially a young mother, must know and be able to take care of her breast properly. Nipple crack care requires:

1. Before each feeding, wipe the breast with clean water, without using soap, dabbing it with a soft towel.
2. Consult with an expert and find out how to give the baby a proper breast, in which position it is best to do it. In the mouth of the newborn should be placed almost the entire areola. If necessary, exclude breast pads.
3. After feeding, lubricate the halos with ointment prescribed by a specialist, for example, sea buckthorn oil or lanolin ointment.
4. If necessary, use special pads for feeding. This will reduce the trauma of the nipple, and, consequently, prevent the formation of cracks.
5. It is necessary to revise their cosmetics and hygiene items. They must be of high quality and hypoallergenic. It is better for the time of feeding to switch to the treatment of the breast with cosmetic products made for the susceptible baby skin.
6. Reconsider your wardrobe. Clothes should not impede movement, squeeze and rub. The material should be only natural and of good quality. This will avoid an allergic reaction and normalize adequate air exchange.
7. If deep cracks are observed, the feeding should be interrupted and seek the help of a specialist for full and effective treatment.

Medications

In more detail, we will discuss those medicines that can be included in the protocol for treating the crack on the nipples.

The basis of treatment considered in this article pathology is the local healing, anti-inflammatory and antibacterial ointments and creams.

The most commonly used are: dexpanthenol, panthenol, d-panthenol, beponen.

Bepanten, developed on the basis of active substance dexpanthenol, is used as an antifungal and antimicrobial antibiotic. It is applied to the damaged halo, after the end of feeding, with light massaging movements. The duration of this therapy is determined individually, based on the severity of pathology and the depth of cracks.

Bepanten is not used in the protocol of treatment in the presence of individual intolerance to its components.

But after five days, this drug is better replaced with an analog. This will avoid habituation and greatly expand the range of effects on the pathogenic flora. For example, it can be olazol, neoderm, triderm.

The combined pharmacological agent olazol is applied externally. It is a wonderful antiseptic, which has anesthetic, wound healing and antibacterial characteristics. Before use, the aerosol can should be shaken well. Then bring to the affected area at a distance of one to five centimeters and spray. This drug is used once a day or every other day. The duration of treatment is one to two weeks. If necessary, you can extend it.

Contra-indications of olazol include hypersensitivity to any of its components, as well as if a history of the patient has severe kidney damage, pregnancy and lactation.

Treating nipple cracks

To get rid of the problem as soon as possible, while not stop breastfeeding the baby, correct treatment of cracks on the nipples is necessary.

A young mother after each feeding can wipe the halos with her own milk - this is an excellent prevention of cracks. Even with minor injuries, this is enough to prolong them. After all, mother's milk in its composition has many substances that have healing properties.

If the crack is not infected, but is large, a specialist can offer a woman to use special pads that will protect the nipple when feeding, giving him more time to heal.

With a combination of cracks and suppuration, you may also need surgical treatment. The doctor will have to open the abscess and sanitize the affected cavity. In the postoperative period, the affected nipple will have to be treated with a drug belonging to the group of antibiotics. Primarily, antibiotics of local action are prescribed. Only in particularly severe cases, broad-spectrum drugs taken orally or subcutaneously can be prescribed.

Nipple pads with cracks

If the breach of the integrity of the dermis halo is insignificant, then the doctor will suggest to the nursing mother with cracks lining the nipples. This device today can be purchased at any pharmacy. The data of an overlay from a thin inert and hypoallergenic silicone are made.

This gasket is superimposed on the painful nipple and it is the baby who captures it with the mouth. It is possible to completely eliminate the pain and not be successful, but its intensity will decrease significantly. At the same time, the main condition of therapy is reached, the nipple stops traumatizing during feeding.

But there are a number of disadvantages of this method:

1. The breast is not emptied completely, which requires an additional expression.
2. The baby receives less than the required amount of mother's milk. Perhaps it will have to be fed with expressed milk from the bottle.

Such tips are used temporarily until the problem is resolved.  

Alternative treatment

When nipples appear on the nipples, alternate treatment methods can be used.

The most popular are the juices of a number of medicinal plants (Kalanchoe, aloe, celandine), infusions, decoctions and ointments of monotraves or their collections, as well as a number of other alternative means.

For example, in the role of antiseptic, 1% alcohol solution of zelenka or 1% silver-containing lapis solution can be used.

The propolis tincture proved to be very good. To make it, you need 100 mg of vegetable oil (it can be olive or sunflower) and one tablespoon of ground bee products. Ingredients to connect. Leave for three weeks in a dark place. Lightly sterilize. Apply to lubricate the nipples. Store in a cool, dark place.

Our grandmothers recommended to lubricate the haloes with butter, fish oil or inverted internal fat of birds.

But the basis of treatment is still herbs.

[17]

Herbal Treatment

Herbal treatment helps quickly and effectively solve the problem of nipple injuries. Are ready to offer some such recipes.

Recipe # 1

1. Create a medicinal collection, taking in equal proportions yarrow herb, St. John's wort, horsetail field and marsh swine. Ingredients grind and mix.
2. In one liter of boiling water insist for 20 minutes, two tablespoons of the drug.
3. Drain and apply liquid when processing halo.

Recipe No. 2

1. To make a medicinal fee: yarrow herb - four lobes, chamomile pharmacy - one share, flowers of marigold - one share. Ingredients grind and mix.
2. In half a liter of boiling water, add two tablespoons of medicinal salt. Insist for one hour.
3. Drain and use liquid in the role of appliqués applied to the affected nipple.

Recipe # 3

1. Take three tablespoons of juice from three-year-old leaves of aloe, juice of onion and fish oil. Ingredients should be mixed thoroughly in a container.
2. Add a little wheat flour, kneading the dough.
3. Form the lozenges and attach as an application to a sore spot, fix it with a bandage and leave it for the whole night.
4.  After waking up, "medicine" is removed, and the nipples are wiped with herbal decoction. It can be chamomile, calendula, nettle, sage, oak bark, plantain.

Homeopathy

Modern homeopathy can effectively heal wounds, stop other symptoms caused by the appearance on the nipples of a woman's cracks.

In our case, homeopathic doctors are ready to offer such medicines: graphites (graphites), causticum hahnemani caustic, americana phalanx (phytolacca americana), silica (silicea terra).

Effectively used are homeopathic ointments such as ointment based on arnica, St. John's wort or marigold, medicines in the form of oils of sea-buckthorn, olive and cedar oil, an oil solution of chlorophyllipt. Widely used and ready-made purchased tinctures of flowers of calendula, mullein scepeter-like, birch leaves and many other preparations of phytotherapy, ready to come to the aid of a woman in the issue of prevention and treatment of cracks in the nipples.

Operative treatment

In a number of cases, doctors have to resort to surgical treatment for the treatment of nipple cracks. Indication for it can become an abscess. Inflammatory and purulent processes occurring in the tissues of the breast, can bring a lot of problems and complications. Therefore, in such a situation, the attending physician raises the question of immediate surgical intervention.

In the area of the abscess a small incision is made, all pus is removed and the wound is sanitized. If necessary, if a purulent bag is large enough, a drainage is placed, which will remove the remnants of purulent discharge and the saccharum. Stitches are applied.

After two to three days, the drainage is removed. The site of surgery is necessarily treated with topical antibiotics.

Prevention

It is advisable not to allow the formation on the nipples of a woman's cracks. For this, simple but effective prevention rules should be followed.

1. Breast health:
   • Do not wash your breasts often with soap, which dries the delicate skin of the halo. Use only pH-neutral soap, treating them with nipples no more than twice during the day.
   • Use quality cosmetics for the body and for taking baths.
   • Bathroom accessories (towel, washcloth and so on) should not be very hard.
   • Take the practice for several minutes daily giving the skin to the chest to breathe. This body element should not overheat, as well as supercool.
2. Clothing worn by a woman should be comfortable, matched to the size and model. This is especially true for a brassiere. He should not squeeze and rub. It's not a secret that many women buy this attribute, relying on their aesthetic tastes (like - do not like it). Some women with big breasts try to put it in a smaller bra, trying to visually reduce their dignity.
3. Clothing, especially underwear, it is desirable that it was made of natural fibers.
4. The same applies to bed linen.
5. Without a doctor's appointment, one should not get carried away with the treatment of nipples with alcohol-containing compounds.
6. Timely and fully treat inflammatory and infectious diseases.
7. Do not ignore visits to regular preventive examinations from a gynecologist and / or mammologist.
8. Do not allow a long stay under the scorching rays of the sun. The sunburn "topless" and the solarium are especially harmful, which is so fashionable today.
9. Avoid hypo- and avitaminosis. The nutrition of a woman must be full and rational.
10. Protect the chest from injury.

The rules that must be met when feeding a baby:

1. You should consult a specialist and learn how to properly apply a newborn to your chest.
2. Do not allow the process itself to take more than 40 minutes.
3. After feeding very carefully, so as not to injure, extract the nipple from the newborn's mouth.
4. After feeding, special disposable pads should be used before putting on the bra. Today they can be purchased at any pharmacy. They sanitize the surface, prevent the invasion of pathogenic flora and protect the nipple from drying out.
5. If the suspicion that the baby is difficult to capture the halo has crept in, it should be shown to the pediatrician. Perhaps he has a short bridle and should be cut. Do not be afraid of it. The procedure takes a couple of minutes, and healing takes several hours.
6. After feeding, it is advisable to massage the nipples with gentle movements, applying breast milk for lubrication. This massage stimulates the production of special fats that moisturize and protect the nipple.
7. If necessary, use special silicone pads to protect the halo from permanent injury.
8. Do not allow milk to stagnate in the mammary gland, after pumping off after the main feeding.
9. Alternate chest with each feeding.

Cream for prevention of nipple cracks

Use and creams for the prevention of cracks in the nipples. Such medicines have wound-healing, disinfecting, analgesic characteristics, which allows a quick and high-quality treatment.

The group of medicines is subdivided depending on the chemical substance that forms its basis:

1. Creams and ointments, developed on the basis of dexpanthenol, which has wound-healing characteristics:
   • Dexpanthenol. 
   • Correregel.
   • Pentanol - D.
   • Bepanten.
2. Medicinal pharmacological preparations made on the basis of zinc oxide. This active chemical compound has high disinfecting, antibacterial characteristics. They are applied locally. Allow to prevent infectious damage to damaged skin:
   • Desitin.
   • Sudokrem.
   • Zinc paste.
   • Ointment of zinc.
   • Tsindol.
3. Creams based on retinol (vitamin A, activates the regenerative processes in the tissues, promotes early healing, makes the skin soft and supple).
   • Radevit - its basis - a vitamin complex (vitamins A, D and E).
   • Retinoic ointment.
   • We'll see.
4. Cream structures based on natural flavored oils. This means make the skin softer and more elastic, they have a wound healing effect:
   • Nipple cream from Mama Comfort.
   • Serum from Mamma Donna.
5. A medicinal product manufactured on the basis of lanolin is a fat structure made from animal fats. Nourishes, moisturizes and protects:
   • Cream for nipples Lanolin.
   • MultiMam Cream.
6. Special medicines that effectively work to heal skin lesions:
   • Actovegin, available in the form of a cream, ointment and gel.
   • Solcoseryl in the form of a gel or ointment.
7. Means based on plant extracts and hydromineral raw materials. Activate the ability of the skin to resist the cracking of the nipple, relieve the symptoms of irritation:
   • Balm for nipples "9 months".
   • Ointment Wulnuzan.

[18], [19]

Forecast

If a woman has taken measures and applied for help to a qualified specialist or conducts adequate prevention of cracking halo, then the forecast for treatment of cracks is favorable.

Women's breasts are a woman's reproductive and aesthetic pride, and if she brings discomfort, the problem is aggravated not only by physical, but also by psychological torments. Therefore, it is desirable to prevent cracks in the nipples by carrying out preventive measures, than to suffer if they are present. But if it happened so, that the skin has dried up, and there are wounds on it, do not despair. It is necessary as soon as possible to seek help from a specialist and take adequate measures to get rid of the problem. Take care of yourself and be well!