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Itchy Nipples Can Have Many Causes

Dear Dr. Roach: I am a woman, 52 years young, and my nipples are itchy. I would like to know what I can use to put a stop to the itching. Is this a sign of menopause? Can it be due to the dry weather? — S.V.

Answer: Itchy nipples are common — especially for women, but also for men — and are usually caused by a benign skin condition. Eczema may be the most common cause, but you could be having a reaction to latex or nickel in your bra, or to any soaps, cosmetics or powder you might use. Some women have reported an allergy to detergents in the sheets or mattress covers that causes nipple itching.

Exercising certainly can cause a friction itch. Fungal infection is possible but uncommon. Mere dry weather definitely can exacerbate any skin condition you might have. Itchy nipples do seem to occur more often in women around the time of menopause.

An Internet search, and even a review of the medical literature, might lead you to suspect that a rare form of breast cancer, Paget’s disease of the breast, is the most common cause of nipple itching, but it’s actually quite rare (responsible for only about 1 percent to 3 percent of all breast cancers).

Still, with any nipple discharge or visible changes in the skin around the nipple, see your doctor.

Most women find that cotton is the best material next to the nipple. Given your dry weather, I would try hypoallergenic cream or ointment. If that doesn’t help, your regular doctor, a gynecologist, a dermatologist or a breast specialist may be able to more conclusively diagnose what’s causing the problem.

Dear Dr. Roach: My 39-year-old son has been hiccupping for a week now. It is constant and painfully irritating for him. He went to the emergency room, where he had a chest X-ray. His blood test and EKG were normal. He does strenuous exercises — 100 push-ups and lifting heavy weights, and he is also a runner. The physician at the hospital prescribed an antipsychotic medicine, to be taken three times daily. The medicine is not working. The hiccups stop only when he lies down.

My son is on the verge of a nervous breakdown. He cannot work or talk, as talking only enhances the hiccupping.

Thank you so much in advance for any advice you can give me. — R.L.

Answer: Hiccups are caused by a reflex causing the diaphragm, the main breathing muscle, to spasm. Hiccups are common, and everybody knows a treatment for them.

However, hiccups that go on for more than 48 hours are not normal hiccups and usually are associated with a medical condition. Treatment for chronic hiccups is treatment of that underlying condition, so it must be found. More than a hundred causes of chronic hiccups have been reported.

There are many neurologic causes, ear, nose and throat causes and gastroenterologic causes, especially reflux disease. The next step is a more thorough workup, preferably done by a team working together.

I am sure I will get many suggestions for hiccup cures that are sure to work, but since some causes of hiccups are serious, I recommend a careful look for the cause. If no cause is found, there are prescription medications and, rarely, surgery that can be tried. Acupuncture also has been successful.

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