On this page
A healing nipple piercing crusts, leaks and gets sore more than most piercings, because a bra or a shirt rubs it all day for six to twelve months. Most of what worries people is irritation from that friction, and it is fixable.
Infection does happen, though, and on a nipple it matters more than on an earlobe. Behind the piercing is breast tissue, and an infection left to spread can form an abscess. Telling the two apart, and knowing when not to wait, is what this page is for.
Irritated or infected
The difference is direction. Irritation stays at the piercing and settles when you remove the cause. Infection spreads and gets worse.
| Irritation | Infection | |
|---|---|---|
| Redness | Pink, around the openings | Red and spreading, sometimes with streaks |
| Heat | Warm at most | Hot to the touch |
| Discharge | Clear or pale straw-coloured, drying to a crust | Thick pus, white, yellow or green, often smelly |
| Pain | Tender, easing over the weeks | Throbbing, getting worse after the first week |
| Swelling | Mild, around the piercing | Spreading, or a hard lump behind the nipple |
| You | Fine | Possibly feverish, shivery or unwell |
Two things that are not infection on their own: crust on the jewelry, which is dried lymph and part of normal healing, and a small pink bump beside an opening, which is usually an irritation bump.
Signs that need a doctor the same day
- Redness spreading away from the nipple, or red streaks running from it.
- Skin that is hot, tight or shiny over a growing area.
- Thick, coloured or smelly discharge.
- A hard, painful or growing lump in the breast behind or beside the piercing.
- Swelling or tenderness spreading into the breast.
- Fever, chills, or feeling generally unwell.
- Pain that is getting worse rather than better after the first week.
A lump behind the nipple deserves particular attention. It can be the start of an abscess, which is much easier to treat early.
Leave the jewelry in
Taking the jewelry out is the instinct, and it is the wrong move unless a doctor tells you to. The NHS advises leaving jewelry in an infected piercing.
The jewelry holds the channel open, and an open channel drains. Remove it and the surface can close within hours over tissue that is still infected. The infection then has nowhere to go, and in breast tissue that is how an abscess forms.
Leave it in, tell the doctor it is there, and let them decide. If an abscess has formed, they may take it out as part of treatment.
While you wait for the appointment
- Sterile saline twice a day, sprayed on and left for thirty seconds, then patted dry with clean paper towel.
- A soft, loose bra without underwire, or none, so nothing presses on it.
- Loose cotton clothing over the area.
- Sleep on your back, not on your front or on that side.
- Hands off, and no picking at crust.
- No ointments, alcohol, hydrogen peroxide or tea tree oil. They irritate or trap moisture over tissue that needs to drain and heal.
- No oral contact with the piercing.
A warm compress of clean gauze soaked in saline can ease a tender, swollen piercing for a few minutes at a time. It is comfort, not treatment.
What a doctor will do
They will look at the piercing and the breast around it, often take a swab if there is discharge, and usually prescribe antibiotics. If there is a lump, they may use an ultrasound to check for an abscess, and an abscess may need draining.
Finish the full course of antibiotics, even when it looks better after a few days.
If antibiotics are not working
Most nipple piercing infections clear with standard treatment. If yours is not improving after a few days, or a lump keeps growing, go back to the doctor rather than waiting it out.
Unusual bacteria are a recognised cause of infections that do not respond. In one published case, a young woman developed a painless breast lump about a month after a nipple piercing, after exposure to pond water. Standard antibiotics did not work, even after the jewelry was removed. Tests eventually found an uncommon type of bacteria, and she needed surgery and several months of specialist antibiotics. The authors’ message to doctors was to suspect unusual organisms when a nipple piercing infection is not getting better.
Cases like that are rare. The practical lesson is simple: an infection that is not improving needs to be looked at again, and it helps to mention any swimming in lakes, ponds or hot tubs.
Why nipple piercings get infected
Knowing the cause helps you protect the piercing for the rest of its healing.
- Friction. Bras, especially underwired or seamed ones, tight tops and sports kit rub the openings open again and again.
- Water. Pools, hot tubs, lakes, ponds and the sea should wait until the piercing has healed.
- Oral contact and bodily fluids during healing.
- Touching it with unwashed hands, and turning the jewelry.
- Jewelry that is too short, which presses into swollen tissue, or low-quality metal that irritates. Nipple piercing jewelry explains how length and material are chosen.
- Changing the jewelry early, before the channel has formed. Nipple piercing healing time explains how long that takes.
- Sleeping on it, which traps and presses the piercing for hours.
Breastfeeding and infection
If you are breastfeeding and the piercing looks infected, get medical advice the same day. Tell the doctor you are breastfeeding so they can choose treatment with that in mind, and ask before changing how you feed on that side. A lactation consultant can help with the practical side.
For breastfeeding with a healed piercing, including removing the jewelry for feeds, see the nipple piercing guide.
If it is not infection
- A small, firm pink lump beside an opening, without heat or spreading redness, is almost always an irritation bump from friction or a bar that needs downsizing. See piercing bumps.
- A bar sitting closer to the surface than it did, with thin or shiny skin over it, is migration. See piercing rejection.
- A lump that spreads beyond the piercing and keeps growing over months may be a keloid. See the keloid guide.
Other infected piercing guides cover the belly button, ear and nose. Every aftercare guide is collected under aftercare.
Not sure whether it is infected? Irritated or infected piercing has a symptom table, and how to treat an infected piercing covers the steps that apply to any placement.
Not medical advice
This page is educational. If a nipple piercing is hot, has spreading redness or thick coloured discharge, there is a lump in the breast, or you have a fever, see a doctor today rather than reading further.
Frequently asked questions
How do I know if my nipple piercing is infected?
Infection spreads and gets worse: redness moving outward, skin that is hot, thick pus that can be white, yellow or green, pain that increases after the first week, a hard or growing lump in the breast, or feeling feverish and unwell. Irritation stays at the piercing and settles once you remove the cause.
Is it normal for a nipple piercing to crust and leak?
Yes. A healing nipple piercing produces more discharge than most, because clothing rubs it all day. Clear or pale straw-coloured fluid that dries to a crust is normal. Thick, coloured, smelly discharge is not.
Should I take out an infected nipple piercing?
No, unless a doctor tells you to. The NHS advises leaving jewelry in. It keeps the channel open so the infection can drain; taking it out lets the surface close over the infection, which can turn it into an abscess.
Can an infected nipple piercing spread into the breast?
It can. Behind the nipple is breast tissue, and an infection that is not treated can spread into it and form an abscess, which needs medical treatment and sometimes drainage. A hard, painful or growing lump behind the piercing needs a doctor the same day.
What if my nipple piercing infection does not get better with antibiotics?
Go back to the doctor rather than waiting. Most infections respond to standard antibiotics, but unusual bacteria have caused breast abscesses after nipple piercing that did not, and those need different tests and treatment.
Can I breastfeed with an infected nipple piercing?
Get medical advice the same day, and tell the doctor you are breastfeeding so treatment can take that into account. Ask before changing how you feed, and involve a lactation consultant if you have one.
Sources
- NHS - Infected piercingshttps://www.nhs.uk/conditions/infected-piercings/
- Association of Professional Piercers - Troubleshootinghttps://safepiercing.org/troubleshooting/
- Association of Professional Piercers - Suggested aftercare for body piercingshttps://safepiercing.org/aftercare/
- Canadian Family Physician (2014) - Mycobacterium fortuitum breast abscess after nipple piercinghttps://pmc.ncbi.nlm.nih.gov/articles/PMC3994836/
This article is for education only and is not medical advice. If a piercing is hot, swollen, spreading redness, oozing yellow or green discharge, or you have a fever, see a doctor today.