Health condition
Paget's disease of the nipple
Paget’s disease of the nipple is a scaly, eczema-like change of the nipple caused by cancer cells within its skin, and it usually signals an underlying breast cancer; one-sided nipple "eczema" that fails treatment needs biopsy.
Why trust this guide
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Editorial team
Written by our editorial team from the UK sources listed on each page.
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Sourced from guidance
Checked against current NHS and UK specialist society guidance at the time of review.
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Current for 2026
Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.
Key facts
The essentials at a glance.
The symptoms to recognise, when to seek help, which specialist to see, and what treatment usually involves.
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Looks like eczema but starts on the nipple itself and is almost always one-sided
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The majority of cases have an underlying in-situ or invasive breast cancer
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Persistent nipple crusting, scaling or ulceration warrants punch biopsy, not repeat steroid creams
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Treatment addresses the underlying cancer and includes nipple removal
Understanding the condition
What it is and what happens next.
What causes it, how it is diagnosed, and the treatment routes available in the UK.
What it is and how it feels
The distinction from ordinary eczema is written in the pattern: true eczema favours both sides, waxes and wanes, and typically involves the surrounding areola before the nipple, while Paget’s begins on the nipple surface of one breast and advances slowly outward - crusting, weeping, sometimes with itching, burning or bloodstained discharge. Months of topical treatment for presumed dermatitis is the classic route to delayed diagnosis.
Diagnosis and treatment routes
A punch biopsy of the nipple skin makes the diagnosis in minutes of clinic time, after which imaging - mammography and usually MRI - maps the underlying disease, which may be ductal carcinoma in situ or invasive cancer anywhere in the breast. Treatment ranges from central excision including the nipple-areolar complex with radiotherapy, to mastectomy with reconstruction, guided by disease extent. Outcomes mirror the underlying cancer’s stage, rewarding the early biopsy. If you are waiting for results or want a second opinion on a proposed plan, a private consultation with a specialist who treats this condition regularly can usually be arranged quickly, and most will review your existing scans, biopsy reports and MDT correspondence.
Seeing a specialist
Who to see, and how quickly you can be seen.
The specialist for this condition is usually a consultant breast surgeon. Your GP can refer you on the NHS, or you can arrange a private consultation directly.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any of the emergency symptoms described above.
Frequently asked
Common questions about Paget's disease of the nipple.
Quick, plain-English answers to what people ask us most.
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What is Paget's Disease of the Nipple?
Paget's Disease of the Nipple is a recognised medical condition that affects the body in ways specific to its underlying cause. Getting an accurate diagnosis is the first step towards understanding your options and what to expect.
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What causes Paget's Disease of the Nipple?
The underlying cause can involve a mix of genetic, environmental, and lifestyle factors, and in some cases no single clear cause is identified. Your doctor can help clarify which factors are most relevant to your case based on your history and any test results.
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What are the symptoms of paget's disease of the nipple?
Symptoms can vary from mild to significant and often develop gradually, though some people notice a more sudden onset. Because symptoms overlap with other conditions, a proper clinical assessment is important for an accurate diagnosis.
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Is paget's disease of the nipple serious or dangerous?
Most cases are manageable with appropriate treatment, though severity varies from person to person. Left unaddressed, some cases can lead to complications, so getting an assessment rather than waiting is generally the safer approach.
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Is paget's disease of the nipple hereditary or genetic?
Some cases have a genetic component that runs in families, while others develop without any inherited link, arising instead from environmental or lifestyle factors. If you have a strong family history, mentioning this to your doctor can help guide whether genetic assessment is worthwhile.
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How is paget's disease of the nipple treated?
Treatment approaches vary depending on severity and individual circumstances, and may include lifestyle changes, medication, or referral to a specialist for more targeted therapy. Your GP or specialist will tailor a plan based on your specific situation.
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How long does paget's disease of the nipple last?
Duration varies — some cases are short-lived and resolve fully with treatment, while others are longer-term or chronic conditions managed over time. Your doctor can give you a more specific expectation once they understand your individual case.
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When is surgery or specialist treatment needed?
Specialist or surgical treatment is usually considered when simpler treatments haven't controlled symptoms adequately, or when the condition is affecting quality of life or function significantly. A specialist assessment can clarify whether this applies to your situation.
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When should I see a doctor about paget's disease of the nipple?
See a doctor if symptoms are new, worsening, or affecting your daily life. On the NHS, routine referrals to a specialist can take 20 to 45 weeks or longer depending on your area; with private healthcare you can typically see a consultant within about 2 weeks, which can be worthwhile if you want a faster diagnosis or reassurance.
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Can lifestyle changes help manage paget's disease of the nipple?
Alongside medical treatment, factors such as a balanced diet, regular appropriate exercise, stopping smoking, and managing stress can support recovery and reduce the risk of the condition worsening or recurring. Your healthcare team can advise which lifestyle changes are most relevant to your specific condition.