Too much moisture softens nipple skin and slows healing or makes pain and damage more likely

Avoid overhydrating your nipple skin

Anything that holds moisture against the skin of your nipple for long periods can overhydrate the skin. Both the outer layer of your skin (the epidermis) and the underlying layer (the dermis) can overhydrate, if you accidentally keep your nipple moist for too long.

Overhydration and what's known as moisture-associated skin damage make your nipple skin softer and more vulnerable to inflammation and damage than it would otherwise be.

This is why it's best to keep your nipples as dry as sensibly possible when you're lactating, and especially if you develop a crack or wound.

Nipples already often start off at a disadvantage when we're breastfeeding, because bras make it more difficult for the epidermis of the nipple to 'breathe', stay dry, and be surrounded by oxygen. You can find out about bras here.
Using balms, lotions, and other medicated or non-medicated applications to try to prevent or heal nipple pain or damage can quickly make everything worse, if we're not careful, because of moisture-associated skin damage.

There is no evidence to prove that moisture and moist wound applications help you heal quicker

Applying moist wound healing principles to nipples when you're breastfeeding is not an evidence-based approach. Saying this might seem very confusing though, because everywhere at the moment you'll hear that keeping your nipples moist helps with healing! You'll hear that moist wounding healing of nipples is evidence-based (even though it's not). It is true that we don't want your nipples sticking to or rubbing on a breast pad or your clothing when they're painful or damaged, though.

You can find out what to do to care for your nipples, including if you have pain or damage, here.

Selected references

Conde-Montero E, Moreau A, Schlager JG, Pastor D, Hafner J. Protocols in wound healing: evidence-based or mere rituals? International Wound Journal. 2024;21:e70062.https://doi.org/70010.71111/iwj.70062.

Douglas PS. Re-thinking lactation-related nipple pain and damage. Women's Health. 2022;18:17455057221087865.

Qi L, Zhao Q, Guo L. Prevention and care for moisture-associated skin damage: A scoping review. Journal of Tissue Viability. 2024;32:362-375.

Rippon MG, Ousey K, Cutting KF. Wound healing and hyper-hydration: a counterintuitive model. Journal of Wound Care. 2016;25(2):68-75.

Park E, Long SA, Seth AK, Geringer M. The use of desiccation to treat Staphylococcus aureus biofilm-infected wounds. Wound Repair and Regeneration. 2016;24:394-401.

Whitehead F, Giampieri S, Graham T, Grocott P. Identifying, managing and preventing skin maceration: a rapid review of the clinical evidence. Journal of Wound Care. 2017;26(4):159-165.