There is no doubt in my mind that the vasospasm itself causes tissue damage
from lack of perfusion.  Even if the original cause of the spasm (ie poor
latch, tongue-tie) is fixed, the spasm often keeps itself going from
continued hypoxia.  If it is long-standing the skin often looks kind of
thickened and flakey...like an eczematous plaque.

I rarely need to use niphedepine.  A heating pad on "low" applied over
clothing to nipples immediately after nursing or pumping AND anytime the
pain is occurring will usually allow healing in a few days, as long as the
original cause has been fixed.

Kathy Leeper, MD, IBCLC
Medical Director, MilkWorks
Lincoln, NE

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