I have a cafe au lait spot the size of a pea next to my nipple sometimes it hurts and sometimes just my nipple hurts. what does that mean?

Tender cafe au lait: these as small flat pigmented birthmarks. they are sometimes (if more than 6 and larger than 5 mm before puberty) a sign of neurofibromatosis and needs to be checked. Assuming this isnt the case - i think its benign and nothing to worry about - I suspect your pain may be coming from the nipple - perhaps from excessive irritation from your bra. Cafe au lait are usually benign. Good luck