Breast skin and nipple changes
Inverted nipple; Nipple discharge; Breast feeding - nipple changes; Breastfeeding - nipple changes
Notice Changes in Your Breasts and Nipples
INVERTED NIPPLES
- This is normal if your nipples have always been indented inward and can easily point out when you touch them.
- If your nipples are pointing in and this is new, talk to your provider right away.
SKIN PUCKERING OR DIMPLING
This can be caused by scar tissue from surgery or an infection. Often, scar tissue forms for no reason. See your provider. Most of the time this issue does not need treatment.
WARM TO THE TOUCH, RED, OR PAINFUL BREAST
This is almost always caused by an infection in your breast. It is rarely due to breast cancer. See your provider for treatment.
SCALY, FLAKING, ITCHY SKIN
- This is most often due to eczema or a bacterial or fungal infection. See your provider for treatment.
- Flaking, scaly, itchy nipples can be a sign of Paget disease of the breast. This is a rare form of breast cancer involving the nipple.
THICKENED SKIN WITH LARGE PORES
This is called peau d'orange because the skin looks like an orange peel. An infection in the breast or inflammatory breast cancer can cause this problem. See your provider right away.
RETRACTED NIPPLES
Your nipple was raised above the surface but begins to pull inward and does not come out when stimulated. See your provider if this is new.
What to Expect at Your Office Visit
Your provider will talk to you about your medical history and recent changes you have noticed in your breasts and nipples. Your provider will also do a breast exam and may suggest that you see a skin doctor (dermatologist) or breast specialist.
You may have these tests done:
- Mammogram
- Breast ultrasound
- Biopsy
- Other tests for nipple discharge
When to Call the Doctor
Contact your provider if you notice:
- Your nipple is retracted or pulled in when it was not that way before.
- Your nipple has changed in shape.
- Your nipple becomes tender and it is not related to your menstrual cycle.
- Your nipple has skin changes.
- You have new nipple discharge.
- You notice bleeding from the nipple.
- You have fever and breast tenderness or pain.
References
Carr RJ, Smith SM, Peters SB. Primary and secondary dermatologic disorders of the breast. In: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, eds. The Breast: Comprehensive Management of Benign and Malignant Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 13.
Klatt EC. The breasts. In: Klatt EC, ed. Robbins and Cotran Atlas of Pathology. 4th ed. Philadelphia, PA: Elsevier; 2021:chap 14.
Wick MR, Dabb DJ. Tumors of the mammary skin. In: Dabbs DJ, ed. Breast Pathology. 2nd ed. Philadelphia, PA: Elsevier; 2017:chap 34.
Version Info
Last reviewed on: 11/21/2022
Reviewed by: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
