Breastfeeding - skin and 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 health care provider right a way. 

• Skin puckering or dimpling. This can be caused by scar tissue from surgery or an infection. Often, there is no reason. See your health care provider. But know that most of the time this does not need treatment. 
• Warm to the touch, red, or painful breast. This is caused by an infection in your breast. See your health care provider for treatment. 
• Scaly, flaking, itchy skin. This is usually eczema or a bacterial or fungal infection. See your health care provider for treatment. Flaking, scaly, itchy nipples can be a sign of Paget's disease. 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. This can be caused by an infection in your breast or inflammatory breast cancer. See a health provider right a way. 
• Retracted nipples. Your nipple was raised above the surface but begins to pull inward and does not come out when stimulated. See a health care provider if this is new.

Take Care of Your Nipples

• Your nipples naturally make a lubricant to prevent drying, cracking, or infections. 
• Avoid soaps and harsh washing or drying of your breasts and nipples. This can cause dryness and cracking. 
• Rub a little breast milk on your nipple after feeding to protect it. Keep your nipples dry to prevent cracking and infection. 
• If you have cracked nipples, apply 100% lanolin after feedings.

When to Call the Doctor

Call for an appointment with your health care 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.

Your health care provider will talk to you about your medical history and recent changes you have noticed in your breasts and nipples. Your health care provider will also do a breast exam and may suggest that you see a dermatologist or breast specialist. 

You may have these tests done: 

• Mammogram
• Breast ultrasound
• Biopsy

Alternate Names

Inverted nipple; Nipple discharge

References

Newton ER. Lactation and Breastfeeding. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 23.

Update Date: 9/27/2012

Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.