What Causes Inverted Nipples?

Some women may notice that their nipples don't point out. If one or both of them point inward, it's called an inverted nipple. You may have been born this way. But if it starts to happen later in life, it could be a sign of a medical problem that needs to be checked by a doctor.

Aging

Beginning in your mid-30s, your breasts start to change, and they keep changing as you get older. Your milk ducts shorten as you get closer to menopause. Sometimes this causes your nipple to move into your body.

Because the chances of getting breast cancer increase as you get older, it's important to check in with your doctor any time you notice a change.

Breastfeeding, Breast Surgery, or Injury

If you've recently finished breastfeeding, your nipples might turn inward. This happens if the milk ducts scarred while you were breastfeeding. Breast surgery or other injury to the breast can cause your nipple to turn inward, too.

Nipple eversion devices might work for these causes of nipple inversion. But the treatment for most inverted nipples is surgery. If you plan to breastfeed in the future, talk to your surgeon about the risk that the operation might harm your milk ducts. Also, keep in mind that some nipples go back to being inverted even after the procedure.

Born With Inverted Nipples

Your nipples formed when you were in the womb. If they pointed inward when you were born, it's because your nipple base stayed small in the womb or your milk ducts didn't fully develop. That pulls your nipple inward.

Talk to your doctor if you have concerns about this and want to consider treatment. A lot depends on how severe the inversion is. Your doctor may suggest popping the nipple outward with a nipple "eversion" device. This is a syringe or suction cup that pulls the nipple out. In more severe cases, you might need surgery to correct the problem.

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Mammary Duct Ectasia

The ducts that carry milk to your nipples can widen and become clogged. This condition, called mammary duct ectasia, usually affects women between the ages of 45 and 55.

In addition to inverted nipples, you may also have:

  • Redness on and around your nipple
  • Tenderness
  • White, green, or black discharge

The blocked milk duct may clear on its own. If it doesn't, treatments include antibiotics to unclog the duct or surgery to remove it.

Bacterial Infection

Bacteria can get into your milk ducts and cause an infection. This condition, called periductal mastitis, is especially common in women who have just given birth or are breastfeeding. Bacteria also can get into the nipples of women who haven't given birth but have cracked or pierced nipples.

If your nipple becomes inverted due to a bacterial infection, you may also have symptoms such as:

  • Tenderness, redness, or a hot feeling in your breast
  • Nipple discharge that could be bloody
  • A lump behind the nipple

To make a diagnosis, your doctor may do an ultrasound or use a needle to collect cells from the infected area.

The most common treatment is antibiotics, though your body may heal itself over time.

Breast Cancer

If one or both of your nipples suddenly become inverted, it could be a sign of breast cancer.

You may also notice:

  • A lump or thickness in your breast
  • Dimples or other skin changes on your breast

Your doctor may use a combination of procedures to diagnose the issue, including a breast exam, mammogram, breast ultrasound, biopsy, and MRI.

Treatment depends on the type and stage of breast cancer. The options include things likes surgery to remove the lump or the entire breast, radiation, chemotherapy, and hormone therapy.

WebMD Medical Reference Reviewed by Sabrina Felson, MD on June 01, 2019

Sources

SOURCES:

HealthyWomen: "Parenting Q&A."

Oxford Academic Aesthetic Surgery Journal: "Inverted Nipple Repair Revisited: A 7-Year Experience."

Breast Health & Healing Foundation: "Does One Inverted Nipple Increase the Chances of Breast Cancer?"

National Health Service (UK): "Breast Changes in Older Women," "Mastitis." 

CDC: "What Are the Risk Factors for Breast Cancer?"

Mayo Clinic: "Mammary duct ectasia," "Breast cancer."

Breast Cancer Care: "Periductal mastitis."

Cancer Council Victoria: "Common Breast Problems."

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