There are two main types of nipple abnormalities:

1.       retraction of nipple into the breast

2.       disorders of skin on or around the nipple.

These nipple issues are mostly minor conditions. These can be easily managed. In case of any recent changes, these should be brought to attention of a surgeon as these may indicate breast cancer.

What are the causes?

·         If breast do not develop properly, nipple inversion maybe first noticed during puberty. This may make breast feeding difficult at a later time. This type of inversion is harmless.  

·         Inflammation of breast tissue below the nipples may also result in nipple inversion. This condition is seen in lactating.

·         Aging may also cause nipple inversion.

·         Breast cancer is also a rare cause of nipple inversion. It will present with other symptoms also.

·         Lactating women may develop fine cracks and tender areas on their nipples during breast-feeding. This may result when baby is not taking the whole nipple into his or her mouth when feeding. Wet nipples after a feed can also cause them to become sore. Cracked nipples produce burning pain during feeding. Nipple and adjacent breast tissue may become infected or inflamed.

·         Eczema can cause itchy, dry and flaky skin on and around nipples. It tends to occur in multiple places on the body. Occasionally, Paget’s disease of the breast can resemble eczema, but it is a rare form of cancer that affects the milk ducts. This type of breast cancer often causes soreness, bleeding from nipple and breast lump that does not heal.

What might be done?

·         Examination by your family physician or surgeon.

·         To rule out malignant causes or to find breast issues that were not evident on examination, an ultrasound scanning or breast x-rays maybe done.

·         A biopsy of breast lump or skin rash using a needle and syringe, can be examined under the microscope for abnormal or cancerous cells.

·         Inversion of nipple can be temporarily corrected by drawing the nipples out between your thumb and forefinger every day for several weeks. Suction devices can also help draw out the nipple.

·         Cracked nipples can be corrected by washing (without soap), drying and applying Vaseline, butter or cooking oil. Bra and beast pads should be made from cotton and should lose to let the air flow through. Infection is usually treated with antibiotics. Eczema can be managed by short-term use of hydrocortisone cream. Nutritious diet and clean drinking water also help.

·         For cancer of the breast and Paget’s disease an oncologist and a surgeon will be needed to manage the case. The affected skin will be surgically removed along with surrounding tissue. Treatment of cancerous lump can include surgery, radiation therapy or chemotherapy.