The nipple, the very center of the areola, can vary in color, size, shape, and general position in both men and women. The nipple can be flat, protruding, inverted, or none of these. Furthermore, one nipple can be in one position and the other a completely different position — there is no singularly normal pattern. An inverted nipple describes one that retracts into the breast instead of pointing outward. See this image here for a visual representation. An inverted nipple can be normal, especially if it has been present from birth.

Common accompanying symptoms of nipple inversion

Other symptoms that may be associated with benign nipple inversion include:

Maintained protrusion after finger pressure: Meaning it will return to inverted position over time
Retraction in response to temperature or stimulation
Protrusion in response to breastfeeding

More serious symptoms

It is important to follow-up on nipple inversion symptoms with your physician if it is a new symptom that you have not had before. You should do so promptly if it is associated with any other symptoms such as the following, which can indicate cancer.

Cracking or excessive dryness of your nipple
Changes to the color of the nipple or skin around the nipple (areola)
Change in the texture of the nipple or areola
Blood or other unexpected nipple discharge
A fixed lump or bump in the breast

Nipple inversion causes

The following details may help you better understand your symptoms. You should see a physician for nipple inversion that was not present before or if it occurs along with other concerning symptoms.

Genetic causes

Many people are born with naturally inverted nipples. This type of nipple inversion is usually benign and simply a variation in positioning. Women with genetically inverted nipples usually do not have problems with breastfeeding or other complications. On the other hand, some congenital genetic conditions are associated with certain specific morphologies and characteristics; in such conditions, inverted nipples are characteristic of the disease.

Malignant causes

Newly acquired inverted nipples may be a sign of cancer, especially if the symptoms are associated with nipple pain, bloody fluid or brown discharge from the nipple and changes in color and texture of the nipple and areola.

Infection-related causes

Nipple inversion may be the result of an infection.

Mastitis: Infection of the milk ducts of the breast is known as mastitis. Mastitis can result in cracked or blistering nipples that may retract into the skin. The inflammation from the infection can cause pain and swelling that is very common among women during breastfeeding.
Breast abscess: Infection in any part of the breast tissue can cause inflammation and result in an abscess (a pocket of pus). Sometimes these abscesses can also result in nipple inversion.

Traumatic causes

Though less common, direct or indirect trauma to the breast that results in scarring or fat necrosis, a condition in which there is an injury to an area of fatty tissue that causes breakdown and cell death, can also affect the nipple and cause inversion.

3 nipple inversion conditions

The list below shows results from the use of our quiz by Buoy users who experienced nipple inversion. This list does not constitute medical advice and may not accurately represent what you have.

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Breast infection (mastitis)

Mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth and redness of the breast. Mastitis most commonly affects women who are breast-feeding (lactation mastitis), although sometimes this condition can occur in women who aren't breast-feeding.

You should visit your primary care physician to confirm the diagnosis and discuss treatment options, such as antibiotics.

Rarity: Uncommon

Top Symptoms: fatigue, nausea, breast pain, signs of breast inflammation like redness, swelling or fever, fever

Symptoms that always occur with breast infection (mastitis): breast pain, signs of breast inflammation like redness, swelling or fever

Urgency: Primary care doctor

Breast cancer

Breast cancer has several names, depending on the part of the breast where it starts:

Lobular carcinoma affects the milk glands.
Ductal carcinoma affects the milk ducts.
Sarcoma affects the connective tissue.
Paget's Disease affects the nipple and areola.

Women over age 50 with a family history of the disease, and/or certain genetic factors, are most at risk, but anyone can get breast cancer at any age. It is rare in men but does occur.

Symptoms include a lump, thickening, or pain anywhere in the breast or armpit; red, flaky, or irritated breast or nipple skin; nipple discharge; and any area of irregular skin or misshapenness.

Many harmless conditions can cause similar signs, so it is important to see a medical provider about any of these symptoms.

Diagnosis is made through physical examination; imaging such as ultrasound, mammogram, or MRI; and sometimes biopsy.

Treatment involves a combination of surgery, radiation therapy, and chemotherapy.

The best prevention is a combination of screening mammograms as recommended by the medical provider, and monthly self-examination.

Breast abscess

Breast abscess is a complication of mastitis, which is an inflammation of the breast tissue. An abscess is a pocket of pus that forms within the breast, usually just under the skin.

Most susceptible are women who are breastfeeding. Bacteria can be transferred into the milk ducts from the skin or from the infant's mouth. Women not breastfeeding can be infected through a sore nipple or from a nipple piercing.

If a milk duct is blocked through trauma, compression, or incomplete emptying, bacteria can gain a foothold and an abscess can form.

The abscess forms a hot, reddened, painful lump in the breast. There will be flu-like symptoms of fever, chills, fatigue, and body aches.

Diagnosis is made through physical examination and sometimes a milk sample.

Treatment is with antibiotics along with rest, fluids, and over-the-counter pain relievers. Unless otherwise directed by the medical provider, it is safe to continue nursing the baby. If the abscess persists, it may be drained under local anesthesia with a needle and syringe.

Nipple inversion treatments and relief

There are many surgical and corrective procedures for benign nipple inversion symptoms not associated with underlying disease.

At-home treatments

If your nipple inversion is genetic and benign, there are various at-home interventions you can try in order to induce protrusion of the nipple.

Hoffman procedure: This is a procedure you can do at home where you place your thumbs on either side of your nipple at the base and press firmly into your breast tissue. You then gently pull your thumbs away from each other, then all around the nipple, and repeat. Regular stimulation may help your nipples protrude more often, but since everyone's breasts are different, do not become discouraged if this method does not work for you.
Suction: These devices function by pulling the nipple into a small cup, stimulating the nipple to protrude.

Let's get right into it and see what over-the-counter (OTC) options might help you out:

Nipple Shields - These can help gently coax your nipple out if the inversion is mild or due to temporary causes like breastfeeding issues. They're usually made of silicone and are easy to use.
Nipple Creams - Sometimes, nipple inversion can cause or result from dryness and irritation. Using a hydrating nipple cream can help improve skin elasticity and comfort.
Breast Shells - These can be worn inside your bra to help draw out inverted nipples gently over time. They're comfortable and can be used throughout the day.
Breast Pumps - Using a breast pump can sometimes help with inverted nipples, especially if you are breastfeeding. The suction can encourage the nipple to come out.

When to see a doctor

If you're looking for a more permanent solution, your physician may suggest surgery. There are two types of surgeries for nipple inversion correction:

Surgery that preserves the milk ducts: This type of surgery is known as the "parachute flap" technique. Women undergoing this procedure do not lose the ability to breastfeed or experience any changes in nipple sensation.
Surgery that does not preserve the milk duct: Though women undergoing this procedure also do not experience changes in nipple sensation, they do lose the ability to breastfeed.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.

Jeffrey M. Rothschild, MD, MPH.

Associate Professor of Medicine, Brigham and Women’s Hospital

Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...

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