What causes breast skin changes?

Dryness, itching, or a rash may follow friction, contact with a new product, eczema, or other skin irritation. Infection such as mastitis can cause redness, warmth, swelling, and tenderness, sometimes with fever. Pregnancy, breastfeeding, and normal hormonal shifts can also alter breast appearance.

Dimpling, puckering, thickened skin, a newly inverted nipple, or a persistent one-sided change needs assessment. Breast cancer can present with a new change in breast shape or skin, while inflammatory breast cancer may cause rapid redness, swelling, warmth, and a peau d'orange texture. Paget disease of the breast can affect the nipple or areola with a persistent eczema-like change.

Note when the change began, whether it is spreading, and whether there is pain, discharge, a lump, or fever. Stop a newly introduced fragranced product if irritation is suspected, but do not rely on home treatment when the change persists or involves the nipple. A clinician can inspect the skin, examine the breast and armpit, and arrange tests when needed.

Photographs taken privately over time may help you describe progression, but they do not replace an examination. Mention pregnancy, breastfeeding, recent injury, and any medicines or skin products.

Book a prompt appointment for a new persistent rash, dimpling, puckering, thickening, nipple inversion, crusting, or discharge. Seek urgent advice for rapidly worsening redness, swelling, warmth, severe pain, fever, or feeling significantly unwell.

Could this be irritation or infection, or does it need breast imaging? What features make the change more concerning? Should the nipple or skin be tested, and what should I do if it spreads?