What Is Skin Dimpling? Causes And When Its A Concern

Skin dimpling is a small indentation or pitting in the skin’s surface. It happens when something pulls the skin inward from below or when tissue beneath the skin shrinks, thickens, or attaches abnormally to the surface layer. Most dimpling is harmless and long-standing, but dimpling that appears suddenly or changes over time can be a sign of a medical problem that needs evaluation.

What Is Skin Dimpling Causes And When Its A Concern

Skin dimpling has two broad categories: dimpling that has always been there or develops slowly, and dimpling that is new. The first category is usually structural or harmless. The second deserves a doctor’s attention.

Dimples on the cheeks and chin are the most familiar example. They form because of differences in how facial muscles attach to the skin. This is a normal variation, present from birth or early childhood, and not a health issue.

Other common causes of long-standing dimpling include:

• Cellulite. The familiar puckering on thighs, hips, and buttocks. It happens when fat pushes through a web of fibrous bands that connect skin to deeper tissue. It is extremely common and not a disease.
• Scarring. Acne, injury, or surgery can leave a small depression where tissue was lost or tethered.
• Lipoatrophy. Loss of fat under the skin from injections, autoimmune conditions, or certain medications. This leaves a sunken area.
• Congenital pits. Some people are born with small dimples near the lower spine, ears, or other sites. Most are harmless.

The concern level changes when dimpling is new, when it appears in a spot that was previously smooth, or when it comes with other symptoms. A new dimple in the breast, for example, is treated differently than cellulite on the back of a thigh.

What Causes a New Dimple in the Breast?

A new breast dimple is a symptom that warrants prompt medical evaluation. It can be caused by a benign (non-cancerous) process, but it is also a recognized sign of breast cancer, so it should never be dismissed without a clinical exam.

When a tumor or abnormal tissue pulls on the fibrous strands inside the breast, it can tug the skin inward and create a dimple or puckering. This is sometimes called skin retraction. The same effect can happen with a benign cyst, scar tissue from a past biopsy, or a fat necrosis (a lump of damaged fatty tissue).

Signs that raise concern include:

• A dimple that is new or that you have not noticed before
• Skin that looks like the peel of an orange (sometimes called peau d’orange)
• A nipple that turns inward (nipple inversion) when it did not before
• A lump you can feel, especially one that is firm and fixed
• Redness, warmth, or scaling of the breast skin
• Nipple discharge, particularly bloody or clear discharge from one nipple

Not every breast dimple is cancer. Many are caused by harmless changes. But because the stakes are high and early detection matters, the standard approach is to have any new breast dimple checked by a clinician. Imaging such as mammogram or ultrasound is often used to sort out the cause.

Can Dimpling Be a Sign of Something Else?

Dimpling is not limited to the breast. It can appear in several other contexts, and the meaning depends heavily on location and timing.

Cellulite is the most common cause of dimpling on the thighs, buttocks, and abdomen. It affects most adult women to some degree. The fibrous bands that create the puckering are normal anatomy. Cellulite is a cosmetic concern, not a medical one, and it does not signal poor health.

Lymphedema is swelling caused by a buildup of lymph fluid, often after lymph node surgery or radiation. In its early stages, pressing on the swollen area can leave a temporary indentation (pitting edema). This is a medical condition that needs management, not a cosmetic issue.

Pitting edema in the legs, ankles, or feet can also come from heart, kidney, or liver problems, or from certain medications. When you press a finger into the swollen area and a dimple remains for a few seconds, that is pitting edema. It should be evaluated.

Morphea is a rare skin condition that causes patches of thickened skin. In some cases, the skin becomes bound down and creates a dimpled or sunken appearance. It is distinct from systemic sclerosis and is diagnosed by a dermatologist.

Fat necrosis can occur anywhere there has been trauma to fatty tissue, including the breast. It forms a firm lump that may dimple the skin. It is benign but can mimic cancer on exam, so imaging is often needed to tell them apart.

When Should You See a Doctor About Skin Dimpling?

See a doctor if the dimpling is new, if it is in the breast, or if it comes with any of the warning signs below. Do not wait to see if it goes away on its own.

Warning signs that warrant a medical visit:

• Dimpling that appeared suddenly or within a few weeks
• Dimpling in the breast, chest, or armpit area
• A dimple that is getting deeper or larger
• Skin that is red, warm, swollen, or painful
• Swelling in a limb that pits when pressed
• A lump or mass you can feel under the dimpled skin
• Nipple changes, discharge, or a new inversion
• Dimpling along with fever, weight loss, or night sweats

Long-standing dimples that have not changed — cheek dimples, old acne scars, cellulite that has been stable for years — do not require a doctor’s visit. The trigger for evaluation is change, not the presence of dimpling itself.

How Is the Cause of Skin Dimpling Diagnosed?

Diagnosis starts with a physical exam and a history. The doctor will ask when the dimpling appeared, whether it has changed, and whether there are other symptoms. Location matters a great deal. Breast dimpling follows a different path than dimpling on the thigh.

For breast dimpling, the usual next step is imaging. A diagnostic mammogram and often an ultrasound are used to look at the tissue beneath the dimple. If imaging shows something suspicious, a biopsy may be recommended to get a tissue sample.

For dimpling elsewhere, the workup depends on the suspected cause:

• Pitting edema: blood tests, urine tests, and sometimes an ultrasound of the heart or legs to check heart, kidney, and liver function.
• Fat necrosis or scarring: often diagnosed by exam and imaging, sometimes with a biopsy to rule out other causes.
• Morphea: diagnosed by a dermatologist, sometimes with a skin biopsy.
• Cellulite: diagnosed by appearance alone. No testing is needed.

There is no single test for dimpling. The cause determines the workup.

What Treatments Exist for Skin Dimpling?

Treatment depends entirely on the cause. There is no general treatment for dimpling as a symptom.

For cellulite, many products and procedures are marketed, but the evidence for most is limited. Some studies suggest that certain laser and radiofrequency treatments can improve the appearance of cellulite for a period, but results vary and the effect is often temporary. No treatment has been shown to permanently remove cellulite. Creams and supplements marketed for cellulite have little to no reliable evidence behind them.

For breast dimpling, treatment is directed at the underlying cause. If cancer is found, treatment may involve surgery, radiation, chemotherapy, or other approaches depending on the type and stage. If the cause is benign, no treatment may be needed beyond monitoring.

For pitting edema, treatment focuses on the underlying condition — for example, managing heart failure, kidney disease, or adjusting medications. Diuretics are sometimes used, but only under medical supervision.

For morphea, treatment may include topical creams, light therapy, or medications that suppress the immune system, depending on severity and location. This is managed by a dermatologist or rheumatologist.

For fat necrosis and scarring, treatment is usually not needed unless the area is bothersome. In some cases, a doctor may recommend removal.

Can Skin Dimpling Be Prevented?

Most dimpling cannot be prevented because it comes from normal anatomy, genetics, or aging. Cheek dimples, cellulite, and congenital pits are not preventable.

Some causes are avoidable or manageable:

• Protecting skin from injury and treating acne early may reduce scarring that leads to dimpling.
• Managing heart, kidney, and liver conditions can reduce the risk of pitting edema.
• Avoiding unnecessary trauma to the breast may lower the chance of fat necrosis, though this is not always within your control.

For breast dimpling, there is no known way to prevent it. The best approach is awareness — knowing what is normal for your body and reporting changes promptly.