Skin dimpling describes an indentation or puckering on the skin’s surface. This article details the visual characteristics of dimpled skin, explores its common causes, and outlines when medical evaluation may be beneficial.
Visual Characteristics of Dimpled Skin
Dimpled skin often presents with a texture likened to an “orange peel,” also known as “peau d’orange.” This appearance includes pitted, lumpy, or uneven areas. The indentations can vary in depth, from shallow depressions noticeable only when the skin is pinched, to more profound pits that create a visibly rumpled surface with distinct peaks and valleys.
The distribution of dimpling can be localized or spread broadly across a body region. For instance, dimpling might appear as small, numerous depressions, or involve larger, more isolated indentations. Pitted scars, for example, can manifest as tiny, deep holes or broader, box-like depressions with sharp edges.
Beyond the indentations, dimpled skin can be accompanied by other noticeable changes. The affected area might show alterations in color, such as redness or discoloration, or feel different to the touch, perhaps firm, tight, or unusually warm. In some situations, the dimpling may not be constantly visible but instead becomes apparent only with certain movements, like raising an arm, or when muscles are tensed.
Common Causes of Skin Dimpling
One widespread cause of skin dimpling is cellulite, which arises from the interaction between fat deposits and the fibrous connective tissue beneath the skin. These fibrous bands, called septae, tether the skin to underlying muscles; when fat cells accumulate, they push upward against the skin while these cords pull downward, creating the characteristic uneven, dimpled surface. This phenomenon is more common in women, partly due to the vertical arrangement of their connective tissue fibers compared to the criss-cross pattern found in men.
Inflammation or infection can also lead to skin dimpling. Conditions such as cellulitis or mastitis can cause swelling and fluid accumulation (edema) in the tissues. This fluid buildup can cause the skin to thicken and appear pitted, as hair follicles become embedded in the swollen tissue. Lymphedema, a condition where lymphatic vessels are blocked, similarly causes fluid retention and can lead to a dimpled skin appearance.
Trauma or scarring represents another mechanism for dimpling. Injuries, surgical procedures, or the presence of underlying scar tissue can pull the skin inward, creating depressions. Fat necrosis, which is the death of fatty tissue often following injury or trauma, can also cause dimpling if it occurs near the skin’s surface. Additionally, pitted scars, often associated with severe acne or chickenpox, form due to a loss of collagen in the deeper skin layers, leading to sunken areas.
Certain medical conditions can manifest with skin dimpling. Inflammatory breast cancer (IBC), for instance, is a rare but aggressive form of cancer where cancer cells block the lymphatic vessels in the skin, causing swelling, thickening, and dimpling of the breast. Other types of breast cancer can also cause dimpling if a tumor grows and pulls on the surrounding breast tissue. Graves’ dermopathy, an autoimmune skin condition, can also present with dimpling, often on the shins and feet, due to specific carbohydrate accumulation.
When to Seek Medical Advice
If skin dimpling appears suddenly or rapidly, it warrants prompt medical evaluation, especially if it is new and not linked to a known cause.
The presence of accompanying symptoms alongside skin dimpling should also prompt a visit to a healthcare professional. These signs can include pain, redness, warmth, swelling, or itching in the affected area. The appearance of a palpable lump, nipple changes such as inversion or discharge, or a noticeable thickening of the skin also indicate a need for medical assessment.
The location of the dimpling is also a consideration. Dimpling in unusual areas, especially on the breast, is a significant concern. Unilateral dimpling, such as on one side of the body or a single breast, warrants thorough medical examination to rule out underlying conditions. If the dimpling worsens, spreads, or changes in appearance over time, or if symptoms do not improve with initial treatments like antibiotics, seeking further medical advice is important for an accurate diagnosis and appropriate management.