How to get rid of inverted nipples?

How do I get rid of my puffy nipples?

• How do I get rid of my puffy nipples? Is there any other way besides surgery?

• Answer:

  Hi himynameisben, Please note the disclaimer at the bottom of this page. "Important Disclaimer: Answers and comments provided on Google Answers are general information, and are not intended to substitute for informed professional medical advice." I can only provide you with general information - your family physician will be able to counsel and advise you on what is best for you. The condition is called Male Gynecomastia - (Male Breast Enlargement) Simply put it is excessive development of the breast in the male. The Male Puffy Nipple from Gynecomastia http://www.plasticsurgery4u.com/procedure_folder/male_breast/male_puffy_nipple.html "A puffy nipple, although a common patient description of this problem, is not an accurate. The area swollen includes the nipples, areola, and surrounding region. In this male patient, the swelling was diffuse through the chest." ================================================= THE ANALYST - Male Gynecomastia http://www.digitalnaturopath.com/cond/C676545.html "Gynecomastia is a common disease of the male breast where there is a benign glandular enlargement of that breast at some time in the male's life. It usually consists of the appearance of a flat pad of glandular tissue beneath a nipple which becomes tender at the same time. The development may be on one or both breasts. There is rarely a continued growth of the breast tissue; ordinarily the process is of brief duration and stops short of the production of permanent enlargement of the breast. Gynecomastia is found only in males, and the signs can appear any time in a male's lifetime. It is the leading breast disorder in males and it accounts for 60% of all disorders of the male breast. About 85% of male breast masses are due to gynecomastia and 40% of the cases affect pubescent boys.. Approximately 40% of normal men and up to 70% of hospitalized men have palpable breast tissue. Active gynecomastia in autopsy data is between 5 and 9%. In one study, more than 80% of hospitalized patients with a body mass index (BMI) of 25 or greater had gynocamastia. About 70% of pubertal males required no treatment. If the threshold for judging that the breast is enlarged is set at 2cm in diameter, the incidence is 32 to 36% in normal aged men 17 to 58 years. Recommendations for Male Gynecomastia: Diet Alcohol Avoidance Several studies indicate a potential role for prolactin and estrogen in the pathogenesis for feminization. Male alcoholic patients frequently show evidence of feminization that is manifested by gynecomastia, spider angiomata, palmar erytherma and changes in body hair patterns. Alcoholic men show a positive association between the presence of clinically apparent gynecomastia and elevated circulating levels of prolactin. The gynecomastia found in alcoholic patients is characterized by a proliferation of the stroma and ducts that are known to be estrogen-positive. Hormone Estrogen-balancing Medications Males with gynecomastia often have an elevation of plasma levels of estrogen which is believed to be due to peripheral conversion of weak adrenal androgens to estrogen. Testosterone Gynecomastia is a common condition in athletes who use steroids or testosterone to build muscle. The condition is caused by the aromatization of testosterone into estrogens. Gynecomastia may be avoided through the use of dihydrotestosterone instead of other forms of testosterone. It can actually even be applied as a treatment for gynecomastia. A further advantage of dihydrotestosterone is that increased levels of the hormone are correlated to increased sex drive and increased sexual function. Not recommended: Melatonin One case of painful gynecomastia has been reported involving a 56 year old man who had been suffering from amyotrophic lateral sclerosis and was taking 1 to 2mg melatonin per day over a 1 1/2 year period. As the gynecomastia disappeared after melatonin use was discontinued, it was suspected that the melatonin caused this side effect. Surgery/Invasive Surgery Often no cause is found for the disorder and the gynecomastia may not resolve on it's own. In these cases, surgery is frequently the best solution." Further information on this subject can be found here. http://www.digitalnaturopath.com/data/Gynecomastia.html "Gynecomastia is a common disease of the male breast where there is a benign glandular enlargement of that breast at some time in the male's life. It usually consists of the appearance of a flat pad of glandular tissue beneath a nipple which becomes tender at the same time. The development may be on one or both breasts. There is rarely a continued growth of the breast tissue; ordinarily the process is of brief duration and stops short of the production of permanent enlargement of the breast. Gynecomastia is found only in males, and the signs can appear any time in a male's lifetime. It is the leading breast disorder in males and it accounts for 60% of all disorders of the male breast. About 85% of male breast masses are due to gynecomastia and 40% of the cases affect pubescent boys.. Approximately 40% of normal men and up to 70% of hospitalized men have palpable breast tissue. Active gynecomastia in autopsy data is between 5 and 9%. In one study, more than 80% of hospitalized patients with a body mass index (BMI) of 25 or greater had gynecomastia. About 70% of pubertal males required no treatment. If the threshold for judging that the breast is enlarged is set at 2cm in diameter, the incidence is 32 to 36% in normal aged men 17 to 58 years. Many who suffer from this disease have a disturbance in the proper ratio of androgen and estrogen levels. The normal ratio of the two hormones in plasma is approximately 100 to 1. The etiology of gynecomastia in patients with a known documented cause appears to be related to increased estrogen stimulation, decreased testosterone levels, or some alteration of the estrogens and androgen so that the androgen-estrogen ratio is decreased. From this information it was discovered that there is also a lower ratio of weaker adrenal androgens (delta 4 androstenedione and dehydroepiandrosterone [DHEA]) found in youths with this disease. It was once believed that there was an imbalance in the ratios of testosterone to estrogen or estradiol, but this is now known to be untrue. There are three areas the can be attributed to the cause of gynecomastia: physiologic, pathologic and pharmacologic. Enlargement of the male breast can be a normal physiologic phenomenon at certain stages of life or the result of several pathologic states. In the case of physiologic gynecomastia the disease can occur in a newborn baby, at puberty or at any time in a man's life. In the newborn, transient enlargement of the breast is due to the action of maternal and/or placental estrogens. The enlargement usually disappears within a few weeks. Adolescent gynecomastia is common during puberty with the onset around age 14. It is often asymmetrical and frequently tender. It regresses so that by the age of 20 only a small number of men have palpable vestiges of gynecomastia in one or both breasts. Gynecomastia of aging also occurs in otherwise healthy men. Forty percent or more of aged men have gynecomastia. One explanation is the increase in age in the conversion of androgens to estrogens in extra-glandular tissues. Drug therapy and abnormal liver functioning can also be causes of gynecomastia in older men. When the disease is pathologic the patient can have increased estrogen secretions, increased conversion of androgens to estrogens or decreased androgen activity due to a failure in protein receptors. Increased estrogen secretions are found in such diseases and disorders as Hermaphroditism, Kleinfelter's syndrome, congenital adrenal hyperplasia, and adrenal carcinoma or testicular tumors. In the second case some examples are adrenal carcinoma, liver disorders, malnutrition and thyrotoxicosis. Decreased androgen activity can be found in complete testicular feminization, incomplete testicular feminization and Reifenstein's syndrome. Many drugs can cause gynecomastia by several mechanisms. The drugs can either act directly as estrogens or cause and increase in plasma estrogen levels. Boys and young men are particularly sensitive to estrogen, and can develop gynecomastia after the use of dermal ointments containing estrogen or after the ingestion of milk or meat from estrogen-treated animals. There have been examples where the mother prepared sandwiches for her boys after applying estrogen cream to her skin. Small amounts of estrogen were consumed by the boys and reversible gynecomastia resulted. Some examples of drugs that may have cause gynecomastia include Cannabinoids (methane and marijuana), Psychotropics (phenothiazine, butyrophenone and reserpine), Antihypertensives (reserpine, alphamethyldopa and spironolactone), Cardiac (digitalis), Gastrointestinal (cimetidine, metoclopramide and domperidone), Antituburculous (isoniazid), Cytoxic (cyclophosphamide, mustine, vincristine and mitotane) and Hormonal (sex steroids, gonadotropins and antiandrogens). Use of these drugs, however, will rarely cause gynecomastia. In some instances, the feminization is due to effects of drugs on liver functions. Signs may appear at any time in a male's life, although the most common time of onset is during puberty. At the first indication of the disease the patient will feel pain and tenderness in the breast area due to the rapid development of the breast. The breasts grow because of the enlargement of the glandular tissue. The concentric arrangement of the connective tissue around the ducts is a characteristic feature of the active phase of gynecomastia. The enlargement of the breast is usually bilateral but some cases have unilateral enlargement. In the case of unilateral enlargement, induration, fixation, or bloody discharge should raise the possibility of cancer. It may be hard to distinguish true breast tissue from masses of adipose tissue without true enlargement (lipomastia). In such cases, a real case of gynecomastia can be distinguished by mammography or by sonography. A satisfactory diagnosis can be made in only half or less of patients referred for gynecomastia. This is a result of insufficient diagnostic techniques, causes that are still undefined or difficult to diagnose, or in some instances, gynecomastia may be normal rather than due to a pathologic state. This disease should only be investigated carefully if there is a negative drug history, if the breast is tender (indicating rapid growth), or if the breast mass is larger than 4cm in diameter. A decision to perform an endocrine evaluation depends on the clinical context. An example would be gynecomastia associated with signs of under androgenization. Obesity can often be confused with gynecomastia. To prevent this, the doctor can palpate the breast to see if there is a lack of glandular elements that would indicate only obesity. Once the signs become evident, the doctor needs to assess the patient with a number of test to give a proper diagnosis since many other diseases and disorders are commonly involved. This can be done with a physical examination. The head and neck area may show signs of a pituitary tumor or goiter which is found in Graves disease. The skin and abdomen may reveal signs of liver failure and the testes should be examined for asymmetric enlargement in Klinefelter's syndrome. Other diseases related to gynecomastia include: testicular tumors, hypothyroidism and hyperthyroidism, Cushing's disease, cirrhosis, spinal cord lesions, Hodgkin's disease, enzymatic defects in androgen synthesis and androgen resistance syndromes, and many others. The evaluation of patients with gynecomastia should include a careful drug history, measurement and examination of the testes, evaluation of liver function and endocrine evaluation to include measurement of serum androstenedione or 24 hour urinary 17ketosteriods, plasma estradiol and HCG, and plasma luteinizing hormone (LH) and testosterone. If LH is high and testosterone is low, the diagnosis is usually testicular failure. If LH and testosterone are both low, the diagnosis is usually increased estrogen production. If they are both high, the diagnosis is either an androgen resistance state or a gonadotropin secreting tumor. In true gynecomastia these tests would prove to be unnecessary because the symptoms would regress. When the primary cause can be identified and corrected, breast enlargement usually diminishes until it usually disappears. For example, androgen replacement therapy may produce dramatic improvement in men with testicular insufficiency. However, if the gynecomastia is of long duration (and fibrosis has replaced the original ductal hyperplasia), correction of the primary defect may not be followed by resolution. In this case, surgery would be the only effective treatment. Candidates for surgery include those with several psychologic or cosmetic problems, continued growth, or a suspected malignancy. Conventional Treatment The treatment selected for this disease is related to how the patient was affected by the disease. The treatment for a person who contracted the disease through certain drug use will be treated different from a person who is affected from a related disease. If gynecomastia is contracted through drug use, the patient will need to discontinue the medications that are associated with the disease. The only exception is when there is a life threatening illness involved, and there is no alternative medication available. For those suffering from gynecomastia, the doctor may prescribe antiestrogens such as clomiphene citrate or tamoxifen to eliminate tenderness of the breast. The non-aromatizable androgen dihydrotesosterone also has been reported to reduce gynecomastia by reducing testicular secretion of estradiol, by decreasing peripheral conversion of precursors to estradiol and by increasing circulating levels of androgen. In patient with painful gynecomastia and who are not candidates for other therapy, treatments with antiestrogens such as tamoxifen may be used. When other related diseases are the cause for the onset of gynecomastia, treatment of these diseases will often cure gynecomastia, too. The removal of a sex steroid producing tumor or treatment of thyrotoxicosis are two examples. Testosterone treatment of androgen deficiency will also cause great improvement in this condition. Prophylactic radiation of the breasts prior to the institution of diethylstilbestrol therapy is effective in preventing gynecomastia and has a low complication rate in elderly men. In most cases of true gynecomastia the signs and symptoms should regress in about a year. However, in the case of severe gynecomastia where the breast has an increase of fibrous tissue stroma the patient will require a surgical reduction mammoplasty. Once this has been done the tissue is sent to a lab to be examined. The results should show elongated circular ducts imbedded in cellular fibrous tissue with a rubbery fatty quality. From these laboratory tests it can be determined if there is any cribiform epithelial hyperlasia or a case of carcinoma. Although the relative risk of cancer of the breast is increased in men with gynecomastia, it is rare nevertheless. There are so many causes and factors that lead to the disease gynecomastia that it is very difficult for researchers to try to agree upon one main factor. So many of the cases differ from one another, and, perhaps, no one cause will ever be agreed upon as the leading factor of the disease. As long as there is no other underlying disease or disorder, gynecomastia is not a life threatening disease. Experimentation with hormone therapy is the main research being tested at this time." ================================================= Drug Side Effects - Gynecomastia Male Breast Enlargement http://www.plasticsurgery4u.com/procedure_folder/male_breast/gynecomastia_causes.html There are many possible reasons for male breast growth. If caused by a medical problem, this should be corrected first. Such issues can be investigated by your internist or an endocrinologist. In most cases there is no known cause. A complete discussion of the many possible causes for gynecomastia is beyond the scope of this introduction. These drugs (according to the Physician Desk Reference) can cause gynecomastia as a side effect. The risks are generally very low for male breast enlargement from these medications, but breasts in men can be a cause for embarrassment. Some medications may be important for your other medical problems. There are other causes of gynecomastia male breast enlargement. (see long list from A - Z) ================================================= Gynecomastia Types and Treatments by James J. Romano, MD http://www.jromano.com/text/gynecomastia.html "Gynecomastia is usually strictly defined as the visible or palpable development of breast tissue in men. The term comes from the Greek words gyne meaning "woman" and mastos meaning "breast." In practical terms, this means abnormally large breasts on men. This is often related to the occurrence of excess fat or overdeveloped muscles. The condition is relatively common in adolescent boys, and 90% of the time symptoms disappear in a matter of months, or, as adolescence wanes, a few years later. But the remaining 10% are burdened with a social handicap that causes a deep and complex shame, and often puts a man?s relationship with his body at risk Drugs, medications, hormonal imbalance, genetic conditions, and exogenous hormones can all cause gynecomastia. During puberty it is normal for most boys to develop some proliferation of breast tissue. Ordinarily this condition is self-limited and subsides within 6 to 18 months. When this gynecomastia persists, it is often embarrassing and psychologically debilitating. Removal of the excess breast parenchyma is the only effective treatment. This condition can be accentuated if the patient is overweight. Marijuana usage is commonly linked to gynecomastia. Men who are taking estrogen's or testosterone inhibitors because of prostate cancer or patients with liver disease who have a hormonal imbalance are also susceptible to this condition. Gynecomastia can develop as a result of taking anabolic steroids to enhance athletic performance or bodybuilding. Appropriate diagnostic studies are necessary prior to treatment, particularly in individuals taking anabolic steroids. These patients should also be evaluated for liver and cardiac disease prior to correction the gynecomastia. Gynecomastia can be emotionally devastating. Feelings of shame, embarrassment and humiliation are common. Men often do not feel masculine in a society where masculinity is exalted. Lack of self-confidence commonly threads itself through many aspects of the individual's life. A man or boy with gynecomastia struggles with anxiety over such simple acts as taking off his shirt at the beach or participating in gym classes in grade school or high school. Men often have a very difficult time talking about their breasts to anyone, but it is the first step toward relief. Realizing that they are not alone and that there is a cure offer powerful remedies and a major advancement toward healing. CLASSIFICATIONS OF GYNECOMASTIA Gynecomastia has been divided into four types: Type I is known as pubertal or benign adolescent breast hypertrophy. This refers to the quite common situation seen in pubertal males. It is usually present between the ages of 10 to 14. The incidence may be as high as 60-70%. It is typically a firm, tender, subareolar mass anywhere from 1-5 cm in diameter. These young men frequently complain of pain in the breasts to the touch or when wearing tight clothing. It usually spontaneously resolves within 2 years or less. Type II is the condition where there is natural gynecomastia without evidence of underlying disease, or with evidence of organic disease (including the use of certain drugs). This type refers to a generalized, nonpainful breast enlargement. In this type it is helpful to differentiate between naturally occurring gynecomastia versus breast enlargement due either to an abnormal (pathologic) process or to the use of certain drugs. Careful history taking regarding the time of onset, family history, duration of enlargement, history of systemic illness, weight change, and drug or medication use, is important. Physical examination should include height, weight, blood pressure, breast size, and careful palpation of both breasts and genitals, in addition to a neurological assessment. Type III gynecomastia is general obesity simulating gynecomastia or the occurrence of excess fat in and around the breast or chest area. This is probably the most often seen type. Type IV is hypertrophy of the underlying pectoral muscle." CLASSIFICATION OF CAUSES OF TYPE II GYNECOMASTIA I. Idiopathic (no known cause) II. Familial causes a. Associated with anosmia (lack of smell) and testicular hypertrophy. b. Reifenstein?s syndrome (male pseudohermaphroditism secondary to partial androgen insensitivity). c. Associated with hypogonadism and small penis. III. Specific illnesses or syndromes a. Kleinfelter b. Male pseudohermaphroditism c. Testicular feminization syndrome d. Tumors e. Leukemia f. Hemophilia g. Leprosy h. Chronic glomerulonephritis IV. Miscellaneous drugs a. amphetamines b. anabolic steroids c. birth control pills d. cimetidine e. diazepam f. corticosteroids g. digitalis h. estrogens j. human chorionic gonadotropin k. insulin l. isoniazid and other TB drugs m. ketoconazole n. marijuana o. methadone and other narcotics p. reserpine q. tricyclic antidepressants ================================================= Enlarged breasts in adult men - Health Information provided by MayoClinic.com http://www.ohiohealth.com/healthreference/reference/7BB5F30F-8628-4876-B280D38A83B9965B.htm "In adult males, the most common cause of gynecomastia is hypogonadism (testosterone deficiency). Gynecomastia also may occur as a result of: Use of some medications such as estrogens, spironolactone or digitalis. Marijuana use, which causes male breast enlargement due to effects on hormone receptors. Chronic liver disease, which can upset the normal balance between male and female sex hormones in men. Rare tumors of the endocrine glands that may produce female hormones. Breast cancer. Breast cancer is rare in men. It occurs at about one percent the frequency that it does in women. It's not certain if gynecomastia increases the risk of breast cancer in men. Breast cancer should be considered if: Breast enlargement is only on one side. Breast tissue feels hard. The nipple area is deformed. Blood comes from the nipple. When gynecomastia occurs in adult males, it requires medical evaluation." ================================================= On the following two links... See illustrations and move your cursor over the purple arrows and the drawing will demonstrate the various common types of gynecomastia anatomy. Anatomy of the Enlarged Male Breast - Gynecomastia http://www.plasticsurgery4u.com/procedure_folder/male_breast/gynecomastia_anatomy.html Skin Fat Muscle Gynecomastia Anatomy Fat Only (default view) Gynecomastia Anatomy of Fat with some Threads of Gland Gynecomastia Anatomy of Fat with More Glandular Tissue Gynecomastia Anatomy of Some Fat and Large Gland Mass The gland is usually centered under the areola and is often attached to the nipple as shown on these drawings. When the skin is tightened over the mousse, the mass of gland may protrude. Treatment of gynecomastia depends on the problem" ***** Anatomy of the Male Chest and Gynecomastia http://www.plasticsurgery4u.com/procedure_folder/male_breast/anatomy_chest.html Nipple can lie flat or protrude from the areola. Areola is the colored area around the nipple. Fat - there is a normal amount of fat between the skin and muscle. Excess fat can accumulate along the lower breast and can give a feminine appearance to the male chest. Gland - tissue is located just behind the nipple and areola. The normal male breast has a contour made by muscle, fat, and skin. There can be glandular tissue that can range from a very small to quite large mass. Contour of the chest comes from the underlying elements. Muscle shape is important for the shape of the breast, exercise can be important to improve the "male look" by improving the tone of the muscles. Excess fat or gland especially along the lower breast can make the chest have a "female" contour. Diet and exercise can help with generalized fat, but cannot be directed to the specific shape of the chest fat. Neither diet nor exercise will help with glandular tissues. As the muscle size increases, fat and gland are pushed further towards the surface making them more obvious. Surgical contouring can address the localized fat and gland. There are many pages of details about cosmetic male chest contouring options. However, the best place to explore your concerns is during a consultation. Dr. Bermant and his staff will be glad to help you better understand your options during a consultation after an evaluation." Keyword search: male enlarged breast male puffy nipples male chest and gynecomastia male gynecomastia benign glandular enlargement males Best regards, tlspiegel