Peau d’orange is a French term that means “skin of an orange” or “orange peel.” In medical writing, it describes skin that looks thick, pitted, or dimpled, like the outside of an orange.

Orange peel skin can occur with lymphedema (fluid buildup), or swelling, a common side effect of breast cancer treatments. Surgery and radiation therapy may lead to lymphedema, especially when lymph nodes are removed or damaged during treatment.

If lymphedema isn’t identified and treated early, it can lower your quality of life. This is why it’s important to report skin changes to your treatment team. We’ll cover what orange peel skin looks like, what may be causing it, and when it’s important to contact your healthcare provider.

🗳️ Did you notice any of these skin changes after breast cancer treatment?

Pitting or dimpling like the skin of an orange

Thickened skin

Discolored skin

More than one of these changes

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What Orange Peel Skin Looks Like

Orange peel skin looks dimpled or puckered like the outside of an orange. You may see skin thickening, pitted skin, and enlarged pores. One MyBCTeam member described it as their skin being “covered with tiny dimples.”

“I still have redness on the underside of my nipple, and the skin looks like orange peel. That breast hurts and stays sore a lot.”

— A MyBCTeam member

“Orange peel skin” doesn’t refer in any way to the color of an orange — though the symptom may be accompanied by other skin changes, such as skin discoloration, a rash, or peeling skin.

“I had only two radiation treatments, but my skin on my remaining breast got very dark in color and thick and bumpy, which I think might be ‘orange peel’ texture,” one MyBCTeam member shared.

Causes of Orange Peel Skin

Many different situations can lead to orange peel skin and other skin changes on the breast. Some of these may be worrying, while others are harmless.

Inflammatory Breast Cancer

Changes in skin texture, such as orange peel skin, can be a sign of breast cancer, specifically a rare type called inflammatory breast cancer (IBC) that is often mistaken for infections like mastitis. IBC may also cause one breast to feel warmer, heavier, and painful. The nipple may also retract or turn inside out.

But developing skin changes doesn’t mean a person has breast cancer. Orange peel skin is also a side effect of some breast cancer treatments, such as surgery and radiation. However, it is important to let your healthcare team know about any changes to your skin.

Orange Peel Skin After Treatment

Surgery and radiation can lead to breast edema (fluid accumulation in the breast), which can then cause changes such as swelling, sagging, and orange peel skin.

“I had a lumpectomy followed by radiation. My breast (around the nipple) feels tough … Like an orange peel.”

— A MyBCTeam member

Research suggests that breast edema is most often caused by breast-conserving therapy. This treatment includes surgery to remove the cancer while keeping as much of the breast as possible, followed by radiation therapy. Types of breast-conserving surgery include lumpectomy, quadrantectomy, segmental mastectomy, and partial mastectomy.

Orange Peel Skin and Lymphedema

Orange peel skin after breast surgery may be a sign of lymphedema. Certain breast cancer treatments, such as surgery and radiation therapy, can disrupt how the lymphatic system works by removing or damaging lymph nodes.

This can then lead to lymph fluid buildup and swelling, affecting lymphatic drainage and resulting in lymphedema. Lymphedema is most common in the arms and legs, but it can also affect the breast, chest, back, hands, or fingers.

Lymphedema is a common side effect of many cancer treatments. Lymphedema may show up right after having surgery or radiation — or months or years later.

In the early stages of lymphedema after breast cancer treatment, you may notice swelling of the arms, often on the same side where you received treatment. For example, lymphedema in the arms may occur on the same side of your body where you had breast-conserving surgery (BCS), especially if you had an axillary lymph node procedure along with the BCS.

In the later stages, chronic inflammation and scar tissue can build up in the affected limbs, changing the skin’s texture and resulting in orange peel skin.

What Kinds of Skin Changes To Expect After Treatment

Orange peel skin after breast cancer treatment may be accompanied by other skin changes. Radiation is a common culprit of skin side effects. In addition to orange peel skin, skin changes due to radiation may include:

• Roughness
• Swelling
• Itchiness
• Skin discoloration, such as redness or a bruised appearance, depending on your skin tone
• Peeling skin, often in the underside of the breast or skin folds

Burned or peeling skin after radiation is a common experience among MyBCTeam members:

• “Some of my skin did peel away after a few weeks, and the dark discoloration is still there after four years.”
• “I did have burning, mostly in my armpit and under my breast.”
• “I have had 32 treatments. My skin burned the last few weeks.”
• “My skin did burn and peel and ooze, like a very severe sunburn.”

If you experience skin changes after treatment, let your doctor know. They can usually prescribe or recommend a medication to relieve some of the discomfort, such as burned or peeling skin. For example, one MyBCTeam member shared, “I had redness and peeling. They gave me an ointment, and it healed within a week or so.”

When To Talk to Your Doctor

While skin changes are common and can be expected after surgery and radiation, it’s a good idea to get any changes checked out by your doctor so they can determine if it’s a side effect of treatment or something else.

Tell your doctor if you notice dimpled skin or orange peel skin after surgery, as this may be a sign of lymphedema. Lymphedema can also be caused by cancer cells blocking lymph nodes or lymph vessels, or it can be triggered by an infection.

If you notice swelling of the affected area that gets much worse within a day or two, talk to your doctor right away. This change is more likely a sign of an infection, but in some cases, it may be a sign of cancer recurrence.

In addition, because orange peel skin can be a symptom of IBC, it’s important to tell your doctor about this skin change.

Speaking of their experience with inflammatory breast cancer, one MyBCTeam member wrote, “My first symptom was a small hint of redness (quarter size), not always visible, and then a thickness of my breast tissue, then the orange texture. … Not everyone has the same symptoms, but please get checked.”

Skin discoloration and swelling on your breast can also be a symptom of potentially serious infections of the deep layers of the skin, such as cellulitis or mastitis.

Get medical care right away if you have swelling that gets worse quickly, skin that becomes more discolored or feels warm, a fever, severe pain, drainage, shortness of breath, or swelling in your arm. Both breast cellulitis and mastitis need treatment with antibiotics.

Orange peel skin does not always mean you have a more serious condition. Still, it’s best to tell your doctor if you notice this change. They can look for possible causes and recommend the right treatment.

Join the Conversation

On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.

Have you noticed orange peel skin on one or both of your breasts after treatment? Let others know in the comments below.