Keloid, hypertrophic scar or piercing bump?
Three different conditions
When you see a swelling around a piercing, there are three possibilities. Usually the bump comes from simple irritation, but telling them apart matters because the treatment is different.
Piercing bump
Caused by irritation, fluid-filled or red, usually confined to the piercing. It shrinks when the cause is removed.
Hypertrophic scar
A raised, firm, pink mark; it doesn't extend beyond the wound boundary. It can improve over time; a dermatologist may recommend treatment.
Keloid
Scar tissue that grows beyond the wound boundary and does not regress on its own. It can occur in people with a family history. A dermatologist makes the diagnosis and treatment.
What should you do?
Don't diagnose yourself. Show it to your piercer and, if necessary, a dermatologist. If you are prone to keloids, talk to your doctor before getting a piercing.
What's the difference?
Both are excess scar tissue, but they behave differently. A hypertrophic scar stays within the wound boundaries and can shrink over time. A keloid can spread beyond the wound boundary and may not regress on its own. Most bumps seen after a piercing are not keloids but irritation bumps or hypertrophic scars.
Risk factors
The risk is higher in people who have formed keloids before and those with a family history of keloids. Keloids may be more common in people with darker skin tones. This information is not meant to scare you, but to help you make the right decision before a piercing.
Treatment and approach
Keloid treatment requires expertise and is usually carried out by a dermatologist. Squeezing or cutting the bump at home or applying “natural” mixtures can make it worse. See a doctor for diagnosis and treatment; your piercer can advise on changing or removing the jewellery.
What is a keloid and what is a hypertrophic scar?
Both are raised scars made of excess healing tissue. A hypertrophic scar stays within the wound boundaries and can shrink over time. A keloid extends beyond the wound boundaries, does not regress on its own and can grow. They are distinguished by clinical examination; it is hard to tell them apart for certain by appearance.
Who is at higher risk?
People with a family history of keloids and those who have developed keloids after previous skin trauma that left scars are at risk. If you have this history, it makes sense to tell your piercer before the piercing and consult a dermatologist if necessary. Areas such as the earlobe and chest are more prone to keloids.
See a doctor for treatment
If you notice a raised, growing or painful scar, see a dermatologist. The doctor will consider options such as injections, pressure therapy, silicone sheets, cryotherapy or surgery depending on your situation. Applying scar-removal products, pressure or cutting on your own can make the problem worse.
Risk assessment before a piercing
If you have a family history of keloids, it makes sense to consult a dermatologist before a piercing. The doctor assesses the level of risk and can tell you which spots are less risky. The piercer also uses this information to choose the spot and jewellery. If the risk is high, temporary options such as an ear cuff can be considered instead of a piercing.
The difference between a scar and a bump
A piercing bump (irritation bump) is a small swelling around the piercing and usually develops due to jewellery and pressure; it shrinks when the cause is removed. A keloid is an overgrowth of scar tissue and does not go away on its own. This distinction matters because the treatment approach is different. If you are not sure, show a photo to your piercer or doctor.
Common mistakes
- Calling every bump a keloid
- Trying to press or cut it at home
When should you get help?
If there is a swelling that is growing, spreading or painful, see a dermatologist.
This article is for general information and is not a substitute for medical advice. Consult your piercer or doctor about your personal situation.
Official and reliable sources
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FAQ
How do I know if I am prone to keloids?
If you have previously formed overgrown scar tissue on a wound or vaccination scar, you may be prone to keloids. Consult a dermatologist.
Can keloids be treated?
There are treatment options but they can recur; a dermatologist decides.
Does a hypertrophic scar go away?
It can improve over time; treatment may be needed.
This content is for general information only and does not replace medical diagnosis or treatment.