How to tell the difference between a piercing bump and a keloid, and what to do about each

Although piercing bumps and keloid scars may appear similar at first, there are ways to tell them apart.

This article will explain what piercing bumps and keloids are and how to tell them apart. We also go over treatment options for both, as well as other conditions that can lead to skin problems after getting a piercing.

Pin it to Pinterest Getty Images/Eugenio Marongiu

Piercing bumps are small lumps that can appear after a piercing. They frequently occur after cartilage piercings, such as nose or upper ear piercings.

Piercing bumps appear when the body's immune system responds to a wound and begins the healing process. This response causes inflammation, which causes the bump.

In the first few weeks after getting a piercing, a person may experience bleeding, bruising, and swelling at the site of the piercing. All of these symptoms are normal. Other symptoms that are usually not cause for concern include:

• itching
• some whitish fluid oozing from the wound
• crusting in the area of the piercing jewelry

A keloid is a raised scar that develops as a result of skin trauma or injury. This type of scar can appear after a piercing.

A keloid develops as a result of fibrous tissue overgrowth. In response to injury, skin cells called fibroblasts produce excessive collagen, resulting in the formation of a keloid.

Keloids can form 3-12 months after the initial injury. They begin as raised scars that can be pink, red, purple, or brown in color and typically darken over time. The appearance of a keloid can vary depending on its location and the person's skin tone.

Earlobe keloid scars are most likely round or oval. They can continue to grow over time, either quickly or slowly, and can reach very large sizes.

Keloids' textures can vary. They can have a soft and doughy texture or a hard and rubbery texture. A person with a keloid scar may also experience the following symptoms:

Keloids and piercing bumps can appear similar at first. However, differences will emerge over time.

The table below highlights some of the key differences between these skin changes:

Piercing bumps are a normal part of the body's response to injury and usually do not require treatment. People can, however, take precautions to keep the area clean, prevent infection, and allow the piercing to heal. These are some examples:

• retaining piercing jewelry in place for at least 6 weeks without changing or removing it
• Before touching the piercing, wash your hands.
• Once a day, clean the piercing with a saline solution or gentle soap and water.
• after bathing or showering, patting the area dry with a clean cotton pad and avoiding using a towel, which can introduce bacteria

Although the American Academy of Dermatology (AAD) recommends applying rubbing alcohol to the piercing, this is generally discouraged because it can slow healing.

Keloids can be treated in a variety of ways. Several factors, including the type and size of the keloid, can influence the best treatment option. Among the treatment options are:

• Corticosteroids: This type of medication can help the keloid shrink. According to the AAD, people need four injections on average, with one every three to four weeks. They also claim that corticosteroid injections cause 50-80% of keloids to shrink.
• A keloid can be surgically removed by a specialist. Keloids, however, can reappear even after surgical removal.
• Laser treatment: Laser treatment can help flatten and fade keloid scars.
• Cryotherapy: This treatment is suitable for small keloids. Cryotherapy involves a doctor freezing the keloid to soften it and reduce its size. Due to the possibility of skin pigmentation changes, cryotherapy is not recommended for people with darker skin.

The AAD advises people who are prone to keloids to avoid getting piercings.

Learn more about keloidal home care techniques here.

Bumps at the site of a piercing can occasionally be a sign of another condition or health problem. Other potential causes include:

Infection

Infections in new piercings are quite common, and they can occur if the needle was not sterile or if the piercing is not kept completely clean. The following are symptoms of an infected piercing:

• soreness
• puffiness and swelling
• The piercing is filled with yellow pus.
• vomiting and nausea

Dermatitis due to contact

Contact dermatitis is a type of skin rash that develops when something that comes into contact with the skin irritates it. The rash could be caused by an allergy, friction, or exposure to something corrosive or toxic.

Possible sources of contact dermatitis in piercings include:

• the metal used in jewelry
• the metal in the needle or piercing gun
• the products used by the piercer to clean the area

Contact dermatitis symptoms include:

• blisters filled with fluid
• hives
• a stinging or burning sensation
• itching
• dryness
• discoloration
• inflammation
• tenderness

The majority of jewelry allergies are caused by nickel. Nickel is found in less expensive jewelry, but gold and silver jewelry may also contain trace amounts of it, which could cause a reaction.

The best way to combat a jewelry allergy is to replace the metal with one that is hypoallergenic, such as titanium, stainless steel, or 18- or 24-karat gold.

If a person believes they have a keloid, they should consult a doctor or dermatologist. Without treatment, the keloid may spread.

If you have symptoms of an infection, you should see a doctor.

Piercing bumps and keloids are two types of skin conditions that can develop after a piercing. Piercing bumps appear quickly and do not grow in size, whereas keloids take time to form and can grow over time.

A dermatologist or doctor can advise you on the best way to treat keloids. Anyone who suspects they have a keloid or another condition that is causing a lump should consult a doctor.