Skin changes can occur at the site of piercings. These changes are not always a cause for concern. For example, piercing bumps are harmless and may go away over time. However, keloid scars can continue to get bigger.

Although piercing bumps and keloid scars can initially look similar, there are ways to differentiate between them.

In this article, we explain what piercing bumps and keloids are and how to tell the difference between the two. We also discuss the treatment options for both, as well as the other conditions that may cause skin issues after getting a piercing.

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

Piercing bumps occur when the body’s immune system responds to the wound and initiates the healing response. This response leads to inflammation, which is what causes the bump.

A person may notice bleeding, bruising, and some swelling at the site of the piercing in the first few weeks after getting it. These symptoms are all normal. Other symptoms that are not typically a cause for concern may include:

  • itching
  • some whitish fluid coming from the site of the wound
  • crusting around the piercing jewelry

A keloid is a raised scar that occurs as a result of trauma or injury to the skin. Sometimes, this type of scar may appear after a piercing.

A keloid forms due to an overgrowth of fibrous tissue. In response to injury, cells in the skin — called fibroblasts — produce excessive collagen, which leads to the development of a keloid.

Keloids can take 3–12 months to develop after the original injury. They start as raised scars that can be pink, red, purple, or brown and typically become darker over time. The appearance can depend on the location of the keloid, as well as the person’s skin tone.

Earlobe keloid scars are likely to be round or oval. They can continue to grow over time — either quickly or slowly — and can become very large.

The texture of keloids can differ. They can feel soft and doughy or hard and rubbery. Other symptoms that a person with a keloid scar may experience include:

  • pain
  • itchiness
  • tenderness

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Initially, keloids and piercing bumps can look similar. However, over time, differences will emerge.

The following table shows some of the key differences between these skin changes:

Piercing bumpKeloid
LocationAround the piercing siteAround the piercing site but can extend beyond it
FormationSoon after a piercing3–12 months after piercing
SizeVaries, but after forming, it does not grow biggerMay start small and grow bigger over weeks, months, or years
ColorPink or flesh-coloredVaries, but it can become darker over time
FluidCommonUncommon

Piercing bumps are part of the body’s natural response to injury, and they do not typically require treatment. However, people can take steps to keep the area clean, prevent infection, and allow the piercing to heal.

The American Academy of Dermatology (AAD) recommend:

  • keeping piercing jewelry in, without changing or removing it, for at least 6 weeks
  • washing the hands before touching the piercing
  • washing the piercing with gentle soap and water once a day
  • twisting the jewelry inside the piercing a few times a day to keep the hole open
  • patting the area dry with a clean cotton pad after bathing or showering and avoiding using a towel, which can introduce bacteria

It is important to note that although the AAD also suggest applying rubbing alcohol to the piercing, the general guidance is to avoid doing this as it can slow healing.

Various treatment options are available for keloids. The appropriate treatment option can depend on several factors, including the type and size of the keloid. Treatment options include:

  • Corticosteroids: This type of medicine can help shrink the keloid. The AAD note that people require about four injections on average, having one every 3–4 weeks. They also say that 50–80% of keloids shrink after corticosteroid injection.
  • Surgery: A specialist can surgically remove the keloid. However, keloids can return, even after surgical removal.
  • Laser treatment: Laser treatment can help flatten the keloid scar and make it fade.
  • Cryotherapy: This treatment is appropriate to use on small keloids. During cryotherapy, a doctor freezes the keloid to soften it and reduce its size. Cryotherapy is not suitable for people with darker skin, due to the possibility of skin pigmentation changes.

The AAD recommend that people who know that they are prone to keloids avoid getting piercings.

Learn more about home care techniques for keloids here.

Bumps at the site of a piercing can sometimes be a sign of another condition or health issue. Some other possible causes include:

Infection

Infections in new piercings are quite common, and they can occur if the needle was not sterile or a person is unable to keep the piercing completely clean. The symptoms of an infected piercing include:

  • soreness
  • swelling and puffiness
  • yellow pus coming out of the piercing
  • nausea and vomiting

Contact dermatitis

Contact dermatitis is a type of skin rash that occurs when something that touches the skin irritates it. The rash may develop as a result of an allergy, friction, or exposure to something corrosive or toxic.

In piercings, possible causes of contact dermatitis include:

  • the metal in the jewelry
  • the metal in the needle or piercing gun
  • the products that the piercer uses to clean the area

The symptoms of contact dermatitis include:

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

Nickel is responsible for most jewelry allergies. Nickel is present in less expensive jewelry, but gold or silver jewelry may contain small amounts of it, so these could also cause a reaction.

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

If a person suspects that they have a keloid, they should speak with a doctor or dermatologist. Without treatment, the keloid may continue to grow.

A person should also seek the advice of a doctor if they are experiencing symptoms of an infection.

Piercing bumps and keloids are different skin conditions that can occur following a piercing. Piercing bumps tend to appear more quickly and do not grow in size, while keloids take time to form and can continue to grow over time.

A doctor or dermatologist can advise on the best way to treat keloids. Anyone who suspects that they have a keloid or another condition that may be causing a lump should speak with a healthcare provider.