How to Treat a Piercing Bump vs. a Keloid: What’s the Difference?

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We’ve outlined the distinctions between piercing bumps and keloids, as well as what to do for each, for all of you newbies out there.

Getting a new piercing can be very exciting if you like jewellery. But what happens if you look at your bling in the mirror and see a strange lump? Well, it could be a piercing bump or a keloid. It can be difficult to tell the two apart.

No matter what kind of piercing you have, finding a bump can be a little scary. This is completely normal, especially if you are new to piercing. To help you decide, we’ve explained below what piercing bumps are and what keloids are, as well as what to do about each.

Describe a piercing bump.

First of all, “piercing bump” is not a real medical term. It’s a casual way to talk about what might happen after you get pierced. Still, there are many things that could cause a piercing bump.

Most of the time, a bump happens because the body has been hurt. After all, piercings hurt the skin, which makes the body try to heal itself. Loretta Ciraldo, M.D., FAAD, a board-certified dermatologist, says it’s like when you cut yourself by accident with a kitchen tool. She says that the bump is a kind of short-term swelling, and that it may feel tender and painful when you press on it.

If the skin around the piercing is very red or dark, a bump could mean that the piercing is infected (depending on your skin tone). Ciraldo says that an infected bump might also leak pus or blood and form a yellow or honey-colored crust.

Describe a keloid.

“A keloid is a less common but more bothersome kind of bump,” says Ciraldo. This is a permanent scar that is hard and rubbery. It was caused by an unhealed wound. Unlike a normal scar, a keloid grows past the original site of injury. This means that it will be bigger than the original wound, which in this case is the hole from a piercing. Keloids can also keep getting bigger, so they can get quite big.

To put things in perspective, keloids have three times more collagen1 (a protein that gives the skin its shape) than thick raised scars, which are called hypertrophic scars. They also have 20 times as much collagen as skin tissue that is healthy. At the site of the piercing, the extra collagen builds up, causing a skin growth. Itching, burning, and pain are also possible symptoms of keloid.

If you have dark skin, you might be more likely to get keloids. Ciraldo says that the same is true if you or a member of your family has a history of keloid formation.

How to tell them apart.

If you’re not sure if you have a piercing bump or a keloid, pay attention to three main things: how long it lasts, where it is on your skin, and how far it spreads.

  • Ciraldo says that a piercing bump is a short-term area of swelling. In other words, it won’t stay for a long time. She says that instead, it will get smaller each week and often go away or be hard to see after six weeks. On the other hand, a keloid is a bump that doesn’t go away. The American Academy of Dermatology Association says it could also keep getting bigger over weeks, months, or years. This could happen slowly or quickly.
  • Placement: The spots are in different places on your skin. Ciraldo says that a piercing bump is below the surface of your skin, so it will only show up when the area is touched. A keloid, on the other hand, grows on the top layer of skin, so it will be easy to see and feel.
  • Space: A piercing bump and a keloid are very different in how much space they take up. Most of the time, a piercing bump is only in the hole of the piercing. It might look like a small flesh-colored ball under the earring. On the other hand, a keloid is likely to grow outside of the piercing site, especially as it gets bigger.

How to take care of a painful bump.

If you have a bump from a piercing and there are no signs of infection, you should take the usual steps to care for it. This usually means using saline to clean the piercing and leaving it alone as much as possible. Also, make sure to follow any specific instructions your piercer gave you. The exact steps might be different depending on who does your piercing and where. Ciraldo also says that using scar gel, which you can get at the drugstore without a prescription, might help. The gel, which may have an onion skin or silicone base, can also be used as a preventive measure, like before a bump even forms.

But if the bump hurts or forms a crust, Ciraldo says you should put hydrogen peroxide on the area twice a day. And if it gets worse? The bump could mean that there is an infection. In this case, she says, “talk to a dermatologist,” because you may need antibiotic creams or pills.

How to take care of a scar.

Ciraldo says, “A keloid is a bumpy scar that won’t go away,” the doctor says. The dermatologist you visit should be able to advise you on how to care for the keloid based on its size and location. For instance, your doctor might advise you to apply silicone gel to a small keloid. Steroid injections may be required for some keloids in order to reduce the size of the scar and break down extra collagen. Ciraldo says that this is usually done with a series of injections given every three to four weeks or until the keloid shrinks or goes away. About 50 to 80% of keloids shrink when steroids are injected into them.

When to get help.

After getting any kind of piercing, it’s important to keep an eye on your skin. Ciraldo says that you should see a dermatologist right away if the area changes colour (turns red or darker), swells, hurts, or forms a crust. “If you’ve had a bump for more than six weeks, that hasn’t hurt,” she says. This kind of bump could be a keloid, which is easier to get rid of if you take care of it and treat it right away.

Conclusion

A piercing bump will usually go away after about six weeks, but a keloid will stay there forever. The only exception is a painful bump caused by an infection, which will get worse over time. If you aren’t sure what the bump is, you should see a doctor, especially if it is growing quickly or if it is leaking pus and/or blood. This will make it less likely that the piercing will go wrong or have long-term side effects.

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