The Piercer's Corner - Keloid vs. Hypertrophic Scar and the Localized Piercing Pimple

Keloid vs. Hypertrophic Scar and the Localized Piercing Pimple

So many of you come in for me to take at look at your piercing to see if the bump that is forming is part of an infection, a keloid or something else.  Well let me take a few minutes of your time and give you the breakdown on these types of “piercing pimples” so you can see what may be going on with your piercing if you are experiencing this.  So much information was given to me at Association of Professional Piercers convention this past June. It was my second convention that I have attended and I’m so excited to give you more ways to combat these pesky bumps.

Localized Piercing Pimple:
Sometimes a pustule (a small round area of inflamed skin filled with pus) will appear under the skin near the opening of a piercing. It may be brought on if you recently snagged your piercing or developed a mild infection but remains contained. It’s a small pocket that forms on the surface and fills up over and over and drains. Sometimes you will think it is gone, then poof! it reappears and the cycle begins weeks or even months later. There are things you can do to help your body break down and absorb the pocket that has formed. Please resist the urge to pop or drain the pocket!! Using soaks and compresses will encourage drainage. If you have one that wont open or drain, go see your doctor.

What to look for:

  • Small, slightly elevated pus-filled bump or pimple adjacent to the piercing
  • Red and inflamed, but contained locally
  • May be tender, itch, or burn, though some are painless
  • Usually secretes pus and/or blood when drained (or popped)

What to Do

  • Over-the-counter antihistamines taken according to package instructions can diminish itching and inflammation.
  • Do plenty of warm saline soaks or hot compresses. Continue them for two weeks after the problem seems to have been resolved.
  • Light massage of the area may help break up the pocket and prevent it from refilling.
  • If you do not respond to treatment, lab analysis for an invading microorganism may be needed to determine if the cause is fungal or bacterial so your doctor can prescribe appropriate medication to target the problem.
  • You must see a doctor if you have increased pain, a fever over 100 ̊F (37.8 ̊C), or the infection obviously worsens or spreads.

A keloid is a very large, dense mound of scar tissue that becomes significantly bigger than your original wound. They can be extremely unsightly, and some grow to shocking dimensions. Unfortunately, once you have formed a keloid, you can seldom fully recover from it and will always have some amount of scar tissue.

Hypertrophic scar:
A hypertrophic scar is a lumpy scar that sits above the surface of the skin. This is the smaller and far more common growth that forms around a piercing. They are not as big or severe as keloids, respond better to treatment, and are more easily resolved. Hypertrophic scarring sometimes goes away spontaneously, or it may recur and recede in cycles for an extended period of time before improving substantially or disappearing.

What to look for:

  • Raised fleshy bump surrounding a piercing that stays within the bounds of the injury
  • Usually somewhat pink or red in color, at least initially
  • Not tender; may itch
  • Tends to form during the healing period
  • No pus or other drainage

What to Do
Try these ONE at a time:

  •  If your piercing is on your helix (ear cartilage) or other area where a disc might sit flush against the scar tissue, check out the silicone disc we sell from NoPull Piercing Disc.
  • A simple and inexpensive form of compression therapy (continuous mechanical pressure on a scar to flatten it) using Micropore breathable paper tape. It comes in “flesh tone,” which will not be visible on certain shades of skin. This is best used on healed piercings.
    • Use scissors to cut a piece of paper tape that will fully cover the entire bump plus a millimeter or so of unaffected tissue. Use a clean hole punch to create a tiny dressing for the smallest of bumps.
    • Cut a slit to the center of the bandage so you can place it around your ring or bar; you should be able to completely seal the piercing without covering the jewelry, as a Band-Aid would.
    • Wear the tape continuously and change it when necessary. It can be left on during normal bathing.
    • Discontinue if you do not see improvement in two to three months.
  • Frequent mild saline soaks plus topical application of alcohol, 3 percent hydrogen peroxide, or Campho-Phenique twice daily for two to three weeks. If you don’t see any improvement, try one of the other options. (The phenol in Campho-Phenique is a caustic substance that destroys tissue, so use it carefully.)
  • Over-the-counter alpha hydroxy acid (AHA) cream used according to package instructions. This exfoliates skin and may diminish scar tissue over time. Useonly over-the-counter strength (containing less than 10 percent AHAs). This concentration promotes exfoliation but  is not potent enough to generate collagen production, which can increase the size of your hypertrophic scar. This product can cause sun sensitivity.
  • Daily massage with emu oil or other nonirritating oil or lotion to soften the tissue can be added to the following methods:
    • Topical treatment with an over-the-counter corticosteroid cream according to the package instructions.
    • Topical application of a chamomile tea bag compress for fifteen minutes, three times a day, for two weeks.
  • Some piercees find laser or other medical treatments are effective for hypertrophic scars. See a dermatologist for other treatment options.

Well I hope this helps answer some of your questions and as always, you can come by the shop, call or email me with any questions or concerns.