Piercing Bump vs. Keloid: The Difference & How to Treat Each

Regardless of the type of piercing, finding a bump can be a bit concerning. This is totally understandable, especially if you're a piercing newbie. To help you out, we've outlined the differences between piercing bumps vs. keloids, plus what to do for each, below. 

In some cases, a bump might mean that the piercing is infected, especially if the surrounding skin is very red or dark (depending on your skin tone). An infected bump might also release pus or blood and develop a yellow/honey-colored crust, notes Ciraldo.  

You may be more likely to develop keloids if you have a darker skin tone. The same goes if you have a personal or family history of keloid formation, according to Ciraldo.

If you're not sure whether you have a piercing bump or keloid, take note of three main factors: how long it lasts, where it is in the skin, and how far it spreads.

However, if the bump hurts or develops a crust, you'll want to apply hydrogen peroxide twice a day to the area, says Ciraldo. And if it gets worse? The bump might indicate an infection. In this case, "consult a dermatologist, [as] you may need prescription topical or oral antibiotics," she notes.

To recap, "if you have a persistent bumpy scar, [it's] a keloid," says Ciraldo. This warrants a visit to the dermatologist, who will provide care instructions based on the keloid's size and location. For example, if you have a small keloid, your doctor might recommend applying a topical silicone gel. Other keloids might need steroid injections, which shrink the scar by breaking down excess collagen. Typically, according to Ciraldo, this "will be done in a series of injections spaced three to four weeks apart" or until the keloid shrinks or disappears. About 50 to 80% of keloids get smaller after being injected with steroids. 

A large keloid might need to be removed via surgery, according to NYU Langone Health. However, surgically removed keloids almost always come back, so this option is usually used with other treatments like steroid injections or a special dressing that places pressure on the keloid. (Pressure decreases blood flow in the area, thus preventing the keloid from redeveloping.) On that note, if the keloid is on an earlobe piercing, your dermatologist might suggest wearing a pressure earring to keep it at bay.

After getting a piercing of any kind, it's a good idea to monitor your skin. You should see a dermatologist ASAP if the area develops discoloration (red or darkened skin), swelling, pain, and/or crusting, according to Ciraldo. The same goes "if you have a painless bump that has lasted more than six weeks," she adds. Such a bump might be a keloid, which is easier to control with early care and treatment.

In general, a piercing bump will go away after about six weeks, while a keloid is permanent. The exception is a piercing bump caused by an infection, which will get worse over time. When in doubt, visit a doctor, especially if the bump is growing quickly or releasing pus and/or blood. This will help minimize the risk of piercing complications, as well as long-term side effects.