It’s officially been a week since you revealed your new nose piercing on Instagram. And seven days later, you’re still riding on the high — especially since your phone is still buzzing, signaling new likes and comments. You can’t help but take another peek in the mirror to admire how cute the delicate stud looks in your right nostril. And then, almost instantly, you see something that wasn’t there before: a bump.
What is it? Most likely, it’s one of two things: a keloid or a hypertrophic scar. But before you make like Dr. Pimple Popper and squeeze the fleshy bump into oblivion, know that with the help of a medical professional, patience, and a gentle aftercare routine, you can get rid of it. We asked New York dermatologists Ellen Marmur, MD, and Rachel Nazarian, MD, exactly what these bumps are and how to get rid of them. Their answers, ahead.
What is a keloid, exactly?
“A keloid is an area of irregular fibrous tissue formed at the site of a scar or injury,” explains Dr. Marmur. Pimple-like in appearance, they are made up of overgrown scar tissue that looks like an intensely inflamed bump on the surface of the skin.
Photographed by Beth Sacca.
What causes a keloid to form?
“Keloids form where a trauma has injured the skin,” Dr. Marmur explains. Trauma could be caused by surgery, blisters, vaccination, acne, or body piercings. In the case of the latter, your body produces collagen to repair the new hole. Unfortunately, it can sometimes produce too much, resulting in a raised scar, like a keloid. Marmur explains that anything from a poor aftercare routine to amateur piercing method to constant irritation near the the piercing site can trigger your body to go into collagen overdrive.
I diligently followed my piercer’s aftercare routine, but I still got this bump. Why?
Sometimes, your immune system just doesn’t love your piercing as much as you do. From the second that needle punctures your skin, your body works to heal the wound, and in some cases, push it out. This is called a rejected piercing. The area around the hole might get inflamed as the hole slowly closes in on itself, shoving the jewelry out, in which case, a keloid may form.
Although there isn’t a lot of evidence to support this claim, Dr. Marmur confirms that if your parents are prone to keloids, then it’s a possibility you’re more likely to get them, too.
How can I tell the difference between a keloid and a hypertrophic scar?
People often get the two confused because both bumps are solid masses of excess scar tissue that form during a piercing’s healing process, explains Dr. Nazarian. Both are thick and firm in texture, typically red or purplish in color, and can appear within the first few weeks or a whole year after a new piercing. However, you can spot the difference by the bump’s size: While the size of a hypertrophic scar is limited to the size of the wound it accompanies, keloids possess a larger growth potential and have the ability to extend the surface area it covers if gone undiagnosed and untreated by a doctor.
Photographed by Beth Sacca.
Should I pop my keloid?
Please, don’t. Unlike a pimple, there’s nothing to effectively pop out of the bump. In fact, the likelihood of infection grows if you cause yet another wound near the new piercing. Luckily, Dr. Marmur suggests several removal methods for keloids, including non-invasive surgery to remove the scar. Unfortunately, even with surgery, there’s a possibility the keloid will grow back. In that case, Dr. Marmur advises treating the bump with low-dose, steroid injections to shrink the overproduction of collagen in the area. Lastly, some people opt for DIY, at-home remedies, like applying honey or vinegar to the keloid with the hope that they will chemically exfoliate the bump away. Keep in mind, they aren’t nearly as effective as surgery or injections.
How can I remove my hypertrophic scar?
These scars respond the best to steroid injections, which diminish the scar in size, says Dr. Nazarian. Afterwards, people sometimes turn to laser treatments to remove long-term evidence of the scar.
Can a keloid or hypertrophic scar cause an infection?
No, says Dr. Nazarian. “In general, any scar tissue is fully healed and not a catalyst for future infection.”
Is it normal for my piercing to produce pus?
White or clear discharge — lymph fluid — is totally normal during a piercing’s healing process. Seek medical help only if it’s yellow or green in appearance: This is likely an infection and needs to be evaluated.
Photographed by Beth Sacca.
My bump hurts! Should I remove my piercing?
First things first: Occasional pain or discomfort is normal for keloids and hypertrophic scars, especially if they’ve formed in an area where there is a lot of movement, says Dr. Nazarian. While some dermatologists recommend you take out the jewelry immediately, Brian Keith Thompson, L.A. celebrity piercer, warns that if you remove the jewelry before the hole heals, then it will most likely close up. Unless the irritation is due to an allergic reaction or infection, your piercer will advise you to keep the jewelry in while maintaining a diligent aftercare routine. Meanwhile, seek medical attention to remove the scar ASAP.
What happens if I don’t get my scar removed?
While neither keloids or hypertrophic scars pose immediate health concerns, they can be relatively uncomfortable. Even worse, the overgrown scars can restrict your range of motion if they form on an area where movement is required, explains Dr. Nazarian. Ultimately, the decision is up to you.
Although we know what a keloid is (and how it’s different from a hypertrophic scar), it’s difficult to fully understand why they form, says Dr. Nazarian. With that in mind, it’s even more difficult to know why the body targets one piercing over another. “The body just misunderstands the signals of injury and continues to create more scar tissue than is needed,” she explains. “Why and where these signals derive from is not fully known.”
What if my bump is neither a keloid or hypertrophic scar?
If the bump is small, red, and bleeds easily, it’s most likely a granuloma. “[It’s] a collection of blood vessels and another overgrowth of tissue that your body just creates,” explains Dr. Nazarian. The most popular removal methods are to leave it alone and hope it goes down by itself, or visit a dermatologist who can remove it during your next office visit.
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