Small bumps commonly form near a new piercing site. These raised areas are the body’s natural response to the trauma created by the jewelry as the skin attempts to heal the wound. When a lump is firm, discolored, and persists beyond the initial healing period, people often worry if the bump is a true keloid and if it will disappear without professional intervention.
Understanding Piercing Bumps: Keloid vs. Hypertrophic Scar
A hypertrophic scar is often confused with a true keloid. A hypertrophic scar is a small, pink or reddish lump that forms relatively soon after the piercing, typically within a few weeks. This type of scar is characterized by an overproduction of collagen that remains confined strictly to the original area of the injury, such as the immediate piercing site. A true keloid, by contrast, is a more aggressive form of scar tissue resulting from a dysfunctional healing process where cells called fibroblasts continue to produce excessive collagen long after the wound has closed. Keloids often appear three to twelve months after the initial piercing and are distinguished by their ability to grow beyond the boundaries of the original piercing site. They tend to be firm, rubbery, and may take on a darker color, such as purplish-red, compared to the surrounding skin.
The Likelihood of Natural Resolution
Hypertrophic scars often shrink, flatten, or fade over time, particularly when the source of irritation is removed and proper aftercare is maintained. The body’s healing mechanism for a hypertrophic scar eventually recognizes the overgrowth and starts to remodel the tissue, leading to improvement. The answer to whether a true keloid will go away on its own is generally no. Keloids represent a sustained, benign tumor of scar tissue that will not be simply reabsorbed by the body and may even continue to grow progressively larger over time without medical treatment. Without professional intervention, the scar tissue remains permanently raised and discolored, although it may soften slightly over many years.
Medical Interventions for Keloid Reduction and Removal
The standard of care involves established medical treatments to reduce the size and appearance of keloids.
Corticosteroid Injections
A common first-line approach is intralesional corticosteroid injections, where anti-inflammatory medication is injected directly into the scar tissue. These injections help to break down the connections between collagen molecules and are typically administered every four to six weeks over several sessions to shrink and soften the keloid.
Non-Surgical Options
Other effective procedures are often used in combination with corticosteroid injections to maximize results and prevent recurrence. Cryotherapy involves freezing the keloid tissue with liquid nitrogen to destroy the excess scar cells, a method most effective for smaller keloids. Laser therapy, particularly using pulsed dye lasers, is another non-surgical option that can help to flatten the keloid and reduce its characteristic discoloration.
Surgical Excision
Surgical excision is sometimes necessary for very large or mature keloids, but this approach carries a high risk of recurrence because the surgery itself creates a new wound that can trigger keloid formation again. For this reason, surgery is almost always combined with other therapies, such as post-operative corticosteroid injections, pressure therapy, or low-dose radiation, to significantly reduce the chance of the keloid returning. These complex treatments require consultation with a dermatologist or a plastic surgeon specializing in scar management.