Keloids are raised skin growths that can form after skin trauma, such as a piercing. Understanding their characteristics and how they differ from other common piercing-related issues is important for addressing them.
Understanding Piercing-Related Bumps
A keloid is a type of raised scar that forms when the body produces excessive collagen during healing after a skin injury. Unlike a typical scar, a keloid extends beyond the original wound, sometimes growing larger than the initial piercing site. They can be firm, shiny, and range in color from light pink to dark brown, often becoming darker over time. These growths can also cause symptoms such as itching, tenderness, or pain.
It is important to distinguish keloids from other common piercing bumps, such as hypertrophic scars and irritation bumps. Hypertrophic scars are also raised but remain confined to the original injury area and appear sooner after a piercing. Unlike keloids, hypertrophic scars may flatten over time. Irritation bumps are usually temporary, resolving with proper aftercare, and do not cause lasting damage once the piercing heals.
The Persistence of Keloids
True keloids generally do not resolve on their own without intervention. They tend to persist and can even continue to grow larger if left untreated, a process that can take months or years.
The persistent overgrowth of keloids occurs because scar tissue continues to actively develop long after the initial wound has closed. Without targeted medical treatments, keloids are unlikely to fade or disappear.
Treatment Approaches for Keloids
Various professional medical treatments are available for managing keloids, and often, a combination of therapies yields the most effective results.
One common approach involves corticosteroid injections. These are injected directly into the keloid to help reduce its size, soften the tissue, and alleviate symptoms like itching or discomfort. Injections are usually administered every few weeks over several sessions, with concentrations varying depending on the keloid’s size and location.
Cryotherapy, which involves freezing the keloid tissue with liquid nitrogen, works by destroying excess scar cells and reducing the keloid’s volume. This method is effective for smaller keloids and is often combined with corticosteroid injections for enhanced outcomes. After cryotherapy, the treated area may swell and form a blister, gradually subsiding over several days.
Laser therapy uses high-energy light to break down scar tissue, which can help reduce the keloid’s thickness and size, while also improving its texture and appearance. Pulsed dye lasers (PDL) are frequently used, sometimes in combination with corticosteroid injections. Multiple sessions are often required, and side effects like changes in skin pigmentation can occur, particularly in individuals with darker skin tones.
Surgical removal is an option for larger or persistent keloids that have not responded to other treatments. However, surgery alone carries a high recurrence rate, so it is typically followed by other therapies like corticosteroid injections, radiation therapy, or silicone products to prevent regrowth.
Silicone sheets or gels are non-invasive treatments applied to the keloid to help flatten and soften the scar by providing continuous pressure and hydration. These products are often recommended for consistent use over several months. Pressure earrings or dressings, which apply continuous pressure, are also used, particularly after surgical removal of ear keloids, to prevent recurrence.
Preventing Keloid Formation
Preventing keloid formation is important for individuals prone to them or considering new piercings. Choosing an experienced and reputable piercer is a primary step, as proper technique and sterile conditions minimize trauma and infection risk. Selecting appropriate piercing locations, avoiding areas with high skin tension or frequent movement, can also reduce the likelihood of keloid development.
Using high-quality, hypoallergenic jewelry made from materials like surgical stainless steel, titanium, or niobium can reduce irritation and allergic reactions, which contribute to keloid formation. Strict adherence to aftercare instructions provided by the piercer is also essential, including regular cleaning, avoiding unnecessary touching, and protecting the new piercing from trauma.
Individuals with a personal or family history of keloids should inform their piercer or medical professional before getting a new piercing. They may be advised to avoid piercings or take extra precautions, like wearing pressure earrings or using silicone products immediately after. Prompt attention to any signs of thickening skin around a new piercing, such as immediately removing jewelry and consulting a medical professional, can help prevent a full keloid.