Keloids, irritation bumps, infection, inflammation... What are they? Where do they come from?

When a piercing is healing, complications can arise because it's a wound that will take several months to heal. Many things can happen during those months.

The problem is that when you have a piercing that's slow to heal, you face two things: your friends and family panic, saying things like, "Oh no, could your piercing be infected?" (sometimes you even panic on your own), and then you start searching online to find out what the problem is. And that's when... you find every possible explanation on forums, social media (often super alarming videos), and home remedies like, "It's a keloid, you should use tea tree oil" (please don't do that!).

At the slightest problem, manypeople immediately panic, thinking it's a keloid or an infection. But it's important to know that most of the time, this isn't the case at all, and that the body, in the process of healing, can have (normal) reactions such as swelling, redness, and lymph drainage in the first few days or weeks after piercing.

A piercing can also experience a temporary regression in its healing process. This can happen after a blow, a snag, because you slept on it, or because you're sick.

In this case, it will swell again, producing lymph and collagen to repair the wound that has just been injured and/or compressed. This is when we start to worry, thinking: "I don't understand, everything was fine for 3, 4, or 5 months, and now there's a problem, I must have an infection!"

However…

If you are stressed, tired, or sick (chronic illness, cold, or other virus), this will lengthen the healing time because the immune system is weakened (and it is the immune system that manages the healing of all wounds, including piercings).

So, when there's a complication, a problem with wound healing? What do we do? When should we be concerned?

Let's look below at the main problems that can occur, their causes, and how to resolve them:L

1. Keloids: what they really are, a (rare) dermatological condition:

Let's start by demystifying something important: a keloid is a fairly rare dermatological condition characterized by complicated wound healing, and it can occur on any type of wound. It involves an excessive proliferation of scar tissue, which then forms a raised scar. This means that people prone to keloid scarring are aware of it, because if they get injured, the wound is more likely to heal with a raised appearance. Therefore, it's not simply a reaction to irritation: it's a medical condition.

So no, you're not at risk of developing a keloid by getting your ears pierced!

How to treat it?

Treatment will be carried out by a dermatologist, who will most likely recommend corticosteroid injections, or sometimes removal followed by preventative treatment.

⚠️ Home remedies will not eliminate a keloid.

⚠️ It is not caused by the jewelry or by improper care.

2. Irritation bump: what many mistakenly call a “keloid”:

What is a keloid? It’s a small bump that forms when the piercing is subjected to stress or irritation, such as: jewelry that’s too short or too tight, unsuitable jewelry (a ring for the initial piercing, poor-quality materials, etc.), snagging, or friction (from a helmet, pillow, hat, headphones, etc.). It can also be caused by an incorrect piercing angle (the body piercer didn’t pierce at the right angle).

The most common cause is when the body piercer doesn’t provide aftercare and the jewelry bar remains long for an extended period. It’s normal for the initial healing phase to have a slightly longer bar, as the skin will swell and the jewelry shouldn’t compress it. The bar should be readjusted after 4-6 weeks. At first we always pay attention to it, but over the months, as the area becomes less and less sensitive, we end up sleeping on it, and that's when the jewelry will deviate from its initial position.

Typical appearance: A soft, pink, red, or translucent bump. Sometimes slightly moist, with a clear fluid (lymph). Occasionally it may bleed and be painful, but most of the time it's not particularly painful, just visually unappealing. Irritation bumps may come and go, depending on whether the piercing is being used/irritated or not.

Key characteristics: Non-dangerous. Reversible. Disappears once the cause of irritation is addressed. For my clients: I always advise you to contact me if you have any problems or questions. This will allow me to monitor the healing process and adjust accordingly (the jewelry, aftercare, etc.).

How to treat it? As you've probably guessed, it will depend on the cause of the irritation!

Let's look at a few examples:

• If the area is swollen, a longer piece of jewelry should be used. Conversely, if the bar is too long and keeps catching, causing it to shift, it will need to be adjusted to a shorter length as soon as possible.

• If the problem stems from a ring that was either inserted at the time of piercing or inserted too soon, it will need to be removed and a straight bar inserted. However, there's no guarantee this will work, as if the ring was inserted at the time of piercing, it may have caused damage, and inserting a straight bar will be ineffective.

  In this specific case (a ring inserted at the time of piercing), I often recommend removing the jewelry, allowing the wound to heal and close, and then having the piercing redone by a truly professional and competent piercer.

• If the jewelry has migrated or shifted out of position, the only solution is often to remove it and have the piercing redone with proper aftercare a few weeks or months later. That is why it is necessary to have follow-up appointments, to have the length of the jewelry bar readjusted, and not to sleep on the pierced area during the healing period.

But each case is different, and for people who ask me for a check-up of a piercing done in another salon, a complete analysis must be done: when was it pierced? What piercing method? What type of jewelry? What care? What lifestyle habits? etc.

3. Infection, inflammation, compression? That's something else entirely.

During post-piercing check-ups (about 4 to 6 weeks after the piercing appointment), I sometimes hear things like, "I had a small infection, but it cleared up on its own in a few days." Well, no, that's not possible... An infection never goes away on its own!

Furthermore, as mentioned above and as I discuss in the article explaining the piercing healing process (article coming soon), there's a period of swelling with lymph drainage that will last several days, and that's normal. Once the swelling has subsided, your body will continue to secrete lymph to further the healing process, so don't worry: it's normal!

Did you really expect me to make a hole in your body and for it to have no reaction and for your body to create a nice clean hole in a few hours?! Unfortunately not, it will take many months to achieve that result.

So what exactly is an infection? What are the warning signs?

In over ten years of experience, I've only seen three or four real infections: that gives you an idea of ​​how rare they are (and even rarer if you get pierced at an excellent studio that exceeds the hygiene and jewelry quality standards mandated by the government). It's similar to true keloids; I've probably seen fewer than ten in over ten years.

An infection is a proliferation of pathogenic bacteria in the piercing channel or surrounding tissue. It's not just normal inflammation or irritation. For it to truly be considered an infection, bacteria must invade the area and trigger a strong immune response.

Most of the situations clients mistake for an infection are actually:

• irritation

• a bump

• normal swelling

• lymph (not pus)

• inflammation due to jewelry that is too short/excessive swelling

What are the signs of a real infection?

To suspect an infection, at least two or three of these symptoms must be present simultaneously:

• Very bright redness that spreads around the piercing (not just at the opening of the piercing channel)

• Significant heat to the touch

• Constant pain, even without touching the area; it may throbbe

• Swelling

• Thick, opaque, yellow/green, foul-smelling discharge

• Shiny, tight skin

  
  

In addition to these, more serious general signs may occur:

• Fever

• Chills

• Unusual fatigue

• Swollen lymph nodes around the area

A single isolated sign (e.g., a little redness or lymph) is never enough to indicate an infection. Note: sometimes compression can cause two or three of these symptoms, so it's important to contact your body piercer immediately for a quick assessment of what's happening and to take appropriate action. In the case of a true infection, you should consult a doctor.

How to treat a true infection?

Above all: DO NOT remove the jewelry. Removing the jewelry can trap the infection under the skin and cause it to develop into an abscess. The jewelry acts like a drain, allowing the infected fluid to escape. If the opening closes with pus inside, it is an emergency.

Consult a doctor if symptoms last more than 24–48 hours, and/or if there is fever, worsening swelling, abundant pus, or severe pain. The doctor may prescribe oral antibiotics (for deep infections) and/or an antibiotic cream (for superficial infections).

Can an infection heal on its own?

A minor, superficial infection, yes, sometimes. The body can fight it off if: it's detected early, the area is no longer irritated, the jewelry isn't too tight, and the person has a strong immune system. In this case, with proper hygiene and adjusting the jewelry, improvement is usually seen within 48–72 hours.

But a deep infection, NO. It requires medical treatment; otherwise, it will spread, an abscess may form, it may leave a scar, and it may necessitate the permanent removal of the jewelry.

Don't confuse compression with infection:

Compression occurs when the jewelry squeezes and compresses the skin.

Here is my ear with an helix that was pierced 5months ago. I did the check up and placed a shorter bar, and after 4months, I started sleeping on this ear because I felt it was ok. Each morning, my body was warning me that it was too early to sleep on it : redness, a bit swolen and sensitive, but it was ok after 2 or 3 hours... So I kept sleeping on it for around two weeks and then... My body had enough and this happened !

Nothing serious, I placed a longuer bar and it took around two weeks to return completely to normal. Now this piercing is around two year and is completely ok.

Why can this happen? If you swell more than expected after getting your piercing, the bar might be too short, causing it to tighten and compress the skin. It's a bit like wearing a ring and your finger swelling; you know you need to remove the ring quickly because it's compressing your finger and the swelling is getting worse. It's the same with a piercing, except that if you remove your jewelry, the newly pierced channel will close. Therefore, you need to use a longer bar so that your piercing stays open and the jewelry stops compressing your skin, allowing it room to swell.

This is a situation that can occur several months after getting pierced. A cartilage piercing, for example, will take a year, sometimes longer, to heal completely. During this long healing period, the piercing can swell again due to an impact, irritation, sleeping on it, a period of high stress, or a weakened immune system.

There are many reasons why your piercing might swell after several months (several years: less common, but it can happen). Furthermore, if you followed your aftercare instructions properly, you should have had a shorter bar fitted to your piercing (once the swelling phase was over), so naturally, if it swells, it will compress more quickly.

Is compression serious? What are the signs?

No, it's not serious! Piercing healing isn't linear; there can be ups and downs, periods when everything is fine, and periods when it's not so good. Compression is simply the body going through a down phase and swelling. The jewelry is tight, it hurts, it can throbb because there's constant pressure on the skin, and naturally, it's red, swollen, and painful even without being touched. The jewelry can sometimes dig into the skin if the swelling is severe.

Don't panic: contact me quickly, I'll see you as soon as possible to fix the problem! Rest assured: it happens from time to time, it's not an infection. After inserting the longer bar, you'll feel instantly relieved, and we'll see each other again for a quick check-up and to put the shorter bar back in after 10 to 15 days.

What is inflammation?

Inflammation is the body's normal response when it heals or protects itself. It's a physiological phenomenon, expected and even necessary after a piercing. Inflammation isn't serious, and it's not an infection. The body sends cells to repair the area, so it reacts. It's completely normal!

The 4 normal signs of inflammation (even for months). These signs are classic, especially on cartilage:

• Mild to moderate redness

• Sensitivity or slight discomfort

• Local warmth

• Mild to moderate swelling

Inflammation is NORMAL when: the piercing is recent, while the cartilage is healing (up to 12 months), if you've slept on it, if there's been slight pressure/friction, if you're wearing jewelry that's a little too short but not yet problematic, if you touch the jewelry too much, if there's a change in climate (cold/hot), stress, fatigue…

Inflammation fluctuates. It's normal for it to be more sensitive some days than others.

Inflammation becomes ABNORMAL if: it increases gradually for no reason, it's accompanied by a thick yellow/green discharge, the skin becomes very red over a larger area, the pain becomes throbbing and intense, or there's a fever or general malaise. This indicates a potential infection.

How to manage normal inflammation? These are the basic aftercare steps I'll explain! Simply clean it with saline solution once a day and dry it gently. Avoid irritants: don't rotate the jewelry, no antiseptics or disinfectants/oils/creams, etc., don't sleep on it, and avoid tight headphones/earbuds/hats. Also, make sure the jewelry isn't too short: a compressed piercing → persistent inflammation → possibly infection.

Conclusion:

The vast majority of small bumps or reactions around a piercing are normal, benign, and reversible irritation or inflammation.

Keloids and infections do exist, but they are rare and quite specific.

Actual infections are very rare, especially if your piercing was done in a good studio and you receive proper aftercare.

Understanding these differences helps avoid panic, improper techniques, and inappropriate treatments. A smooth healing process rests on three simple pillars: a quality piercing, suitable jewelry, and good care and patience.

If in doubt, contact a professional body piercer. While waiting for a response or treatment, don't attempt anything rash at home in a panic. Proper aftercare is always better than bad advice found online (and believe me, there's plenty of it!).

I hope this article has helped you better understand the different issues you might encounter during the healing period of your piercing, and has also helped you put things into perspective and worry less.

Don't hesitate to contact me if you have any questions.

See you soon for another article!

See you soon,

Sélina.