Piercing Bump vs. Keloid: What Are the Differences?

Piercing bumps and keloids are types of scar tissue that can develop after a skin injury. They appear similar, but there are key differences in why these two scar types form, how they feel, what they look like, and how they are treated.

In this article, you will learn how to tell a keloid from a piercing bump and how to prevent or treat these reactions.

Symptoms

Piercing bumps and keloids form as a result of injury or trauma to the skin and often look similar. However, there are some key differences in the appearance and other sensations you might have with a piercing bump compared to a keloid.

Piercing Bump Symptoms

Piercing bumps are also called hypertrophic scars. These scars are a thin film of tissue that develops over the injured area, often a hole from a piercing or other small wound. These scars usually form in a fine, raised, symmetrical pattern over the wounded area.

Piercing bumps start as red or pink raised areas in the first month or two after injury but can flatten and lighten in color as time goes on. The scar tissue that forms over a skin piercing or in other areas of hypertrophic scarring is usually limited to the original injured area and does not spread. You may, however, notice itching, pain, or scabbing over areas of hypertrophic scarring.

Keloid Symptoms

Keloids are another type of scar tissue but are notably larger and shaped differently than a piercing bump. A keloid is an abnormal overgrowth of scar tissue that can form months after a skin injury.

Unlike a hypertrophic scar, keloids can be large irregularly shaped, raised scars that form beyond the boundaries of the original injury. They may also change in color and shape over time. The exact size, shape, and texture of a keloid vary.

You may develop itching, tenderness, or irritation where a keloid forms. In severe cases where large keloids form, it’s possible for them to restrict your normal movement.

Causes

Scars occur when clusters of cells come together to repair damaged skin. When scars form, new cells blend together to create a patch, which can take on a different pattern than healthy areas of skin.

The type of injury and the way the scar forms are two things that differentiate piercing bumps and keloids.

Causes of Piercing Bumps

A raised, sometimes discolored appearance characterizes a piercing bump or hypertrophic scar. These scars can develop after any skin trauma but are common after piercings or surgical incisions. They are a normal bodily reaction to injury, causing inflammation and repairing tissue.

Causes of Keloids

A keloid is a less typical response that can develop when your body overcompensates in the healing process. Anything that can produce a scar can cause a keloid, including a piercing. However, keloids typically run in families, and you aren’t likely to develop this type of scar if you aren’t prone to keloids. In people with keloid-prone skin, these scars can appear after injuries like:

  • Piercings
  • Acne
  • Chickenpox
  • Burns
  • Cuts
  • Scrapes
  • Bug bites
  • Puncture wounds
  • Inflammatory skin conditions
  • Tattoos
  • Surgical wounds

Who Gets Keloids?

Keloids can run in families, but certain factors can increase your risk of developing these scars. They are most common in people:5

  • With darker skin tones
  • Of Black, Asian, or Latinx populations
  • Between the ages of 10 and 30
  • Who are pregnant

Diagnosis

While you might feel confident guessing what kind of scar you have, an official diagnosis should come from a healthcare provider, such as a dermatologist. Scars are complicated tissue formations, and it’s important that a scar isn’t mistaken for another skin condition.

A healthcare provider will make a diagnosis after a physical examination of the scar and questions about your individual and family health history. In rare cases, a biopsy (removing a sample of skin for analysis in a lab) is performed to rule out other causes.

Treatment

Treatment for piercing bumps and keloids is another key difference between these two types of scars.

Treating Piercing Bumps

Piercing or hypertrophic scars typically fade over time. Other treatments to reduce or lighten the appearance of these scars can include things like:1

  • Radiation
  • Laser therapy
  • Corticosteroids
  • Topical gels or treatments

Surgery is a last-resort consideration, since it can worsen hypertrophic scars.

Treating Keloids

Keloid scars are usually more challenging to treat and require more aggressive treatment. Depending on the severity of the keloid, a provider may prescribe more than one medication or therapy.

Treatments can include those used to treat piercing bumps, but surgical removal usually comes with the warning that keloids may reappear in the same area after surgery. In some cases, if keloids return after surgical removal, they can become even more prominent.63

Prevention

There’s no way to prevent scarring completely, but good skin care habits can help. Using sunscreen and covering keloids can prevent additional changes that make them appear larger or more prominent over time. You may also want to consider the risks and benefits of nonmedical surgical procedures, piercings, or other things that could lead to scar formation if you are prone to keloids.

Summary

Piercing bumps and keloids are scars that can develop in response to a skin injury. Piercing bumps may blend with your natural skin tone, shrink, or even disappear in time without any treatment at all. Keloids can develop from any scar, including a piercing wound, and become darker over time. Talk to a healthcare provider about prevention and treatments to help reduce the appearance of scar tissue.

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