Hypertrophic Scars & Ear Piercing Bumps
Prevention and Treatment
Have you ever developed a bump on your piercing and wondered what it could be? Hypertrophic scars (also referred to as friction bumps) can happen to anyone after receiving an ear piercing. Fortunately, they are not permanent and will go away with proper care and treatment.
Understanding Hypertrophic Scars
Although scary sounding, hypertrophic scars are forms of irritation that often develop as a result of friction around a piercing. A small bump develops, and sometimes clear fluid will drain from the site. Sometimes referred to simply as “friction bumps,” they are a small, raised, flesh-colored bump that develops immediately around the site of the entry and/or exit points of a new piercing.
Hypertrophic scars are often confused with keloids. Per the Mayo Clinic (2023), hypertrophic scars stay within the bounds of the original wound and will go away on their own without treatment, whereas keloids are an overgrowth of scar tissue that extends beyond the boundaries of the initial “injury.” Keloids often have a shiny appearance, are firm, and are raised from the surrounding tissue. Keloids can develop years after a piercing and can be itchy. In comparison, hypertrophic scars may also be itchy but are usually only slightly raised and can have a pink-reddish appearance (dermnetz.org, 2023).
Causes of Hypertrophic Scars from Ear Piercing
Hypertrophic scarring is a result of too much collagen production at the wound site (Cleveland Clinic, 2023). Essentially, they are signs that irritation is happening in the area; usually, this is due to friction (for example, an earring back rubbing against the skin), trauma (catching your earring on a pillowcase or clothing, or a small child grabbing and pulling your earring).
Recognizing and Assessing Hypertrophic Scars
It can be difficult to determine whether the bump on your piercing is an infection, hypertrophic scar, or keloid. Per the Mayo Clinic (2023), hypertrophic scars stay within the bounds of the original wound and will go away on their own without treatment, whereas keloids are an overgrowth of scar tissue that extends beyond the boundaries of the initial “injury.” Keloids often have a shiny appearance, are firm, and are raised from the surrounding tissue. Keloids can develop years after a piercing and can be itchy. In comparison, hypertrophic scars may also be itchy but are usually only slightly raised and can have a pink-reddish appearance (dermnetz.org, 2023).
Signs of infection include redness, swelling, yellow-green discharge, or fever. If you suspect that your piercing is infected, always seek medical care from your primary care provider. Early treatment can mean saving your piercing.
When to Seek Professional Help
If you ever have questions about your piercing and aren’t sure what next steps to take, come see our nurses in a studio near you, or write to our nurse helpline anytime!
Prevention Strategies for Hypertrophic Scars
When it comes to preventing hypertrophic scars after an ear piercing, it’s important to recognize that you can do all the right things in caring for your earring and choosing a safe establishment to get pierced and still develop a hypertrophic scar. After all, a piercing is a wound that our bodies are trying very hard to heal. Fortunately, there are a few things you can do to give yourself and your piercing the highest chance of success:
- Go to a studio that specializes in high standards of piercing excellence
- Use only hypoallergenic and nickel-free jewelry
- Follow your aftercare regimen as instructed for your individual piercing
- Do not sleep on the ear with the piercing(s)
- Pro tip: if you’re a side sleeper, try out our piercing pillow - it will allow you to sleep on whatever side you want without disturbing your piercings!
Treatment Options for Hypertrophic Scars
Most hypertrophic scars will go away on their own with no treatment. The first course of action is to continue cleaning your new piercing as instructed and avoid touching, turning, or sleeping on it. You may want to consider changing your earring type depending on your individual ear anatomy and where the friction is developing. For example, if you have a cartilage piercing with a standard stud or flatback in place with a hypertrophic scar developing on the back side of your ear, you may try switching out the earring for an endless hoop. This eliminated the need for an earring back, thus relieving the friction and pressure. If you love the stud over a hoop, check and see what kind of earring back you have. If it’s a traditional butterfly back, you can try switching it to a safety bell back.
In some cases, conservative treatment options can help. Corticosteroids, available as a topical or injectable, may be prescribed by a healthcare provider (UpToDate, 2023). In extreme cases, laser therapy or surgery can be used to take care of hypertrophic scars. This is incredibly rare in the case of ear piercings and is often related to hypertrophic scars in other areas of the body.
Massage is not recommended for treating hypertrophic scars. Evidence suggests that massaging a hypertrophic scar while it’s inflamed will make it worse instead of better (UpToDate, 2023).
Conclusion
Although annoying, hypertrophic scars aren’t permanent or painful. The best course of action is to limit the amount of friction that is causing the scar by either changing the earring back or earring style and to continue to provide the best aftercare for your piercing. If you’re not sure if your symptoms are merely a hypertrophic scar or an infection, it’s best to seek medical attention.
With proper care, a hypertrophic scar will go away on its own over the course of several months, leaving you with a beautiful piercing you will love for life!
Resources:
https://www.mayoclinic.org/diseases-conditions/keloid-scar/symptoms-causes/syc-20520901
https://www.uptodate.com/contents/keloids-and-hypertrophic-scars
https://dermnetnz.org/topics/keloid-and-hypertrophic-scar
